Patient and Family Education

Milk Soy Protein

Intolerance

In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away.

Nutrition l PFEL 043 / 12.09 / MSPI Page 1 of 4
This teaching sheet contains general information only. Your childs doctor or a member of your
childs health care team will talk with you about specific care for your child.

What is milk soy protein intolerance?
Milk soy protein intolerance (MSPI) is a reaction to the proteins found in milk and soy. These proteins damage
the inside lining of the digestive tract and may cause bloody stools, watery diarrhea, vomiting, irritability and
weight loss. Infants with MSPI can appear hungry often or refuse to eat.

What formula should my child drink?
A child with MSPI needs a formula that does not contain milk or soy proteins. Some examples of these
formulas include Alimentum, Elecare, Pregestimil, Nutramigen, and Neocate. Older children can use Neocate
One Plus. Your nutritionist can help you choose the right formula for your child.

Is Breast milk okay?
Human milk is the standard for infant feeding. Infants with MSPI can continue to breastfeed (or receive breast
milk) when mom follows this diet.

What foods contain milk and soy protein?
Milk Protein Solids:
Artificial Butter Flavor Curds Lactoglobulin Nougat
Butter Custard Lactose Pudding
Buttermilk Solids Ghee Malt Milk Simplesse
Calcium Caseinate Half and Half Milk Sodium Caseinate
Casein Ice cream Milk Chocolate Whey
Caseinate Junket Milk Solids Whey Solids
Cheese Lactalbumin Nonfat Milk Solids Yogurt
Cream
Soy Protein Solids:
Edamame Soy Flour Soy Sprouts
Miso Soy Grits Tamari
Modified Food Starch Soy Milk Tempeh
Shoyu Sauce Soy Nuts Teriyaki Sauce
Soy Albumin Soy Protein Isolate Textured Vegetable Protein
Soy Bean Soy Sauce Tofu
Foods that may contain soy protein:
Hydrolyzed Plant Protein Vegetable Broth
Hydrolyzed Soy Protein Vegetable Gum
Hydrolyzed Vegetable Protein Vegetable Starch
Natural Flavoring
Milk Soy Protein Intolerance, continued


In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away.

Nutrition l PFEL 043 / 12.09 / MSPI Page 2 of 4

What about soy oil and soy lecithin?
Soy oil is allowed because it is a fat and not a protein. Studies show that most people may safely eat soy lecithin.
Soy lecithin is a mix of fatty content from the processing of soybeans.

How are solids introduced?
Solids are started later in children with MSPI. You may begin solids at six months of age. Foods are also
introduced in a different order for children with MSPI:
Begin with vegetables, then add meats, fruits, and cereals
Start with strained or pureed foods, then advance the texture to ground or chopped finger foods between
eight or nine months of age
Avoid foods that could cause choking such as hard candy, nuts, raw vegetables, grapes, popcorn, chips, or
sunflower seeds
Introduce new foods one at a time.
Wait three to five days before introducing a new food. Allow time between foods to help you find out if
your child has trouble with the new food.

What are some signs of milk soy protein intolerance?
Signs of intolerance may include:
Vomiting
Diarrhea
Abdominal cramping
Rash
Irritability
Weight loss
Bloody Stools
If your child has one of these symptoms with a new food, do not give the food for two to four weeks.
You may try the food again after that time to see if the intolerance still exists. If there are no signs of intolerance
you may continue to introduce new foods in the same pattern.

What about food safety?
Good personal hygiene practices are important for everyone to help prevent the spread of infection. It is
especially important for infants and young children due to their immature immune system.

Food Safety Guidelines:
Always wash hands before preparing food
After opening the baby food jar, place the food to be served into a separate bowl; do not feed from the jar,
germs will spoil the food
Cover and refrigerate unused portion; discard after two days if unused; store unopened food in a cool dry
place
Store infant cereal away from soaps, cleaners, drugs, and strongly flavored vegetables since it may absorb
these strong odors




Milk Soy Protein Intolerance, continued


In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away.

Nutrition l PFEL 043 / 12.09 / MSPI Page 3 of 4

Milk Soy Protein Free Diet

FOOD GROUPS FOODS ALLOWED FOODS TO AVOID
Breads and Grains Breads, rolls, bagels, crackers,
waffles made without milk and
soy. Most hot cereals (oatmeal,
Cream of Wheat

), commercial
cereals not containing milk or
soy

Breads, rolls, bagels, crackers, muffins,
pancakes, biscuits made with milk or soy
Starches Potato, rice, or pasta prepared
without milk and soy products
Any potato, rice, or pasta prepared with
milk or soy products: au gratin, creamed,
and scalloped potatoes, instant potatoes;
macaroni and cheese, commercial pasta and
rice sauces, canned and dry pizza mixes

Vegetables All vegetables: fresh, frozen,
canned
Any vegetable prepared with milk or milk
products: au gratin, creamed, scalloped, soy
sprouts, commercially prepared breaded
vegetables or contain soy sauce, canned or
frozen Oriental style vegetables in any sauce
Fruits All fruits: fresh, frozen, canned Any fruit prepared with milk or soy
products

Milk and Milk
Products
Alimentum, Breast milk, Elecare,
Pregestimil, Nutramigen,
Neocate, Neocate One Plus
All forms of cows milk, soy milk,
powdered milk, half and half, coffee
substitutes, non-dairy creamers, cream, ice
cream, yogurt, cheese, cottage cheese, goats
milk, cows milk based infant formulas,
whey, casein, caseinate, curds, lactose,
lactalbumin
Meat and Meat
Substitutes
Plain meats, beef, poultry, turkey,
fish, lamb, pork, beans, lentils,
plain eggs, all nuts except soy
nuts
Any prepared with milk or soy products:
meatloaf, hot-dogs, cold cuts, commercial
frozen patties, hamburger extenders,
yogurt, cheese, tofu, textured vegetable
protein, meat extenders, scrambled eggs,
canned tuna in vegetable oil

Fats and Oils Corn oil, safflower oil, coconut
oil, olive oil, peanut oil, milk- and
soy-free margarine
Cream, sour cream, fats prepared with
added milk and soy solids: butter,
margarine, mayonnaise, salad dressings,
vegetable oil, vegetable oil sprays,
shortening unless the type of oil is
specified, gravies, and some coffee
creamers

Milk Soy Protein Intolerance, continued


In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away.

Nutrition l PFEL 043 / 12.09 / MSPI Page 4 of 4

FOOD GROUPS FOODS ALLOWED FOODS TO AVOID
Desserts and
Sweeteners
Hard candy, candies and desserts
made without milk or soy
products
Candies containing milk or soy:
caramels, milk chocolate, semi-sweet
chocolate, chocolate chips, hard candy,
nougats, and fondants; desserts prepared
with milk or soy: cakes, pastries,
doughnuts, pies, ice cream, ice cream
cones, ice milk, sherbet, soy ice cream
products, custards, puddings, creamy
gelatin desserts, frosting, sauces, cookies,
pancake syrup, fudge
Snack Foods Those without milk or soy
products, plain chips, corn chips,
popcorn, and crackers, salsa, all
nuts except soy nuts
Those containing milk or soy products,
dips, ranch flavored snacks, cheese dips,
cheese crackers, pretzels, pizza rolls
Beverages Alimentum, Pregestimil,
Nutramigen, Neocate, Vivonex
Pediatric, Neocate One Plus
coffee, tea, fruit juice, vegetable
juice, carbonated beverages
All forms of cows milk, soy milk,
powdered milk, goats milk, cows or soy
milk based infant formulas, drink mixes,
coffee substitutes, beer, wine
Seasonings and
Condiments
Salt, pure spices and seasonings,
oil based dressings, ketchup,
mustard, relish, homemade salad
dressing and mayonnaise, pure
beef or chicken broth
Cheese sauces, Hollandaise sauce, white
sauce, soy sauce, Teriyaki sauce, some
steak sauces, some Worcestershire sauce,
some flavor enhancers, some sandwich
spread
Miscellaneous Homemade soups made with
milk and soy free noodles
Frozen dinners with cheese sauces,
canned spaghetti sauce with cheese,
commercial soups, canned and dry
mixes, soups containing tofu (soy bean
curd), non-dairy creamer

What are some resources on milk soy protein free diet?
Books
The Parents Guide to Food Allergies by Marianne S. Barber
Caring for the Child with Severe Food Allergies by Lisa Cipriano Collins, M.A., M.F.T.
Internet Web Sites
- www.Faan@foodallergy.org
(The Food Allergy & Anaphylaxis Network)
- www.aaaai.org
(American Academy of Allergy, Asthma & Immunology)
- www.breastfeeding.com

Who should I call if I have questions about my childs milk soy protein free
diet?
Call your childs nutritionist or your childs doctor.