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Allergy: Milk Allergy Diet (271)

Allergy: Milk Allergy Diet (271) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition


Milk Allergy Diet

Allergy to cow’s milk is more common in young children than adults. The majority of children
outgrow a milk allergy by age 5, though some may have it a lifetime. Treatment of milk allergy
is removing all milk and milk products from the diet.

Milk contains many essential nutrients including protein, vitamins A and D, and calcium. The
closest substitutions for cow’s milk are soy-based infant formulas or fortified soymilk, but there
are many milk substitutes on the market today.

Many commercial products have milk or a milk derivative in part of the food. It is important to
carefully read all product labels. The Food Allergen Labeling and Consumer Protection Act of
2004 requires manufacturers to clearly list the eight most common food allergens on product
labels. They must use the common or usual name for the allergen. Example, “milk” must be
used instead of “casein.”

Label ingredients that indicate the presence of milk protein are (though labels should
clearly state milk in common terms):

Butter or butter solids Lactalbumin (curds and whey)
Butter fat Lactoglobulin
Butter flavor Lactoferrin
Buttermilk Malted milk
Casein/caseinates (any form) Lactoalbumin phosphate
Cheese Milk protein (all forms)
Cottage cheese Nougat
Cream Pudding
Curds Rennet
Nisin Sodium caseinate
Custard Half and half
Ghee Sour cream
Whey (any form) yogurt

Foods that may indicate the presence of milk protein (the label should clearly state if the
food contains milk). If in question, call the manufacturer.

Caramel Chocolate
High protein flours Lactic acid starter culture
Lactose Cold cuts, processed meats
Margarine Non-dairy products




Protein hydrolysate formulas,
fortified soy milk, soy formulas;
rice milk, almond milk, coconut
milk, fruit juices, tea, coffee,
carbonated beverages.

Milk-based infant formulas (e.g. Good
Start , Enfamil , Similac , Lactofree
formulas ) Milk; cream; dairy creamers;
cocoa made with milk; malted milk;
chocolate or cocoa drink mixes; smoothies
made with milk or yogurt; powdered drink
mixes with milk or milk based
ingredients. “Non-dairy” creamers
or whipped toppings that contain
casein, sodium caseinate or
other milk proteins.


Plain sugar or honey candy; fruit
candy; jelly beans; licorice;

Most commercial candy; caramels;
chocolates; fudge; German chocolate;
milk chocolate; nougats.


Enriched and whole grain cereals
(cooked or dry) that are prepared
and served without milk protein.

Cereal mixes containing milk proteins;
any cereal cooked or served with milk
or cream.


Angel food cake; gelatin desserts
and ices made without milk;
fruits; any milk-free dessert
containing soy milk, fruit
juice, or water as a milk
substitute; carob or plain cocoa
powder; sponge cake; some dark
baking chocolate. Icings made
without milk or milk products.

Any dessert made with dairy products:
custard; puddings made with milk;
junket; tapioca; whipped cream
toppings; some sherbet; ice cream; cakes
and cookies with dairy products;
prepared flour mixes; baklava;
baking mixes; biscuits; cheesecake;
coffee cakes; cream-filled pastries;
cream pies; crumb mixtures;
doughnuts; pancakes made with milk
or butter; pie crusts made with butter;
popovers; sweet rolls, breads and
pastries glazed with butter.

Fats and

Shortenings; kosher margarine;
margarine made without milk
protein; vegetable oils.

Butter; margarine containing milk;
Simplesse (fat substitute).




Fresh or canned fruit served
without milk, cream, sour
cream or whipped cream.

Some commercial gelatin desserts
containing sour cream, whipped
cream, or whipped toppings.

Meat and

All meat, fish or poultry prepared
without milk or milk products.
Sausage products without milk
filler. Eggs prepared without
milk, butter or milk products.
Peanut butter. Soy or rice cheeses
(read labels, some contain milk
protein) and soy, almond,
coconut yogurts.

Any meat, fish or poultry sautéed
in butter or margarine containing
milk. Cold cuts and sausages with
milk fillers. Eggs prepared with
milk or fried in butter. Breaded or
creamed meat dishes. Meats
prepared in white sauces, Morney
or Béarnaise. Quiches, soufflés,
fondues. Cottage cheese.

Potato or

Potatoes, pasta or rice without
milk or cheese.

Mashed potatoes made with milk or cheese,
creamed or scalloped dishes;
pasta made with cheese; lasagna;
instant potatoes.

Salad and

All fruit and vegetable salads
with dressings not containing
milk or milk products. Real
commercial mayonnaise.

Yogurt or sour cream dressings.
Cooked dressings containing milk.
Salads containing cheese.


Gravy made with water or broth.

Gravy made with milk. White
sauces; béchamel; Florentine
sauce; Morney sauce; Dijonnaise
sauce; Hungarian sauce; Pasta sauces that
contain cheese.


Salt, spices and herbs; mustard;

Read labels on marinades, dips, appetizers,
spreads, sauce mixes, and gravies.




Broth soups made without butter
or margarine containing milk;
bouillon; consume; homemade
soup made without milk or
milk products.

Some canned soups; bouillabaisse;
chowders; cream soups made with
butter, cream, milk or margarine
containing milk; all canned
cream soups.


All sugars (brown, white,
powdered). Honey, jam, jelly
and syrups.


Any canned, frozen or raw
vegetable prepared without milk
or milk products.

Au gratin dishes; creamed
vegetables; any vegetable seasoned
with butter, cream, milk,
margarine containing milk, or

Formulas or Milk Substitutes
ξ Substitute formulas include the soybean formulas: Isomil , Prosobee
ξ Protein hydrolysate formulas may be acceptable to use and include: Alimentum ,
Nutramigen , Pregestimil . Amino acid based formulas are often used for milk allergies.
Neocate and Elecare are widely used amino acid based formulas.
ξ Soy formulas are well accepted by most children, especially if introduced in infancy.
ξ The nutritive value of calcium fortified commercial soymilk is almost equal to that of
cow’s milk. The infant soy milk formulas are fortified with the needed vitamins,
minerals, and essential fatty acids in specified amounts. There are many other milk
substitutes suitable for people with a milk allergy. Most are fortified with vitamin D and
Calcium. Discuss alternatives best suited for you with your doctor or dietitian.

Tips and Substitutions
ξ A small number of milk-sensitive individuals may also become allergic to soy protein.
ξ If buying “deli” meats, ask about what other products are cut on the slicers to reduce
cross contamination.
ξ Be clear about your allergy and ask how foods are prepared at restaurants. It is a good
idea to ask if they have a separate grilling space or fryer or if your item will be cooked
near or in an area where milk might be used. If you are not sure it will be safe, avoid
ordering the food or choose a restaurant that is more able to accommodate your requests.
ξ Blenderize fruit and non dairy yogurt to make a smoothie. Use applesauce on hot cereal.
ξ Use a milk substitute on cereal.
ξ Look for non dairy substitutes for sour cream and cheese. Tofutti® and Daiya® are two
common brands.
ξ Calcium fortified orange juice has approximately the same calcium content as milk but
does not contain all the other nutrients that milk offers. It is not a suitable substitute for

Tips to Follow to Prevent an Allergic Reaction

1). Avoid foods that cause a reaction. Sometimes just touching foods can cause a severe reaction.
Remember to wash hands if handling foods with milk.
2). Read the ingredients lists on food labels each time you purchase them to make sure
ingredients have not changed as they often can.
3). If you are traveling, bring along some of your own special foods. Make sure to wipe the area
where you will be eating to avoid cross contamination.
4). When eating out, always ask restaurant staff about ingredients in food and how it was
prepared. Tell them about your allergy. Sometimes it is best to ask to speak with the
manager as well.
5). For infants, elemental formulas or formulas with broken down proteins should prevent food
reactions. Discuss the various formula options with your doctor or dietitian. Do not assume
products labeled "hypoallergenic" will not cause a reaction.

Other Resources
Food Allergy Association of Wisconsin- www.foodallergywis.org or 608-575-9535
Food Allergy and Anaphylaxis Network – http://www.foodallergy.org or 1-800-929-4040
Medline Food Allergy Resource Page - http://www.nlm.nih.gov/medlineplus/foodallergy.html
Kids With Food Allergies- www.kidswithfoodallergies.org
Living Without Magazine and website- www.livingwithout.com
Allergic Child- www.allergicchild.com

Nutrition recommendations:
Age appropriate “milk substitute” beverage:__________________________________________
Multivitamin/Calcium Recommendations:____________________________________________

The Spanish version of this Health Facts for You is #466

Teach Back:

What is the most important thing you learned from this handout?

What changes will you make in your diet/lifestyle, based on what you learned today?

If you are a UW Health patient and have more questions please contact UW Health at one of the
phone numbers listed below. You can also visit our website at www.uwhealth.org/nutrition

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s
Hospital (AFCH) can be reached at: (608) 890-5500.

Nutrition clinics for UW Medical Foundation (UWMF) can be reached at:
(608) 287-2770

Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 1/2015 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department and the Department
of Nursing. HF#271