HEALTH INSIGHTS

When Your Child Has a Food Allergy: Milk

May 26, 2019

When Your Child Has a Food Allergy: Milk

Foods containing milk.

When a child has a milk allergy, even a small amount of milk can cause a serious reaction. For that reason, your child must stay away from dairy products and any foods likely to contain milk. Make sure you know:

  • About milk allergy

  • What foods to stay away from

  • What to look for on food labels

  • How to prepare dairy-free meals

Foods to stay away from

Children with milk allergies should not eat any dairy foods, including:

  • Butter. Also some margarines, butter substitutes, and spreads. Some "nondairy" spreads, including margarine, contain whey, a milk protein.

  • Cheese. Cheese made from rice or soy may also contain casein, a milk product.

  • Cream, sour cream, half-and-half, and some "nondairy" creamers

  • Ice cream, frozen yogurt, and sherbet

  • Milk. This includes whole, low-fat, skim, evaporated, condensed, powdered, buttermilk, and goat's milk.

  • Yogurt

The following foods often contain milk.

Desserts

  • Baked goods, such as cakes, muffins, and some cookies and pies

  • Puddings, custards, and cream sauces

  • Eggnog, milkshakes, and malts

  • Candy made with milk, such as fudge, caramel, and nougat

Meats, other meat dishes

  • Meatloaf, breaded meats, and meats containing casein, a milk protein

  • Many processed meats, including hot dogs, sausages, and luncheon meats

  • Canned tuna containing casein

  • Cream soups, bisques, and chowders

  • Pizza

Starches

  • Pancakes, waffles, and french toast

  • Some boxed cereals or precooked cereals

  • Some breads

Vegetables

  • Frozen vegetables in sauce

  • Buttered, creamed, scalloped, or au gratin vegetables

  • Mashed, au gratin, creamed, and scalloped potatoes. Some french fries may contain lactose, a milk sugar.

Other foods

  • Salad dressings or mayonnaise containing milk, milk solids, or milk products

  • Caesar salad and Caesar dressing. These often have Parmesan cheese.

  • Some high-protein flours and protein powders

Medicines

  • Vitamins and medicine in pill form. Pills often contain lactose as a filler.

  • Some dry-powder inhalers used to treat asthma

What to look for on labels

Food labels can be misleading. “Nondairy” foods often contain milk proteins such as casein and whey. And kosher foods labeled “pareve” may have traces of milk from processing. Pareve means the food doesn't contain meat or dairy products. Read labels carefully, and stay away from products that contain:

  • Casein or caseinates

  • Hydrolysates

  • Lactalbumin or lactalbumin phosphate

  • Lactoglobulin

  • Lactose

  • Rennet casein

  • Whey or whey protein

Allowed foods

These foods are safe for children with milk allergies:

  • Boxed pastas, such as macaroni and spaghetti

  • Breads made without milk

  • Fresh and frozen fruits and vegetables

  • Fresh, frozen, or canned fruit and vegetable juices

  • Grains, such as rice, wheat, barley, and oats

  • Meat, chicken, and fish cooked without butter or other milk products. Precooked meats such as ham may contain lactose.

  • Noncream soups

  • Peanut butter and other nut butters made without milk solids

  • Rice, soy, and nut milks. These are found in most natural food stores and some grocery stores.

  • Sauces that don’t contain milk or cream, such as spaghetti sauce

  • Tofu and other soy products

  • Vegetable oils

  • White or sweet potatoes cooked and served without butter or milk

Cooking without milk

Try these tips for making your favorite recipes without dairy products:

  • In baking, substitute equal amounts of water, fruit juice, rice milk, or soy milk for cow’s milk.

  • Use three-quarter cup applesauce for every cup of butter called for in baked goods, or use a butter substitute made from soy.

  • Use chicken broth for cream in sauces and soups, or puree foods for a creamy texture.

  • Dress potatoes, vegetables, and grains with olive oil, vegetable oil, or soy lecithin spread instead of butter.

Your child needs calcium

Ask your healthcare provider about calcium or vitamin D supplements for your child. Be aware some will contain milk, so be sure to read the labels. These foods are good sources of calcium:

  • Calcium-fortified orange juice

  • Canned salmon (with bones) and sardines

  • Cooked dried beans

  • Enriched soy milk and rice milk

  • Soy yogurt

  • Tofu

  • Turnip greens, kale, broccoli, and cabbage

If your child has any of the symptoms listed below, act quickly!

If an epinephrine auto-injector has been prescribed, use it right away. Then call 911.

  • Trouble breathing or a cough that won’t stop

  • Swelling of the mouth or face

  • Dizziness or fainting

  • Vomiting or severe diarrhea

Updated:  

May 26, 2019

Sources:  

Guidelines for the Diagnosis and Management of Food Allergy in the US: Report of the National Institute of Allergy and Infectious Diseases. Boyce J. The Journal of Allergy and Clinical Immunology. 2010;126(6):s1-s58.

Reviewed By:  

Deborah Pedersen MD,Amy Finke RN BSN,Daphne Pierce-Smith RN MSN CCRC