Skip to main content
Type of food (foods not recommended during dietary intervention) Average frequency during the preceding month
Not at all Times per week Times per day
Less 1–3 4–6 1–2 3–4 5 or more
Regular cow’s milk‐based formula, as such or used in cooking
Brand name? ________________
Nutramigen or other hydrolyzed formula
Brand name? ________________
Soy‐based formula
Brand name? ________________
Soured milk and sour milk products (e.g. soured milk, cultured milk, yoghurt, quark)
Regular cow’s milk, ice cream or cheese, as such, in commercial baby foods, or when used in cooking (e.g. baby foods)
Foods containing beef, veal or meat extract (e.g. strained beef and vegetables)
Sausage and other meat products containing beef
Other – please list (e.g. milk containing lactic acid bacteria supplements) ______