When Your Child Has a Food Allergy: Milk

When a child has a milk allergy, even a small amount of milk can cause a life-threatening reaction. For that reason, your child must avoid dairy products and any foods likely to contain milk. This sheet tells you more about your child’s milk allergy. You’ll learn what foods to avoid, what to look for on food labels, and how to prepare dairy-free meals.

Milk Allergy: Foods to Avoid

Children with milk allergies should avoid all dairy foods, including:

• Butter

• Cheese and cottage cheese

• Cream, sour cream, and half-and-half

• Ice cream and ice milk

• Milk (whole, low-fat, skim, evaporated, condensed, powdered) and buttermilk

• Yogurt

These foods often contain milk:

• Baked goods, such as cakes, muffins, and some cookies and pies

• Some breads (check the labels)

• Buttered, creamed, scalloped, or au gratin vegetables

• Candy made with milk, such as fudge, caramel, and nougat

• Canned tuna containing casein

• Casseroles made with milk, cream soups, or cheese

• Caesar salad and caesar dressing (often contain Parmesan cheese)

• Some boxed or precooked cereals

• Cheese made from rice or soy (it may contain casein)

• Cream soups, bisques, and chowders

• Eggnog, milkshakes, and malts

• Ghee, a clarified butter often used in Indian cooking

• Goat’s milk and goat cheese, which usually cause the same allergic reaction as cow’s milk

• Some high-protein flours and protein powders

• Some margarines, butter substitutes, and “non-dairy” creamers and spreads

• Mashed, au gratin, creamed, and scalloped potatoes (some french fries—including those at fast food restaurants—may be sprayed with lactose, a milk sugar)

• Meatloaf, breaded meats, and meats containing casein, a milk protein

• Pancakes, waffles, and French toast

• Pizza

• Many processed meats, including hot dogs, sausages, and luncheon meats

• Puddings, custards, and cream sauces

• Salad dressings or mayonnaise containing milk, milk solids, or milk products

• Soufflés

• Frozen vegetables in sauce

• Vitamins and medication in pill form (pills often contain lactose as a filler)

• Some dry-powder inhalers used to treat asthma

What to Look For on Labels

Food labels can be misleading. “Non-dairy” foods often contain milk proteins such as casein and whey. And kosher foods labeled “pareve” (meaning they don’t contain meat or dairy products) may have traces of milk from processing. Read labels carefully, and avoid products that contain:

• Casein or caseinates

• Hydrolysates

• Lactalbumin, lactalbumin phosphate

• Lactoglobulin

• Lactose

• Rennet casein

• Whey or whey protein

Allowed Foods

These foods are safe for children with milk allergies:

• Boxed pastas such as macaroni and spaghetti

• Breads made without milk

• All fresh and frozen fruits and vegetables

• Fresh, frozen, or canned fruit and vegetable juices

• All grains such as rice, wheat, barley, and oats

• Meat, chicken, and fish cooked without butter or other milk products (check the labels on precooked meats such as ham, which may contain lactose)

• Non-cream soups

• Peanut butter and other nut butters made without milk solids

• Rice, soy, and nut milks (found in most natural food stores and some grocery stores)

• Sauces that don’t contain milk or cream, such as spaghetti sauce

• Tofu and other soy products

• Vegetable oils

• White or sweet potatoes cooked and served without butter or milk

Cooking Without Milk

Try these tips for making your favorite recipes without dairy products:

• In baking, substitute equal amounts of water, fruit juice, rice milk or soy milk for cow’s milk.

• Use 3/4 cup applesauce for every cup of butter called for in baked goods, or use a butter substitute made from soy.

• Substitute chicken broth for cream in sauces and soups, or puree foods for a creamy texture.

• Dress potatoes, vegetables, and grains with olive oil, vegetable oil, or soy lecithin spread instead of butter. Some “non-dairy” spreads, including margarine, contain whey, a milk protein.

• Check natural food stores for these products made from soy or rice: ice cream, butter substitutes, yogurt. Avoid cheeses made from rice and soy (they’re likely to contain casein).

How Does Milk Allergy Differ from Lactose Intolerance?

Some children who are sensitive to dairy foods may not have a milk allergy. Instead, they may be lactose intolerant. This means they can’t fully digest the sugar in milk. Here are some differences between the two:

Lactose intolerance:

• Causes digestive symptoms such as diarrhea, bloating, and gas

• Doesn’t involve the immune system

• May not cause a reaction when the food is eaten in small amounts

• Often develops in teens and young adults

Milk allergy:

• May cause symptoms throughout the body

• Is an immune system response

• Occurs after the slightest exposure to a problem food

• Is most common in infants and young children (feeding cow’s milk to infants increases the risk of milk allergy)

Your Child Needs Calcium

Ask your doctor about calcium or vitamin D supplements for your child. (Be aware some will contain milk, so be sure to read the labels.) These foods are good sources of calcium:

• Calcium-fortified orange juice

• Canned salmon (with bones) and sardines

• Cooked dried beans

• Enriched soy milk and rice milk

• Soy yogurt

• Tofu

• Turnip greens, kale, broccoli, and cabbage