Ahhh, the milk allergy. Anyone who has this allergy or knows someone with this allergy knows just how truly horrible it is.
Milk can be found in so many products (usually unexpectedly), and to make things worse, so frequently people mistake a milk allergy for lactose intolerance.
In this article we will discuss what a milk allergy is, which ingredients to avoid, how to stay safe and what the difference is between a milk allergy and lactose intolerance.
Remember: this post is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. Keep in mind food production can change, always check food labels to be sure products are free of your particular food allergen. For further information please see full Disclaimer.
Table of Contents
How Common is a Milk Allergy?
Approximately 2.5% of children who are under the age of three have an allergy to milk (1). Although milk allergies are common in childhood, milk allergies are also common for adults (2).
Most children outgrow a milk allergy (3). The statistic is about 75% of children will outgrow a milk allergy.
Can I have Other Animals’ Milk if I Have a Cow’s Milk Allergy?
There is a chance with a milk allergy that you can have other animals’ milk without issue. However, the chance of this is small.
Talk to your Board Certified Allergist about this.
The protein found in goat milk happens to have a similar chemical structure to the protein found in cow’s milk. Oftentimes, someone with a cow milk’s allergy is unable to tolerate goat milk. However, this is not always the case.
What are the 9 Most Common Food Allergies?
The top 9 food allergies also known as the big 9 allergens in the United States are:
You can be allergic to many other foods besides these top nine.
What are Symptoms of a Milk Allergy?
Milk allergy symptoms can vary from person to person but some typical reactions are listed below.
- Swelling of lips, tongue, throat, face
- Itching or swelling of the lips, tongue, or throat
- Difficulty swallowing
- Abdominal pain and cramps
- Wheezing (difficulty breathing)
- Nausea and vomiting
- Runny nose
- Congestion (stuffy nose)
- Digestive problems
- Loss of consciousness
An allergic reaction to milk can occur minutes to hours after ingestion. Reactions to milk vary. Reactions can be mild (requiring only an antihistamine) or they may be a severe reaction such as anaphylaxis. If a severe reaction occurs, epinephrine is required.
A Food Allergy and Anaphylaxis Emergency Care Plan is a great tool for personalized food allergy treatment.
Can I have Milk in Baked-Goods with a Milk Allergy?
Heat can change the structure of a protein molecule. Therefore, there are some individuals with a milk allergy who can tolerate milk in baked products. Always check with your board certified allergist to find out what is appropriate in your particular scenario.
It is estimated that roughly 70% of children with a milk allergy can tolerate milk when it is in a baked product where the milk protein has been subjected to high temperatures (4).
If you have a child who is able to eat milk that has been baked, you have a higher probability of having a child who may possibly outgrow their milk allergy (5).
If given approval by your Board Certified Allergist to try a product with milk baked in it, you may want to pay attention to the ingredients in the product and avoid any product with milk or milk products listed as a first or second ingredient.
Ingredients on a food label are listed in order of predominance. The ingredients used in the greatest amounts are listed first on the food label.
Milk Allergy in Infants
If you suspect that your infant has a milk allergy, talk to their pediatrician. It may be something known as Cow’s Milk Protein Intolerance. Fortunately, there are many milk free formula options that are now available. Talk to your baby’s doctor about which formula is best for your baby.
And if you are concerned about what to do with breastfeeding, talk to the Pediatrician or Allergist. You may have to eliminate milk and milk products from your diet. Again, talk with a doctor.
What is the Difference Between a Milk Allergy and Lactose Intolerance?
A lactose intolerance has to do with lacking an enzyme needed to break down milk. Someone with lactose intolerance lacks the enzyme, lactase, needed to break down lactose.
Symptoms of lactose intolerance may include gas, bloating, and diarrhea. Lactose intolerance is not life threatening, but is uncomfortable. Lactose intolerance affects only your gastrointestinal tract.
A milk allergy can potentially be life threatening. Symptoms may be mild or severe as discussed above. A milk allergy involves something called IgE antibodies. These antibodies are released by the immune system when having an allergic reaction.
Unlike lactose intolerance where the discomfort is focused to the gastrointestinal tract, food allergies are systemic. This means that food allergies affect many organ systems or the whole body.
That is why someone with a food allergy may have a reaction such as hives, itching of the throat, and wheezing when consuming milk. Someone with a lactose intolerance would have just gastrointestinal symptoms.
To learn more about the difference between food sensitivities, food intolerance, and food allergies I have written an article explaining the differences: Food Allergies, Food Sensitivities, and Food Intolerances, Oh My!!!
Foods to Avoid with a Milk Allergy
Milk is found in many foods in the American diet. If you have a milk allergy, you should also mindful of traces of milk that may be in products.
Milk and whey protein can be used as a stabilizer, emulsifier, flavoring agent. For that reason, milk may be found in foods that you would not expect to contain milk. Some examples are hot dogs, lunch meats, sausage, and canned tuna.
Some possible food sources which contain milk include but are not limited to:
- Artificial butter or cheese flavor
- Au gratin dishes
- Baked goods — bread, cookies, crackers, cakes
- Battered and fried foods
- Breakfast foods (waffles, pancakes)
- Cake mix
- Caramel Candy
- Chewing gum
- Coffee creamers
- Creamed or scalloped foods
- Energy drinks
- Granola bars
- Indian food (ghee is very common)
- Lactic acid starter culture and other bacterial cultures
- Malted milk
- Mashed potatoes
- Meats (this includes canned and processed such as deli meats, sausages, hot dogs, etc.)
- Non Dairy Products (don’t assume because it is non-dairy that it is milk free)
- Protein powders
- Salad dressings
- Shellfish- sometimes shellfish is placed into milk to reduce it’s odor.
- Some chips
- Tuna fish (check label)
- Vegan Foods (may contain traces of milk protein)
- White sauces
Ingredients That Indicate Milk is Present
- Anything with the word “butter”
- Anything with the word “casein or caseinates”
- Anything with the word “cheese”
- Anything with the words “sour cream”
- Anything with the word “whey”
- Half and Half
- Lactalbumin, lactalbumin phosphate
- Lactic Acid Starter Culture
- Lactose, lactoglobulin, lactoferrin, lactulose, lactulose
- Milk (in all forms including condensed, derivative, dry, evaporated, low-fat, malted, milkfat, non-fat, whole, powder, skimmed, solids)
- Milk from other animals unless cleared by your Allergist.
- Milk in Kosher Foods (this includes Kosher Pareve foods which may still have trace amounts of milk)
- Milk protein hydrolysate
- Protein powders
Commonly individuals will wonder if the below ingredients are safe with a milk allergy. According to FARE (Food Allergy Research and Education) these ingredients DO NOT contain milk and are considered safe.
- Calcium lactate
- Calcium stearoyl lactylate
- Cocoa butter
- Cream of tartar
- Lactic acid (lactic acid starter culture may contain milk)
- Sodium lactate
- Sodium stearoyl lactylate
Milk may also be found in personal care products such as moisturizers and soaps. Milk may also be found in medications.
Arts and Crafts supplies may also contain milk. Allergens in Arts and Crafts are always an important consideration when someone has a food allergy, especially young children.
Food Allergy Labeling. About FALCPA
In 2004, the Food Allergen Labeling and Consumer Protection Act (FALCPA), identified the following foods as major food allergens: milk, eggs, fish, shellfish, peanuts, tree nuts, wheat, and soy.
Effective January 1, 2023, the FASTER Act (the Food Allergy Safety, Treatment, Education, and Research Act) was signed into law, adding sesame as the 9th major food allergen recognized in the U.S.
FALCPA requires that foods or ingredients that contain major food allergens be labeled with the name of the allergen source.
FALCPA states that major food allergens should be listed in one of three ways:
- In the ingredient list, using the allergen’s common name.
- By citing the word “Contains” followed by the name of the major food allergen—for example, “Contains milk”
- In the ingredient list in parentheses after a less common name of ingredient that may contain an allergen. Example: Lactalbumin (milk).
Again, discuss with your provider which foods you should avoid with a milk allergy.
Made in a Facility/Cross Contamination Statements for Milk
Food manufacturers may use equipment to produce multiple products. This may lead to cross contamination of allergens. Some manufacturers disclose this information and others do not. This is true for both FALCPA and non-FALCPA allergens.
Cross contamination statements are not required in the U.S. Call the manufacturer to learn about their manufacturing practices.
Always be sure to ask how food is prepared. Be careful when buying shellfish as it may have been soaked in milk to decrease the odor.
Cross contamination is a huge concern when dealing with a milk allergy. Many restaurants use butter on meat to add flavor or butter the grill.
Popular specialty drinks like coffee products or smoothies have great risk of having cross contamination with milk. Although places that offer these popular drinks have milk substitutes like almond milk or soy milk, etc., cross contamination risk is high due to equipment utilized.
Milk Allergy Treatment
- Always read food labels closely and look for ingredients that indicate milk.
- Avoid all foods related to your allergy. Learn less common names for your particular food allergy.
- Become familiar with labeling laws.
- Talk to your Board Certified Allergist
- Be mindful of risk for cross contamination
- Be prepared to treat your milk allergy in the case of accidental ingestion. Be sure to have not one, but two doses of epinephrine available when eating. Always call 911 if epinephrine is given.
- Talk to your doctor about how to treat symptoms of an allergic reaction and visit www.foodallergy.org for more detailed information about treating food allergies.
Milk allergies are arguably one of the most difficult allergies to manage outside of the home. Milk is widely used in recipes and products found in the American diet.
A milk allergy can affect both children and adults. Children have a fairly good chance of outgrowing the allergy, especially if their Allergist has cleared them for milk in baked foods.
It is vital that those with a milk allergy become familiar with terms used that indicate milk.
Be sure to ask about how food is prepared when dining out as milk can be used as an ingredient unexpectedly. Indian food often contains ghee and ghee should be omitted from your diet if you have a milk allergy.
If you think you may be allergic to milk see a Board Certified Allergist.
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Last Updated on March 2, 2023 by Amber DeVore, RD, CSSD, CLT