MILK ALLERGY
Milk Allergy
You're allergic to milk. Maybe you're wondering what that really means. Is it like your friend who's lactose intolerant? And is it really a big deal? After all, it's not like you're a little kid who needs milk to grow, right?
A milk allergy can be a big deal because milk is in lots of foods. Some are obvious, like pizza, and others may not be so obvious, like baked goods. If someone who has a milk allergy eats any of these foods, they can make the person sick. Plus, teens do need calcium and vitamin D, which milk has lots of, because their bones are still growing. So how can a person who's allergic to milk deal with the allergy? Read on to find out.
What Is a Milk Allergy?
People who are allergic to cow's milk react to one or more of the proteins in it. Curd, the substance that forms chunks in sour milk, contains 80% of milk's proteins, including several called caseins (pronounced: kay-seenz). Whey (pronounced: way), the watery part of milk, holds the other 20%. A person may be allergic to proteins in either or both parts of milk, but whey is responsible for most problems.
When a person who is allergic to milk ingests milk or a food that contains milk products, the body's immune system mistakenly sees the milk proteins as dangerous "invaders" and tries to fight them off. It starts an allergic reaction that involves the release of chemicals called histamines (pronounced: his-tuh-meenz) from some of the body's cells and the production of immunoglobulin E (IgE) antibodies to fight the proteins. This reaction can make a person feel sick.
A milk allergy usually starts when an infant is given formula and has a reaction. Up to 7% of babies and toddlers are allergic to milk, but most outgrow the allergy within the first 6 years of life. Some kids never outgrow it, however.
Signs and Symptoms
The symptoms of milk allergy can occur within minutes (this is called a fast-onset type of milk allergy) or several hours or more after eating or drinking something containing milk protein. Symptoms can include runny nose, hives (itchy bumps on the skin), facial swelling, wheezing and other breathing problems, irritability, vomiting, diarrhea, and eczema (an itchy, scaly rash).
People often confuse milk allergy with lactose intolerance because the two can share some symptoms. But the conditions are not related. Milk allergy is a problem involving the immune system, whereas lactose intolerance involves the digestive system. When someone is lactose intolerant, it means that his digestive system doesn't produce enough of the enzyme needed to break down the sugar in milk. The sugar ends up fermenting in the small intestine, which can lead to nausea, cramps, bloating of the abdomen, gas, and diarrhea.
How Is an Allergy to Milk Diagnosed?
People who have the fast-onset type of milk allergy, in which the body reacts almost immediately, often can be diagnosed with a blood or skin test that detects IgE antibodies to milk protein. The skin test involves placing bits of milk protein on the forearm, scratching the skin, and waiting to see if a reddish, raised spot forms, indicating an allergic reaction. For the blood test, a sample of blood will be analyzed in a laboratory to look for the antibodies.
But for people who have the slower-developing form of milk allergy, skin and blood tests are not as helpful. In these cases doctors try to make a diagnosis based on dietary elimination. The person is told not to eat or drink anything made with milk for a period of time. If the person is symptom free during this trial, the doctor can diagnose a milk allergy fairly confidently. And if the person has a reaction when he begins eating products containing milk again, the diagnosis is confirmed.
How Is It Treated?
To treat a milk allergy, the person who's allergic needs to completely avoid any foods that contain milk or milk products. Babies diagnosed with the allergy can be switched to a soy or hypoallergenic formula relatively easily. For older kids and teens, though, cutting out favorite treats like ice cream, pizza, and many sweets can be a drag. But avoiding milk involves more than just leaving the cheese off your cheese fries. If you are allergic to milk, you need to read food labels carefully and not eat anything that's questionable. It may sound hard, but there are many milk substitutes available as well as foods that can give you plenty of calcium and vitamin D.
Some people who are allergic to milk can have a severe reaction to even the smallest exposure to milk proteins. For them, just inhaling the powder in powdered milk might be dangerous enough to bring on an anaphylactic (pronounced: ah-nuh-fuh-lak-tik) reaction. Anaphylaxis can cause a person's blood pressure to drop, airways to narrow, and tongue to swell, resulting in serious breathing difficulty and, in some cases, death.
If you're one of these people, you should probably keep a shot of epinephrine (pronounced: eh-puh-ne-frin) in an easy-to-carry container that looks like a pen with you in case of an emergency. If you accidentally ingest milk protein and have an anaphylactic reaction, you can give yourself the shot to help counteract it. Make sure your school and close friends' houses each have injectable epinephrine on hand, too.
Living With a Milk Allergy
It may be challenging to eliminate milk from your diet, but it's not impossible. Because most people don't get enough calcium in their diets even if they do drink milk, many other foods are now enriched with calcium, such as juices, cereals, and rice and soy beverages. These are good substitutes for dairy foods, and they're tasty, too. But before you eat or drink anything calcium enriched, make sure it's also dairy free.
Milk and milk products can lurk in strange places. For instance, be sure to check the labels of processed meats and "non-dairy" products. And for anything made with chocolate, be sure to check if it contains dairy products.
Look for these ingredients on food labels and avoid them. In some cases, you may need to check with the product's manufacturer to be sure:
- ammonium caseinate
- artificial butter flavor
- butter
- butter fat
- butter solids/fat
- butter oil
- buttermilk
- calcium caseinate
- caramel color
- caramel flavoring
- casein
- caseinate
- cheese
- condensed milk
- cottage cheese
- cream
- cream curds
- custard
- delactosed whey
- demineralized whey
- dry milk
- dry milk solids
- evaporated milk
- flavoring (this may contain milk products, so make sure it is dairy free)
- ghee
- goat's milk
- half-and-half
- high protein flour
- hydrolysates
- hydrolyzed casein
- hydrolyzed milk protein
- iron caseinate
- lactalbumin
- lactalbumin phosphate
- lactate
- lactic acid
- lactoferrin
- lactoglobulin
- lactose
- lactulose
- low-fat milk
- magnesium caseinate
- malted milk
- margarine (this may contain milk products so make sure it is dairy free)
- milk
- milk derivative
- milk fat
- milk powder
- milk protein
- milk solids
- natural flavoring
- nonfat milk
- nougat
- opta
- potassium caseinate
- powdered milk
- protein (this ingredient could be milk protein so check to be sure)
- rennet casein
- Simplesse
- skimmed milk
- sodium caseinate
- sour cream
- sour cream solids
- sour milk solids
- whey
- whey powder
- whey protein concentrate
- whey protein hydrolysate
- whole milk
- yogurt
- zinc caseinate
After looking at this list, you may wonder what someone who's allergic to milk can eat. To help answer that question, it's important to talk with a registered dietitian. He or she will help you substitute other foods for dairy products to make sure you get all the nutrition you need and still enjoy your meals and snacks.
Reviewed by: Susan Konek, MA, RD, CSP
Date reviewed: March 2003
