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Got (Non-Dairy) Milk?

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As we are in the process of saying good-bye to Neocate, one must ask the next logical question: “Now what?”

My son is a creature of habit.  I have always worked hard to provide him with a predictable routine that I think he really appreciates.  Even before he could walk, when Dinosaur Train ended he would crawl over the stairs and start making his way to bed.  Although even E eventually got tired of rewatching the same episodes of Dinosaur Train over and over and over and over, he is still very much enamored of his three “cups” a day.  So, what should we put in those cups?

A couple of months ago E’s dietician told me that when children have to avoid dairy she typically recommends soy, followed by oat or hemp milk.  She said those are the “milks” that are most like dairy milk.  She was specifically referring to amount of fat and protein, which support growth and brain development and are the most important components of milk for one to two-year-olds.  Unfortunately we didn’t get around to trying hemp milk until last month, which wasn’t a big deal because E was still getting everything that he needed from the Neocate.  But I was curious about whether hemp milk would still be best now that E is over two years old, an age when pediatricians recommend switching to 1% or nonfat milk anyway.

I found surprisingly very little about which type of “milk” is the best substitute for dairy milk in toddlers. I actually couldn’t find anything in the medical literature! (Admittedly I am not a nutritionist or dietician and may have been looking in the wrong places, so if you know of any published papers, please share!).  There are several websites and blogs that discuss the merits of various “alterna-milks,” but most are written with the assumption that an adult will be using them.   There were two sites that seemed to give good information about milk alternatives for children (KC Kids Doc and Amazing and Atopic ) and I encourage you to read what they have to say.

For my own edification I wanted to compare all of E’s “milk” options side by side (have I mentioned that I tend to over-research?).  And because this question comes up all the time among parents of children with milk allergies, I even included the “milks” that aren’t safe for E right now.  I’ll admit that this is a quick survey of some of the most common “milks” on the market.  I just chose one brand for each type, so it is possible that the nutrition information can change from brand to brand.  It is also important to always check the ingredients.  For example, the Tempt Unsweetened Original Hemp Milk is the only rice-free version of hemp milk that can find!

The chart below includes the basic nutrition information for each of the major types of non-dairy milk, as well as whole and 1% cow’s milk, to give you some perspective.  All of the information is based on a serving size of 8 fluid ounces.  The daily recommended values (DVR) are the ones provided by the manufacturers, so remember that they are based on the recommendations for adults.

Non-Dairy “Milk” Comparisons

Click on the picture to open a more readable .pdf

milk chart

Most people think of calcium as milk’s most critical component. The companies that make “alterna-milks” are well-aware of this and are happy meet that requirement.  It seems that all types of “milk” are fortified to ensure that they have at least as much calcium as cow’s milk, often more.   So, I don’t think it makes sense to base my decision on calcium content alone and looked closer at the rest of the nutrition information, like ingredients, calories, sugar, sodium, fat, and protein, as well as the nutritional “perks” provided by some of the “milks.”

The plant-based “milks,” tend to have fewer calories than whole cow’s milk. However, the alterna-milks require more ingredients to achieve a cow’s milk-like taste. This often includes sugar or another sweetener (like brown rice syrup). So, watch out for sugar (rice milk and oat milk have way more sugar than others). The plant-based milks also require some sort of thickener, like carrageenan or xantham gum. I’ve heard of these additives causing reactions in some FPIES kids so make sure you keep that in mind if you fail a milk trial (i.e., it might be the carrageenan not the almonds that are the allergen). Carrageenan is pretty controversial but that is beyond the scope of this post. As far as I’m concerned, there isn’t enough evidence that food-grade carrageenan is harmful and it’s so pervasive in alterna-milks that trying to avoid it isn’t worth the aggravation. We already avoid so many things that we know will hurt E, I’m not interested in adding poorly supported “maybes” to the list.  We’ll just hope that future research doesn’t come back to point out that I’m an awful mother for poisoning my child with carrageenan. Obviously, this is a personal decision so please do your research.

If you are looking for a beverage that has a nutrient makeup similar to milk, soy is the way to go. It has the same amount of protein as cow’s milk.  The calories are similar to 1% milk and it has approximately the same amount of fat as 2% milk (not shown on the table).  All this with less sugar, cholesterol, and sodium.  But soy is controversial too. I’m not well-versed in the GMO and phytoestrogen issues related to soy. E is clearly allergic and so we generally keep it out of the house. Again, do your research, talk to your doctor and/or dietician, and decide for yourself whether the benefits are enough to outweigh any possible risks.

       

While we are on the topic of “milks” that aren’t an option for E right now, let’s look at rice and oat milk. These two have almost as many calories as whole milk with the about the amount of fat as 1% milk.  They have more sugar and significantly less protein (though oat milk’s 4g of protein is pretty high compared to the other options).  They do not boast any additional nutrients, either.  Another no-no for us, coconut milk, has far fewer calories but more fat and less protein.  I’ve gotta say, the stats here do not make me sad that they aren’t options for E right now.

We’ve been drinking almond milk for about a year. It’s been really helpful as a milk substitute in recipes (I’ve used it in everything from cupcakes to mashed potatoes) and I like it in my cereal. It has a mild and slightly nutty flavor and I never notice a difference in recipes but would rather skip a latte than use almond milk (yuck!). We tried it as a way to test a tree nut and get a milk substitute.  I never cared much about the nutrition stats because E was still getting everything he needed from Neocate and almond milk was never meant to provide him with everything he missed out on in cow’s milk.  But now I wondered how it stacked up.  It’s really low in calories and fat. It has no sugar but only 1g of protein and is higher in sodium than the other options.  It does include bunch of vitamins and minerals including 50% of the (adult) daily recommended value of vitamin E. I feel pretty good about using it daily (for E and me) but I don’t think we can rely on it solely and, because of the low protein, I definitely wouldn’t have been comfortable using it in his cups before his second birthday.

We’ve recently added hemp milk to our repertoire. I think it’s creamier than almond milk but also has a stronger flavor. Even the unsweetened original flavor has added vanilla. Vanilla is one of E’s favorite flavors, making hemp milk an automatic winner in his book. As I mentioned before, it was recommended by E’s dietician so I expected it to compare well to the other milks. And it does. It has more calories than almond milk but not as many as cow’s milk. It is the alterna-milk with the most fat, actually the same amount as whole milk!  This is good for the brain development of one-year-olds but I’m not sure that my 95th percentile-for-weight two-year-old needs all that fat. The good news is that it’s supposedly “good fat” and has a lot of omega 3 and omega 6 fatty acids.  It has no sugar and a respectable amount of sodium but just an ok amount of protein (2g).  My favorite thing about the hemp milk is that it’s safe for E and he loves it.  The other stats make me comfortable serving it to him on a daily basis but I’m still happy that he had the protein of the Neocate until age 2.  It’s vanilla flavor makes me hesitant to try it recipes.  I assume it will be ok in sweet recipes but I don’t know how it will hold up in savory ones.  Oh, and it also failed the latte test 😦

           

Out of curiosity I added cashew milk and flax milk to the list.  E passed a cashew trial this summer so I know the milk would be safe for him.  However, that seems to be one of its few positives.  Another one is that it is low in calories, but it is on the high side for fat and has no protein.  Flax milk, on the hand looks like a winner!  It’s low in calories and fat (which might make it a poor choice for the under-two crowd) as well as sugar and sodium.  BUT it has 5g of protein!  That’s higher than any of our other options.  It also contains omega 3 and omega 6 fatty acids.  I haven’t tasted it so I can’t report on that.  However, flax milk really does seem like the best option.

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So, what will be in E’s cups? We decided to let him decide – between almond milk and hemp milk.

These are the two that are safe for him and I feel comfortable with the stats. They each have their pros and cons and I don’t feel like one really wins in the nutrition field.  As far as taste, hemp seems to have E’s favor but almond will be better to have around for recipes.  The hemp milk is sold in smaller containers that are about half the size of the almond milk and the same price, so the almond is easier on the wallet.  They are both available in shelf-stable versions, which is nice for stocking up.  I’m also really excited that the shelf-stable almond milk is sold in 11oz containers.  This will be great when we are on the go!  I like the idea that E gets to choose, I try to allow him autonomy as much as possible and this is one more way that he can feel in control of his diet.  We’ve only been doing this for a couple of days but so far he doesn’t seem to favor one or the other.  I think it really depends on his mood, just like what you drink depends on how you are feeling at the time.

I’m kind of bummed that we tried hemp milk instead of flax milk.  I really think that would be the best version and if E passed it (and the taste was ok) I might consider that as our primary milk.  However, as my husband so eloquently said, “we don’t really need him to have another weird milk right now.”  He’s right.  We have two good “milk” options and other foods to try.  I don’t really see a compelling reason to push another version of milk.  Also, we are just over a month away from E’s cow’s milk challenge (eek!).  If he passes milk and likes it we’d likely just switch over to cow’s milk anyway.  If he doesn’t pass maybe we’ll give the flax a try, but I’m really trying to be optimistic about a pass

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                                        I love seeing this little boy with a (hemp) milk mustache!! 

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So, what are your thoughts? What “alterna-milks” do you use?  Have you tried flax milk?

Remember, this is just my analysis.  I’m not qualified to make recommendations but I hope that sharing this information will help to give you an idea of what’s out there and how we made our decision.  Please talk to your child’s pediatrician, allergist, gastroenterologist, and/or dietician so that you can make the best choice for your child.  Good Luck! And (as always) please share any additional information in the comments section.
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Veggie Bites – A Great Way to Sneak in Some Calcium & Veggies!

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I realize that most of the recipes I have posted are of desserts and sweet treats.  I don’t necessarily hear anyone complaining (who doesn’t love cookies and candy?) but I want to assure you that there is also some healthier cooking taking place at our house.

A couple of months ago I learned that E’s Neocate wasn’t covering his daily recommended dose of calcium so I started to look for creative ways to incorporate more calcium into his diet, which is difficult when you are avoiding all dairy products.  E’s dietician recommended we try salmon and green leafy vegetables, like kale and spinach.   I came across a recipe for spinach bites that sounded great.  Unfortunately they didn’t turn out right for me so I tweaked it a little and made my own version.

I love these Veggie Bites and so does E!  I usually make them with spinach but I have also had success with broccoli and I’m guessing you could use just about anything. Not only are they a good way to sneak some veggies into my little guy, but they were also a good way to transition him to more flavorful food.  I have a tendency to get caught up in pure food trials, during which I try not to add too many variables, like spices.  This was a good opportunity to trial a bunch of spices that were likely going to be passes.   It also contains three chia “eggs,” which helps boost the fiber, calcium, and omega-3.

I won’t lie – they are a little bit time-consuming to make and I always end up with a sink full of dirty dishes, but they are totally worth it.  Besides all the nutritional benefits, they are a great make-ahead dish.  This recipe makes about 12 good-sized servings, so I usually freeze about half of the try.  If you pre-cut them, you can just pull them out of the freezer and defrost/reheat as needed.  I love having them on hand for use as a side dish whenever I need them. I think they would also work well as a quick, healthy snack.

I usually just cut them into square or strips to serve but I’ve been wanting to try to make them a little more fun, so today I pulled out the cookie cutters.  I recommend letting them cool completely before your try cutting them, or you’re likely to get more of a veggie mush (which still tastes delicious).  If you are feeling creative and want to use cookie cutters, refrigerating them overnight will help you get a more workable consistency.  I hope you enjoy them as much as we do!

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Spinach Bites (egg free, grain free, dairy free, soy free)

Ingredients: 

4 Russett or White potatoes

1 8oz package frozen chopped spinach

3 chia seed “eggs” (3 tbsp ground chia seed + 9 tbsp water)

½ tsp onion powder

½ tbsp garlic powder

½ tbsp Italian seasoning

¼ tsp pepper

¼ tsp sea salt

2 Tbsp Canola oil

Directions:

Pre-heat your oven to 350°F.

Peel and cut the potatoes into small pieces.  Boil with a dash of salt until they are soft.

Steam or lightly cook your spinach.  Drain any extra liquid.

Mash the potatoes.

Blend the spinach until creamy.

Mix the spinach with potatoes.  I use an immersion blender for the mashing and blending, this results in a creamy, well-incorporated mixture (and cuts down on the dishes).

Make your chia egg: mix the ground chia with water and let sit to gel while you prepare the rest of the recipe.

Add the spices and oil to the potato/spinach mixture.

Stir well.

Fold in the chia eggs and stir until well combined.

Spray a 13×9 glass baking dish with olive oil (or other cooking spray).

Pour the mixture into the prepared dish.  Make sure you spread it out so that it’s flat and even in the dish, It won’t settle at all in the oven.

Bake at 350º for 40 minutes.

Let cool (refrigerate for a couple of hours if you have time), cut (into fun shapes if you want) and serve!

Enjoy!

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This recipe was adapted from the one I found here: For the Love of Food!
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On The First Day of Salmon My True Love Gave to E…

salmon close up
…A quarter salmon patty 🙂

That’s right, Saturday we started the 12 Days of Salmon, which isn’t nearly as exciting or interesting as the 12 Days of Christmas, but we do what we can to keep things fun around here.

At our last allergist appointment (in November) our doctor encouraged us to try fish and shellfish, which are E’s last two top 8 allergens to try.  He’s never had a positive scratch test or blood test to either and they aren’t very common FPIES allergens, so there really wasn’t a reason not to go ahead and give it a try.  (FYI, this information has absolutely no bearing on how nervous I feel about starting a new trial, especially one with a higher likelihood of an IgE allergy.)  Well things got pretty crazy after that appointment and we finally have the time and motivation to start the trials.

The motivation for the fish trial was also spurred by a not-so-recent (January) trip to the dietician, who is a little concerned about E’s calcium intake.  It’s really hard to get enough calcium without any dairy products. I’m not sure why Neocate doesn’t meet all of the calcium requirements, but that’s a rant for another day. She suggested several things – almond milk, leafy greens, and salmon.  She specifically recommended canned salmon, explaining that it  contains tiny bones which are an excellent source of calcium.  So, it seemed like no-brainer to use canned salmon for the fish trial.

Ok, I’ll admit it. Besides the nerves-factor, the hustle and bustle of the holiday season, and several illnesses, the main reason why I put off the fish trial is because I don’t really like fish.  In small doses it’s ok, and I like a lot of shellfish, but fish just isn’t my favorite. That doesn’t really matter though, because I, of course, want the best for E.  So I went grocery shopping. When I found the canned salmon I was horrified to learn that the salmon that contained the bones also contained skin.  Ewww.  I have served my son some pretty gross things on this journey (think pureed lamb mixed with pureed peas).  However, at that moment, in the grocery store aisle, as the nausea set in, I decided that my husband would be preparing this dish for our son.  He graciously accepted the challenge (and only mocked me a little bit).

We found a recipe for Potato Salmon Patties and made a few modifications to get to the recipe below. Jonathan whipped them up first thing in the morning (nothing like a fishy-smelling house at 9 am) and they were ready by lunch.  I got to be the one to serve the little man a lovely lunch of peanut butter and jelly with a side of salmon patty (yum).

 PB&J with Salmon

E was not instantly in love with them.  He spit out his first two bites.  That meant that I had to walk a very thin line between forcing him to eat something that he might be allergic to and encouraging him to try a new food.  It’s even more difficult because I’ve started to notice that E tends to reject the foods that he later reacts to.  But he’s also a toddler who is used to eating the same thing day after day.  So I explained to him that they are like “meat-a-balz-a” (ala Chef Pisghetti from Curious George), at which point he decided they were worth another try.  He then allowed me to feed him the rest of the salmon on his plate.  We always start food trials at a very low dose, so it was only a 1/4 of a patty that day.  I watched him carefully, jumping at every sniffle or cough, and checked the monitor a little more closely and obsessively during nap time.  I’m happy to report that there was no sign of a reaction!  He ate the quarter of a patty much more readily on Sunday (without any theatrics and by himself) and so far, so good.  The plan is to give him half a patty for the next three days and then a full patty until the end of the 12 day trial.  I’ll let you know how it goes.

In the meantime, if you’d like to join E on his latest food adventure, here is Jonathan’s adapted recipe:

Salmon Patties By Jonathan

Makes 6 Patties

Ingredients:

2 (7.5 ounce) cans salmon, drained and flaked
2 Tbsp Chia Seed, Ground
6 Tbsp water
¼ cup bread crumbs
6 “vigorous shakes” of Italian Seasoning
¼ cup dry potato flakes
1 medium onion, minced
1 clove garlic, minced
Salt and pepper to taste
Olive Oil (or other non-stick) Cooking Spray
 
Directions:
Preheat the oven to 350º
Combine the ground chia and water and set aside.
Combine the salmon, breadcrumbs, seasoning, garlic, onion, salt, pepper, and chia mixture.
Spray a cookie sheet with olive oil spray.
Form the mixture into 2 inch balls and flatten to about 1/2 inch thick and place on prepared cookie sheet.
Bake at 350º for 39 minutes, until golden brown.
Enjoy!
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Fruity Quinoa Porridge

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I’m trying to psych myself up to wake up to a scene like this tomorrow morning (again).  This winter has totally taken all the fun out of snowstorms.   We’ve already had nearly 60 inches of snow, making it Philadelphia’s third snowiest winter ever.  We are pretty much over it.  And we are expecting another 4 to 8 inches tonight along with near record lows.  Our charming old stone house with its original windows is not up for the challenge.  Tomorrow morning will be like many others this winter – really, really cold.  The kind of morning that makes you long for a nice, steamy bowl of hot oatmeal that warms you to your core and leaves you with that full, happy feeling.

But, alas, E is allergic to oatmeal 😦

This actually doesn’t bother him because he’s never really had it (except to thicken his bottles, but that’s a whole other post) and he doesn’t know what he’s missing.  I, on the other hand, feel awful as he submerges his chubby little fingers into a bowl of Corn Chex smothered in cold applesauce.  So you can only imagine how excited I was when I stumbled across a recipe for Apple Cinnamon Quinoa on Pinterest.

I’m not sure why I hadn’t thought of it.  Quinoa was one of E’s first safe foods, back when we were still pureeing everything.  In fact, my unscientific observation is that many FPIES kiddos do well with quinoa and it’s often one of the first safe foods, perhaps because it’s actually a seed, not a grain (who knew?).   Anyway, as we added more safe foods and moved onto finger foods, we kind of abandoned quinoa.  It hadn’t even occurred to me to use it for breakfast.  Another bonus was that the recipe cooked the quinoa in almond milk instead of water.  Another lightbulb moment.  I’ve been trying to get more calcium into E’s diet and almond milk is a great safe source for him.  It’s just difficult to get him to drink more milk on top of his Neocate formula, so cooking with it is an excellent option.  I couldn’t wait to try it!

The recipe (with a couple tweaks to fit E’s diet) was a huge success (you should definitely check it out at FitnessRx for Women)!  More exciting, it got me thinking about other ways to prepare quinoa.  I happened to have a bunch of strawberries on hand, so I started experimenting.  I pulled out my new favorite toy, my electric pressure cooker, and threw the strawberries in with the quinoa, almond milk, vanilla, canola oil (to prevent foaming) and brown sugar.  I thought the result was delicious and E agreed!  It’s so wonderful to find a fast (3 minutes at pressure!), easy, healthy, and safe way to give E that warm, full, happy feeling.

I also love the versatility of this recipe!  We use almond milk because that’s safe for us, but I’m sure you could use soy, cow’s milk, or even water.  Right now I can sometimes get Plant City (FL) strawberries at our local supermarket so I love throwing them in the cereal, but I’m sure you can use any fruit.  In fact, I had a bag of frozen sliced peaches on hand that I used the other day and it worked great.  I’m a pretty big fan of brown sugar, but use whatever sweetener works for you. This is a perfect pressure cooker recipe but I assume it would work on the stove top too, it’ll just take longer to cook.  This recipe makes about 4-6 servings, which lasts us several days.  I store it in the fridge and then reheat it in the microwave.  I just pour a little almond milk in the bowl before nuking it so  it doesn’t dry out.  Let me know if you try something different and how it worked for you.

I hope you enjoy it as much we do!

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Peach Quinoa Porridge (we ate the strawberry before it occurred to me to take a picture)
 

Fruity Quinoa Porridge

1 cup white quinoa

2 cups unflavored, unsweetened almond milk

2 heaping tbsp brown sugar

2 tbsp vanilla extract

Approximately 1 lb strawberries, hulled and cut in half (or any other fruit)

1 tbsp canola oil

Throw everything into the pressure cooker, give it a quick stir and cook at high pressure for 3 minutes.  When time is up, let the pressure release naturally.  Make sure you stir it well when it is finished to distribute the strawberry juices and complete the breakdown of the strawberries (warning – it might look a little gross when you open the lid and see the deflated strawberries but they should fully dissolve after stirring).  Enjoy!