A world without milkshakes, cheese platters or the joy of dunking cookies into a glass of milk. This may be a reality for some due to a milk allergy. The only way to avoid an allergic reaction to milk is eliminating the sources completely, unless advised by a doctor. But avoiding dairy extends beyond cutting out just cow’s milk. Let’s take a look.
What is a Food Allergy?
A food allergy is when the immune system reactions to proteins found in certain foods. When an individual with a food allergy consumes these specific foods, their immune system mistakenly identifies certain proteins in food as harmful invaders, triggering an allergic reaction. This is the immune’s response and can lead to various symptoms, ranging from mild to severe, in some cases this could also be life threatening known as an anaphylaxis.
What is an allergy to milk?
What does this mean?
A milk allergy occurs when the immune system is triggered by the proteins found in milk and foods containing milk. Symptoms can range from mild to severe. It is very different to lactose intolerance and is usually diagnosed by a health care professional. Managing a milk allergy involves staying clear of anything that contains milk or milk proteins such as whey and casein which are often hidden ingredients in processed food.
Cow’s milk is the most common milk allergy trigger. But it is also possible for people with a cow's milk allergy to also react to sheep, goat and buffalo milk. Exposure to even a tiny amount of milk protein can be enough to trigger an allergic reaction.
Read more about a Lactose intolerance here.
Can someone grow out of a milk allergy?
An allergy to cow’s milk is common in babies and young children. The good news is that most children will outgrow their milk allergies within the first few years of life. However, it is important to consult a healthcare professional to determine when reintroducing milk into the diet is safe.
Nutrition Considerations with a Milk Allergy
Individuals with a milk allergy need to be mindful of their nutritional intake to ensure they meet their dietary needs whilst avoiding milk products. Some nutrition considerations for someone with a milk allergy include:
Calcium intake: With dairy being a primary source of calcium, individuals with a milk allergy need to find alternative calcium sources. Some of these may include calcium fortified non-dairy milk such as soy or almond milk, dark leafy greens, certain types of fish, legumes and nuts. It is important to choose the fortified variety and look for the ‘no added sugar’ version where possible.
Vitamin D: Dairy products are often fortified with vitamin D. Alternative sources include fortified non-dairy products, fortified juices, eggs, mushrooms and naturally when you spend time in the sun.
Protein: Milk and other dairy products like cheese, yoghurt and custard are high sources of protein. Individuals with a milk allergy will need to ensure they are meeting their protein requirements from other sources like meat, poultry, fish, eggs, legumes, nuts and seeds.
Is there Possible risk of deficiencies by eliminating or avoiding milk
Individuals with milk allergies face potential risks of nutritional deficiencies as they are required to eliminate milk and milk containing products from their diets. Milk is a rich source of various essential nutrients including calcium, vitamin D, protein and B vitamins. Without adequate substitutes and careful planning, individuals with milk allergies may be at risk of deficiencies.
Calcium and vitamin D play a crucial role in bone health, and their absence could increase the risk of osteoporosis and bone fractures. Protein is vital for muscle preservation, wound healing and other body processes, whilst B vitamins are essential for energy metabolism and nerve function. To limit these risks, it’s essential for those with milk allergies to seek alternative sources for these nutrients through a well-balanced diet, fortified foods and supplementation.
Surprising Foods that contain Milk
Numerous foods contain traces of dairy protein such as baked goods, cereals, chocolates, salad dressing and even bread. Therefore, it is important to read all ingredient labels and exclude any food and products containing dairy.
Food Group | Foods that contain or may contain milk | Milk free foods & alternatives |
Fruit and Vegetables | Potato salad, mashed potato, muesli bars, vegetable soups, baked vegetable with white sauces or cheese | All plain fresh, dried, canned fruit and vegetables, fruit and vegetable juice |
Grains (Bread and Cereals) | Bread containing milk, instant oats or oats made with milk, cakes, pastries, biscuits, tinned spaghetti. | Most bread, breakfast cereal (e.g weetbix, rice bubbles, cornflakes, all bran, oats cooked in water), rice, pasta. |
Milk, yoghurt, cheese or alternatives | Milk: Cows, sheep, goats, lactose free, reduced and skim milk, ice cream, yoghurt, mousse, cheesecake, milk powder, all cheese e.g ricotta, cheddar, brie, cottage cheese, etc. | Soy Milk, plant based milks including nut milks, coconut milk, dairy free cheese, dairy free yoghurt. |
Meat, poultry, fish, eggs, legumes and nuts | Some patties, sausages, chicken nuggets, battered food, some sandwich meats, any dishes containing milk e.g quiches, omelette, scrambled eggs, lasagne, macaroni cheese, etc. | All plain meat, poultry, fish, eggs, legumes, nuts, tinned fish, tofu, nut pastes. |
Salad Dressing and Sauces | Commercial Gravy, creamy salad dressing – tartare sauce, mayonnaise, hollandaise, white sauce. | Vinegar based salad dressing e.g balsamic, soy sauce, tomato sauce, BBQ sauce – check labels. |
Soups | Any soups made with cream, milk, butter or cheese. Creamy Soups – Crème of Chicken, pumpkin soup (often has sour cream) – check ingredients. | Homemade soups made without milk |
Fats and Oils | Butter, margarine, ghee, cream, spreads. | Cooking oil, milk free margarine |
Note, this list is not exhaustive and there are many more foods that may have hidden sources of milk products. Therefore, it is imperative to become familiar with the various milk ingredients and check every level before use.
Managing a Milk Allergy
Read Labels Thoroughly
Look out for hidden milk ingredients, check the allergy list and be mindful of ‘May Contain’ foods which could be processed along with milk containing products. Find out more about Food Labels here.
Explore Dairy Free Alternatives
Keep an eye out when shopping for dairy free alternatives, these may be found in the health food section. Aim for options that are fortified with calcium and vitamin D.
Plan Balanced Meals
Plan meals that are nutritionally balanced and meet dietary needs, include a variety of fruits, vegetables, wholegrain and protein sources.
Be Prepared
When dining out or attending social activities, communicate your milk allergy to staff and hosts to prevent accidental exposure to milk. Always carry an emergency action plan especially if an Epi-pen is prescribed. Being prepare can be crucial in managing a severe allergic reaction.
Nutrition Supplements and Milk Allergy
It’s important to consult a Dietitian when considering nutritional supplements, as they might also include milk-derived ingredients, even the fruit-based ones. Renowned for their high protein content, creamy consistency and neutral taste, both whey and casein are widely used in many protein-based drinks. A Dietitian can advise a nutrition supplement or specialised infant formula suitable for those with a milk allergy.
How else can a Dietitian help?
Dietitians can provide practical advice on meal planning, label reading and navigating social situations without the fear of accidental milk exposure. The nutritional needs of individuals may vary and it’s crucial to tailor dietary choices to achieve a balanced diet, avoid allergic reactions and prevent deficiencies. Reach out to an OSCAR Care Group Accredited Practising Dietitian for support in managing milk allergies.