Intro
Has your child recently been diagnosed with a milk allergy?
Here you’ll learn the difference between a milk allergy and lactose intolerance (and yes, they are very different!). You’ll also learn about symptoms, testing and which foods must be avoided.
Let’s jump in!
What is a Milk Allergy?
A milk allergy occurs when the immune system overreacts to dairy-containing products (1). Milk allergies can be life-threatening, and your child must avoid all dairy if they are allergic.
A Milk allergy, also known as a dairy allergy, is considered a priority food allergen in Canada.
Symptoms
Milk allergies allergy symptoms can vary but may include the following:
- Rash
- Hives
- Stomach cramps, nausea, diarrhea, vomiting
- Runny nose, congestion
- Difficulty breathing
- Swelling of the face, tongue, lips or throat
- Anaphylaxis
If your child accidentally consumes dairy, always carry an epinephrine auto-injector for safety reasons.
Prevalence of Milk Allergies
Cow’s milk allergy affects less than 2% of children under four, but this can vary per country. However, milk allergy prevalence is much lower in adults affecting roughly 0.1-0.3% of adults (2).
Research indicates that children with a milk allergy typically outgrow it by age three. However, talk to your doctor first before trialling dairy with your child (3).
Milk Allergy Testing
Food allergy testing should be done by an allergist, a medical doctor specializing in allergies. Let’s go over two common types of allergy testing.
IgG Testing
Immunoglobulin (IgG) tests claim to determine food allergies, intolerances or sensitivities. These tests measure the presence of IgG antibodies, indicating exposure to food rather than a true allergy.
Most foods you consume regularly will likely appear on an IgG test. However, it does not mean you’re allergic, intolerant, or sensitive to those foods. Thus, these tests are inaccurate and not recommended for allergy, intolerance or food sensitivity testing.
On the other hand, what is recommended is IgE testing.
IgE Testing
When you’re allergic to food, your body makes what’s known as Immunoglobulin E (IgE) antibodies. An IgE blood test helps to indicate the presence of these antibodies.
Further, this diagnostic tool is used by allergists to help diagnose an allergy. This is the most accurate form of allergy testing. So, if you suspect you have a food allergy, please contact your doctor.
Treatment
Milk allergies can only be treated by avoiding foods containing any amount of dairy.
Here is a list of foods you must avoid if you have a milk allergy:
Foods to Avoid
- Dairy milk
- Buttermilk
- Kefir
- Yogurt
- Cottage cheese
- Sour cream
- Butter
- Ghee
- Cheese
- Whey protein
- Chocolate made with dairy products
Ingredients to Avoid
Milk ingredients can appear as other less common names in an ingredient list. These milk ingredients must be avoided if you have a dairy allergy:
- Caseinate
- Beta-lactoglobulin
- Casein
- Curds
- Declactosed/demineralized whey
- Dry milk, sour cream or sour milk solids
- Hydrolyzed casein or hydrolyzed milk protein
- Lactalbumin or lactalbumin phosphate
- Lactoferrin
- Lactoglobulin
- Milk derived from fat/protein
- Modified milk ingredients
- Opta, Simplesse (fat replacers)
- Rennet casein
- Whey protein or whey protein concentrate
Please note this list may not include all milk-based ingredients. Always check with your healthcare provider to ensure you know all possible dairy sources.
Shopping for Non-Dairy Substitutes
Regarding dairy substitutes, there are many tasty and nutritionally adequate plant-based options.
Always read the label and ingredient list before selecting a product to ensure the product is dairy free. Health Canada and the Canadian Food Inspection Agency have strict requirements for allergen information on food labels.
Here are some vegan swaps for some common dairy-based foods:
Vegan Milk
- Soy milk
- Pea protein milk
Vegan Yogurt
- Soy yogurt
- Almond yogurt
- Coconut yogurt
Vegan Cheese
- Soy cheese
- Cashew cheese
- Tapioca based cheese
Vegan Butter
- Coconut based butter
- Olive oil-based margarine
Plant-Based Formula for Infants
- Soy-based formulas
When choosing a plant-based formula, always work with your Registered Dietitian to see which formula is best to ensure your baby gets all the necessary nutrients they need.
Nutritional Risks
Dairy products are essential sources of:
- Protein
- Calcium
- Vitamin D
- Vitamin A
When selecting a dairy alternative, it is crucial to ensure you are getting adequate alternate sources of these vital nutrients. To help you meet your needs for these nutrients:
- Choose non-dairy products fortified with vitamin D and calcium
- Read labels to check for protein content (aim for 8 g per 250 ml for non-dairy milk)
- Check for a source of fat, as young kids need adequate fat to meet their growing needs
If your child is newly diagnosed with a milk allergy, connect with a registered dietitian to ensure they meet their nutrient needs.
Dining Out with a Milk Allergy
Here are 6 Tips for staying allergy alert when eating at a restaurant with your child:
- Consider choosing an allergen-friendly restaurant. Some restaurants have strict guidelines for allergen-free foods. Give them a call or check out their website in advance to see.
- Plan. Read the menu online ahead of time and check the website for the restaurant’s policies on allergens.
- Try dining out before or after peak hours. When restaurants are busy, there is a higher risk for the chef preparing your food to miss your allergy and a higher risk for cross-contamination.
- Notify your server upon arrival. The more notice you give your server, the better prepared the kitchen staff can be to prevent cross contaminants.
- Always have your epinephrine auto-injector with you in case of cross-contamination.
- Do not allow your child to consume something if you’re uncertain the item is dairy free.
Safety
Since a milk allergy reaction can be life-threatening, here are some tips to promote safety
- Double-check nutrition labels when reading for ingredients that contain dairy.
- If you do not recognize an ingredient in a product, do not let your child eat it.
- Carry foods with you that you know are safe.
- Plan ahead when travelling abroad, as food label regulations vary in each country.
How is a Milk Allergy Different from Lactose Intolerance?
Lactose intolerance is when your body is unable to digest lactose properly. This occurs when you lack sufficient amounts of the enzyme lactase, which helps us to break down lactose.
Lactose intolerance is not a true allergy and is not life-threatening.
Symptoms of Lactose Intolerance
Symptoms of lactose intolerance include:
- Gas
- Bloating
- Discomfort
- Cramps
- Nausea
- Diarrhea
If you suspect your child may be lactose intolerant, see your doctor for testing or speak with a registered dietitian to manage symptoms.
Bottom Line
Milk allergies in children are serious and should be taken seriously. However, when working with a registered dietitian, you can find suitable alternatives to meet your child’s needs.
If your child is newly diagnosed with a milk allergy, contact a registered dietitian to help them meet their nutrition needs.
