Avoidance of milk or items containing milk products is the only way to manage a milk allergy. People who are allergic to milk and the parents of children who have this allergy must read ingredient labels very carefully.
Milk is one of eight allergens with specific labeling requirements under the Food Allergen Labeling and Consumer Protection Act of 2004. That law requires manufacturers of packaged food products sold in the U.S. and containing milk as an ingredient to include the presence of milk or milk products, in clear language, on the ingredient label.
There are two main types of milk protein — casein and whey. Casein, the “solid” part of milk, comprises about 80 percent of milk protein. Whey proteins, found in the liquid part of milk, make up the other 20 percent. Milk proteins are found in many foods, including all dairy products, and in many places where they might not be expected. For example, some canned tuna, sausage, meats and other nondairy products may contain casein. Beverage mixes and body-building and energy drinks commonly contain whey. Milk protein has also been found in some chewing gum.
Some companies may voluntarily include information that their food products “may contain traces of milk” or that they are manufactured in a facility that also processes milk, though such advisory statements are not required by law.
Allergies to food (including milk) are the most common causes of anaphylaxis, a potentially life-threatening allergic reaction. Symptoms include swelling of the airways, impairing the ability to breathe, and a sudden drop in blood pressure, causing dizziness and fainting. An allergist will advise patients with a food allergy to carry an auto-injector containing epinephrine (adrenaline), which is the only treatment for anaphylactic shock, and will teach the patient how to use it. If a child has the allergy, teachers and caregivers should be made aware of his or her condition as well.
Some people with this allergy can tolerate foods containing milk that has been extensively heated, such as a baked muffin. Still, people with an allergy to milk protein should consult an allergist before determining whether they should completely avoid milk and other dairy products.
Milk is a fairly easy ingredient to substitute in recipes. Most recipes calling for milk can be just as successful by substituting the equivalent in water, juice, or soy or rice milk. If your infant is allergic to milk, talk to your pediatrician about which formula to use. Often, an extensively hydrolyzed elemental formula or a casein-hydrolysate formula is recommended for milk allergy in infants, as the proteins in these formulas have been extensively broken down. Alternatively, your infant’s doctor may recommend a soy-based formula.
Milk allergy or lactose intolerance?
People with a milk allergy experience symptoms because their immune system overreacts as though milk were a dangerous invader. Individuals who have lactose intolerance cannot digest the milk sugar (lactose) because they have a deficiency of lactase, the enzyme in the lining of the gut required to metabolize lactose. The lack of this intestinal enzyme leads to reactions such as abdominal gas, diarrhea or abdominal cramps. Milk allergy and lactose intolerance are not related.