So many foods are made with milk and milk products these days that people with
milk allergies have to pay attention to what's in just about everything they eat.
And a milk allergy is not the same as lactose intolerance — some people with
food allergies can become suddenly and severely ill if they eat or even come in contact
with the food they're allergic to.
Some foods that contain milk are obvious, like pizza. But others, like baked goods,
might not be so obvious. Plus, teens need calcium
and vitamin D, which milk has lots of, because their bones
are still growing.
So what should a person who's allergic to milk do? Read on to find out.
What Happens With a Milk Allergy?
Food allergies involve the body's immune system, which normally fights infection.
When someone is allergic to a particular food, the immune system overreacts to proteins
in that food.
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.
Every time the person eats these proteins, the body thinks they are harmful invaders.
The immune system responds by kicking into high gear to fend off the "invader." This
causes an allergic reaction, in which chemicals like histamine are released in the
The release of these chemicals can cause someone to have the following problems:
itchy, watery, or swollen eyes
a drop in blood pressure
Milk allergy is like most food allergy reactions: It usually happens within minutes
to hours after eating foods that contain milk proteins.
Although it's not common, milk allergies can cause a severe reaction called anaphylaxis. Anaphylaxis may begin
with some of the same symptoms as a less severe reaction, but then quickly worsen.
A person might have trouble breathing, feel lightheaded, or pass out. If it's not
treated, anaphylaxis can be life-threatening.
Milk allergy is often confused with lactose intolerance because people can have
the same kinds of things happening to them (like stomach pains or bloating, for example)
with both conditions. But they're not related:
Milk allergy is a problem involving the immune system.
involves the digestive system (which doesn't produce enough of the enzyme needed to
break down the sugar in milk).
How Can Doctors Tell It's a Milk Allergy?
If your doctor suspects you might have a milk allergy, he or she will probably
refer you to an allergist or allergy specialist for more testing. The allergy specialist
will ask you questions — like how often you have the reaction, the time it takes
between eating a particular food and the start of the symptoms, and whether any family
members have allergies or conditions like eczema and asthma.
The allergy specialist may do a skin test on you. This involves placing liquid
extracts of milk protein on your forearm or back, pricking the skin a tiny bit, and
waiting to see if a reddish, raised spot forms, indicating an allergic reaction.
You may need to stop taking anti-allergy medications (such as over-the-counter
antihistamines) or prescription medicine 5 to 7 days before the skin test because
they can affect the results. Most cold medicines and some antidepressants also may
affect skin testing. Check with the allergist's office if you are unsure about what
medications need to be stopped and for how long.
The doctor also might take a blood sample and send it to a lab, where it will be
mixed with some of the suspected allergen and checked for IgE antibodies.
These types of tests are used for diagnosing what doctors call a fast-onset type
of milk allergy. But for people whose allergic reactions to milk develop more slowly,
skin and blood tests are not as helpful.
In these cases, doctors try to diagnose the person using a food challenge. The
person is told not to eat or drink anything made with milk for a period of time —
usually a few weeks. Then, during the challenge, the person eats foods containing
milk under a doctor's close supervision. If symptoms come back after eating milk products,
it's a pretty sure bet the person has a milk allergy.
How Is It Treated?
To treat a milk allergy, the person who is allergic needs to completely avoid any
foods that contain milk or milk products.
Avoiding milk involves more than just leaving the cheese off your sandwich. If
you are allergic to milk, you need to read food
labels carefully and not eat anything that you're not sure about. It's a good
idea to work with a registered dietitian to develop an eating plan that provides all
the nutrients you need while avoiding things you can't eat.
If you have a severe milk allergy — or any kind of serious allergy —
your doctor may want you to carry a shot of epinephrine (pronounced:
eh-peh-NEH-frin) with you in case of an emergency. Epinephrine comes in an easy-to-carry
container about the size of a large marker. It's easy to use — your doctor will
show you how.
If you accidentally eat something with milk in it and start having serious allergic
symptoms — like swelling inside your mouth, chest pain, or difficulty breathing
— give yourself the shot right away to counteract the reaction while you're
waiting for medical help. Always call for emergency help (911) when using epinephrine.
You should make sure your school and even good friends' houses keep injectable epinephrine
on hand, too.
Keeping epinephrine with you at all times should be just part of your action
plan for living with a milk allergy. It's also a good idea to carry an over-the-counter
antihistamine, which can help ease allergy symptoms in some people. But antihistamines
should be used in addition to the epinephrine, not as a replacement for the
If you've had to take an epinephrine shot because of an allergic reaction, go immediately
to a medical facility or hospital emergency room so they can give you additional treatment
if you need it. Sometimes, anaphylactic reactions are followed by a second wave
of symptoms a few hours later. So you might need to be watched in a clinic or
hospital for 4 to 8 hours following the reaction.
Living With a Milk Allergy
It can 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. 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, such as processed lunchmeats,
margarine, baked goods, artificial butter flavor, and non-dairy products. Chocolate
is another product that may contain dairy — so be sure to check the label before
you eat it.
Manufacturers of foods sold in the United States must list on their labels whether
a food contains any of the most common allergens. This means that you should be able
to find the word "milk" stated plainly in the ingredients list, in parentheses in
the ingredients list, or somewhere on the label with a statement like: "Contains milk."
It is optional, however, for food manufacturers to use "may contain" statements.
The U.S. Food and Drug Administration does not control whether companies can say things
like "Processed in a facility that also processes milk products" or "May contain milk."
So call the manufacturer to be sure if you see statements like this on a food label.
New labeling requirements make it a little easier than reading the ingredients
list — instead of needing to know that the ingredient "hydrolyzed casein" comes
from milk protein, you should be able to tell at a glance which foods to avoid. But
it's still a good idea to get to know the "code words" for milk products when you
see them in the ingredients of a food.
Vegan foods are made without animal products, such as eggs or milk. You can buy
vegan products at health food stores. Be careful to read the labels of soy cheeses,
though. They may say "milk-free" but could contain milk protein.
For your sweet tooth, soy- or rice-based frozen desserts, sorbets, and puddings
are good substitutes for ice cream (as long as you're not allergic to soy), as are
ice pops. For baking, milk substitutes work as well as milk and some come out better.
Dairy-free margarine works as well as butter for recipes and spreading on your bagel.
Try to avoid fried foods or foods with batter on them. Even if the batter doesn't
contain milk products, the oil used to fry the foods may have been used to fry something
that contains milk.
People are usually understanding when it comes to food allergies — nobody
wants to risk your health. When dining out, tell the waitstaff about anything you're
allergic to. Order the simplest foods and ask the waitstaff detailed questions about
menu items. At a friend's house, explain your situation and don't be embarrassed to
ask questions if you're staying for a meal.
Having a milk allergy doesn't mean you can't still enjoy eating. In fact, some
people think that some of the milk substitutes — like vanilla soy milk —
taste better than regular cow's milk. As with any specialized diet, you'll probably
find that avoiding milk gives you the chance to explore and discover some great foods
that you'd never have found otherwise!