What is a milk allergy?
A milk allergy occurs when the body reacts to one or more of the proteins in cow’s milk.
How serious is a milk allergy?
Milk allergy reactions are different for each child, but they usually happen soon after your child consumes milk. A milk allergy can sometimes cause anaphylaxis, a severe and life-threatening allergic reaction.
Other names for milk
Milk can have many names in ingredient lists. Learning these names can help you catch any hidden sources of milk in food.
When buying packaged foods, always check the list of ingredients in the store and again when you bring the product home. It is also a good idea to check the ingredients every time you buy the food in case the recipe has changed. You can also call the manufacturer to ask about any recipe changes.
The following table provides a list of some names for milk. Use it when you are grocery shopping or calling food manufacturers.
| Casein or caseinate (also, ammonium/ calcium/ magnesium/ potassium/ sodium caseinate) | Dried milk |
| Hydrolyzed casein, hydrolyzed milk protein | Lactate/lactose |
| Lactoferrin/lactoglobulin/lactalbumin | Milk protein/solids |
| Modified milk ingredients | Rennet |
| Whey (delactosed, demineralized) | Whey protein concentrate |
Possible sources of milk
Milk is used in a range of packaged foods and drinks. Below is a list of some of the many food products that contain milk.
| Artificial butter, butter fat, margarine | Baked goods and baking mixes (including bread, cookies, cake mixes, donuts or pancakes) |
| Buttermilk, cream, dips, dressings, sour cream, spreads | Canned tuna |
| Caramel colouring/flavouring | Cereals, crackers |
| Cheese, cottage/soy cheese | Dessert (custard, pudding, sherbet) |
| Egg/fat substitutes | Flavoured coffee, coffee whitener |
| High-protein flour | Glazes, nougat |
| Gravy, sauces | Meats (deli meats, hot dogs) |
| Non-dairy products (kosher food) | Prepared potatoes (instant/mashed, scalloped) |
| French fries, potato chips | Seasonings |
| Snack foods (candy, chocolate, fruit bars, granola bars) | Soups, soup mixes |
| Soy products (soy cheese, tofu) |
What do I do if my child has a milk allergy?
Your child should see an allergist (a doctor who specializes in diagnosing and treating allergies) who can discuss the milk allergy with you in more detail. Children who have a milk allergy should avoid all products that may contain milk. Some children who have a milk allergy are able to safely eat baked goods containing milk. If your child has a milk allergy, you should consult with an allergist before giving your child baked goods containing milk.
Your child’s doctor may also prescribe a medication called an epinephrine autoinjector, which can be used to treat allergic reactions, in case your child accidentally eats a food containing milk.
What type of milk can my infant have if they are allergic to cow’s milk?
Breastfeeding is the best way to feed an infant. If your infant is already breastfed, this can continue even if they have been diagnosed with a milk allergy. However, the rest of your infant's diet should not include cow’s milk or milk ingredients.
If your infant is not breastfed, they can take a soy-based infant formula. If they have an allergy to soy and to cow’s milk, a doctor or dietitian will recommend a hydrolyzed (completely broken down) formula to meet your infant’s needs.
Always speak with your doctor or dietitian about your infant’s food allergies and what option is best for you and your infant.
Reducing the risk of cross-contamination
Cross-contamination occurs when one substance unintentionally comes in contact with another substance, for example a potential allergen. If the substances mix together, one substance taints the other substance, making it unsafe to eat.
Food allergens can contaminate other foods when, for example, the same containers, utensils or frying pans hold a range of foods.
Bulk food containers pose a high risk of cross-contamination because they are often used for different products.
Be sure to avoid using utensils or containers that may have come in contact with allergy-causing foods and ask about possible cross-contamination when eating out.
How can my child get the right mix of nutrients if they must avoid milk?
Milk and milk products are rich in calcium, a mineral that helps bones stay strong and healthy. Children who are allergic to milk can have non-dairy calcium-rich foods instead of milk and milk products. This table lists some examples.
Non-dairy sources of calcium
| Food or drink | Serving size | Approximate calcium content |
|---|---|---|
| Almonds | 1/4 cup | 90 mg |
| Bok choy, boiled | 1 cup | 160 mg |
| Broccoli, boiled | 1 cup | 55 mg |
| Orange juice, calcium fortified | 1 cup | 300 mg |
| Salmon, canned, with bones | 4 oz | 175 mg |
| Sardines, canned, with bones | 4 medium | 180 mg |
| Soy beverage, fortified | 1 cup | 300 mg |
| Tahini (100% crushed sesame seeds) | 3 tbsp | 190 mg |
| White beans, boiled | 1 cup | 170 mg |
It is important that children also eat foods rich in vitamin D. This vitamin helps the body absorb calcium. Vitamin D-rich foods include egg yolks, fish, liver, fortified margarines and soy drinks.
When to see a dietitian for a milk allergy
If you have removed many foods from your child’s diet because of a milk allergy, it may be a good idea to speak to a registered dietitian. The dietitian can review the foods your child eats to decide if they are getting enough calcium and vitamin D. They can also let you know if your child needs a milk-free calcium and vitamin D supplement.
Will my child always have a milk allergy?
A milk allergy is one of the most common food allergies in infants, but most children outgrow it as they grow older.
An allergist can help you find out when to test your child and see whether they have outgrown their allergy. Consult them regularly to check if there have been any changes to your child's food allergy.
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For more videos from SickKids experts in collaboration with Youngster, visit Youngster on YouTube.
When to go the emergency room
If your child is having a severe allergic reaction to milk, call 911 or go to your nearest emergency department immediately. If your child’s doctor prescribed them an epinephrine autoinjector, administer this medication to your child right away. See Anaphylaxis: How to recognize and respond to a severe allergic reaction for more information.
Further information
Health Canada. Milk – A priority food allergen