All About Food Allergens: Milk

A food allergy causes a reaction of the immune system that affects multiple organs. Food intolerance symptoms typically are not life-threatening and may include intestinal discomfort (pain, gas, diarrhea). A person with a milk allergy must avoid all milk-containing foods.

On the other hand, a person with lactose intolerance lacks an enzyme to digest the sugar in milk (lactose). This is different from a milk allergy. Typically, those with lactose intolerance can drink lactose-free milk or take a lactase enzyme pill before they consume foods containing lactose. Some people with lactose intolerance tolerate cheese or smaller amounts of milk (such as 1 cup) with meals.

• Hives
• Wheezing or impaired breathing
• Vomiting
• Loose stools that may contain blood
• Diarrhea
• Abdominal cramps
• Itchy skin rash (commonly around the mouth)

• Butter or butter products
• Casein, whey or milk protein products
• Cheese, cottage cheese, sour cream
• Creams, custards and puddings
• Lactose, lactulose, lactoferrin
• Milk or milk products
• Yogurt

If you are allergic to milk, look for “contains milk or milk products” after the ingredient list on food labels. If you are at a restaurant, make sure the staff are aware of your allergy so they can show you options that are safe for you to eat. If you are unsure if a product contains milk, do not eat it.

Note: People allergic to cows’ milk often need to avoid milk from other domesticated animals such as goats because goats’ milk protein is similar to cows’ milk.

The amount of milk needed to cause an allergic reaction can vary for each individual. Sometimes consuming trace amounts can cause people to have an allergic reaction, but in more severe cases, even skin contact with dairy can cause an allergic reaction.

Symptoms of a milk allergy can occur within minutes or up to a few hours after eating a food. Sometimes two sets of symptoms may appear. First, a symptom may occur and then go away after a while, but then a more severe reaction may occur hours after the first.

A variety of new codes and standards have been set for food manufacturing. These businesses must avoid cross-contact of foods. Many labels state the other foods made in the factory. Restaurants may label their menu with items free of certain allergens.

Severe reactions require immediate medical intervention, so call 911. Epinephrine is the first-line treatment for anaphylaxis, a rare but severe whole-body allergic reaction that causes severe symptoms, including tightening of the airway. After a food allergy diagnosis is made, your allergist likely will prescribe an epinephrine auto-injector and teach you how to use it.

Key to abbreviations:

c. = cup

Tbsp. = tablespoon

tsp. = teaspoon

g = gram

mg = milligram

*These recipes are prepared without cows’ milk; “milk” derived from almonds is used as a substitute. Note: Be sure to check the ingredient statements on food package labels to avoid allergens in these recipes.

Visit the U.S. Department of Agriculture Food and Nutrition Information Center at https://www.nal.usda.gov/legacy/fnic/allergies-and-food-sensitivities.

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