Milk is one of the top eight foods that account for 90% of food allergies in the United States (Source: AAAAI). If you’re one of the millions of Americans with a food allergy, milk is probably the hardest ingredient to avoid. It’s difficult having a milk and dairy allergy when you love ice cream or cheese, but you don’t have to be left out of life’s celebrations. You can learn how to avoid milk while still enjoying tasty and nutritious foods.
How Will I Know If I Have a Milk Allergy?
You may have a milk allergy if you, or your child, have any of these symptoms after eating or drinking foods that contain milk or dairy products:
Diarrhea that may be bloody
Excessive crying in infants (colic)
Feeling queasy and vomiting
Itchy skin and rash
Pain or cramps in your abdomen
Runny or stuffy nose
In rare cases, milk allergy symptoms are serious or life threatening. These can include:
Difficulty talking or breathing
Dizziness or blacking out
High-pitched whistling sound with breathing (wheezing)
Large areas of raised welts on your body or face (hives)
Swelling, tingling or tightness of your throat, lips, or tongue
Some symptoms of milk allergies can also be caused by milk (lactose) intolerance, a more common and less serious condition. To diagnose the cause of your symptoms, your doctor will ask you questions about your medical history. Your doctor will want to know when and how often your symptoms occur.
A positive skin prick test is an indication that you have an allergy to milk and dairy products. Your doctor will make a minor prick in your skin and apply milk proteins. A positive reaction looks red and puffy. Skin testing is not always accurate. Your doctor will also consider your symptoms, diet, and your physical health to make a diagnosis.
Who Gets Milk and Dairy Allergies?
Milk allergy is a common food allergy. It occurs most often in infants and young children, who usually outgrow the allergy by age three. In some children predisposed to allergic reactions, the body responds to milk proteins by making special antibodies and tries to eliminate the protein from the body.
Milk allergy affects about 2.5% of children younger than 3 years. You can reduce your child’s risk of milk allergy by breastfeeding for the first four months of life.
What Foods Should I Avoid If I Have a Milk and Dairy Allergy?
Milk and dairy products are so common that you may feel overwhelmed when trying to choose foods. Milk is also frequently a “hidden” ingredient in baking, cooking and processing many foods. Your best plan is to look for these foods and ingredients on food labels and ask about them when eating out:
All types of animal milk, including cow and goat milk
Any ingredient word that contains "lact", including lactose, lactate and lactalalbumin
Butter, margarine, and butter flavor
Casein, which can be found in many nondairy products including meats
Cheese or cheese flavor
Chocolate, nougat and caramel
Half-and-half, cream, sour cream, and cream sauces
Ice cream, sherbet, and gelato
What Are Some Good Milk Substitutes?
You can generally substitute water or fruit juice for milk in baking and cooking recipes. Some people may also tolerate almond, rice or soy milk in place of cow’s milk. Be aware that having a milk allergy increases your risk of a soy allergy.
Some foods labeled as "milk-free" or "nondairy" may contain milk proteins and cause an allergic reaction. The safest plan is to ask your doctor before trying dairy-free products or any milk substitutes.
When Should I Call My Doctor?
Contact your doctor right away if you suspect that you, or your child, have a milk allergy. Prompt diagnosis and treatment can prevent serious reactions.
If you have ever had a serious reaction to milk and dairy products, such as dizziness, facial swelling, or trouble breathing, you should carry an injectable epinephrine solution. If you have these symptoms again, inject yourself with epinephrine as directed and call 911 for emergency care.