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Allergy: Milk & Soy Elimination Diet (580)

Allergy: Milk & Soy Elimination Diet (580) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Nutrition


Milk & Soy Elimination Diet

The only known treatment for a person with food allergies or protein intolerance is to
avoid foods that contain the allergen. Allergy to cow’s milk is more common in young
children than adults. A milk “allergy” can happen very fast. Reactions come on quickly.
The symptoms include fussiness, vomiting, wheezing, swelling, hives, itchy skin rashes,
and blood in the stool. If the child has milk protein intolerance, the reactions are slower.
The infant may be irritable, have reflux, stooling issues (may contain blood), vomiting,
gagging, be refusing food, and have eczema.

If a child has milk protein allergy or protein intolerance, he or she may also have soy
protein allergy or intolerance. Most children outgrow milk protein intolerance by 1-2
years and a milk allergy by age 5. For some, it may last longer. In infants and children
who are breastfed, the mother must watch her own intake as well as her child’s.

Foods now list ingredients that are common allergens, including milk and soy. You still
need to review all ingredients on food labels. Many products may have byproducts of
milk or soy. Below is a list of foods and ingredients that have milk or soy protein.

Food and Ingredients that contain Milk or Soy protein:
ξ Butter or Butter solids
ξ Butter fat (Milk)
ξ Butter flavor (Milk)
ξ Buttermilk (Milk)
ξ Casein/Caseinate
ξ Cheese (Milk)
ξ Cottage cheese (Milk)
ξ Cream (Milk)
ξ Curds (Milk)
ξ Custard (Milk)
ξ Edamame (Soy)
ξ Ghee (Milk)
ξ Half & Half (Milk)
ξ Hydrolyzed vegetable
protein (Soy)
ξ Kinnoko flour (Soy)
ξ Kyodofu, Freeze-dried
tofu (Soy)
ξ Lactalbumin (Milk)
ξ Lactalbumin
ξ Lactoglobulin (Milk)
ξ Lactoferrin (Milk)
ξ Malted milk (Milk)
ξ Milk protein, all (Milk)
ξ Miso (Soy)
ξ Natto (Soy)
ξ Nisin (Milk)
ξ Nougat (Milk)
ξ Okara, Soy pulp (Soy)
ξ Pudding (Milk)
ξ Rennet (Milk)
ξ Sodium caseinate
ξ Sour Cream (Milk)
ξ Soy beans (Soy)
ξ Soy concentrate (Soy)
ξ Soy curds (Soy)
ξ Soy flour (Soy)
ξ Soy granules (Soy)
ξ Soy grits (Soy)
ξ Soy nuts (Soy)
ξ Soy milk (Soy)
ξ Soy sauce (Soy)
ξ Shoyu sauce (Soy)
ξ Soy sprouts (Soy)
ξ Soy yogurt/cheese
ξ Supro (Soy)
ξ Tamari (Soy)
ξ Tempeh (Soy)
ξ Teriyaki Sauce (Soy)
ξ Textured soy protein
ξ Textured vegetable
protein, TVP (Soy)
ξ Tofu (Soy)
ξ Whey, any form (Milk)
ξ Yakidofu (Soy)
ξ Yuba (Soy)
ξ Yogurt (Milk)

Most people who are allergic to soy can safely eat highly processed soybean oil and soy lecithin.
These are common ingredients in processed foods. Soy will be clearly labeled in the ingredient
list or just below the list in a “contains statement.” It is fairly easy to see if a product contains
soy. Be sure to ask your doctor or registered dietitian if you have questions about these

Food and Ingredients that are safe to eat (“Can Eat”) and those not safe to eat (“Avoid”)

Food Group Can Eat Avoid
Beverages Coffee; tea; fruit juices; carbonated
beverages; vegetable juices; rice
milk; almond milk; hemp milk; oat
milk; flax milk.
Coffee substitutes; drink mixes; non-
dairy creamers; soymilk. Milk- or soy-
based formulas; Milk; cream; dairy
creamers; cocoa made with milk; malted
milk; chocolate or cocoa drink mixes;
powdered drink mixes with milk or milk
based ingredients. “Non-dairy” creamers
or whipped toppings that contain casein,
sodium caseinate or other milk proteins.
Bread Breads, crackers, rolls, waffles, and
pancakes that do not contain milk
or soy flours or milk or soy
Commercial baked goods containing
soybean flour or soy nuts.
Food Group Can Eat Avoid
Cereal Enriched and whole grain cereals
(cooked or dry) that are prepared
and served without milk or soy
protein, such as unflavored oatmeal
or cream of wheat. Commercial
cereals that do not contain milk or
soy protein.
Processed breakfast cereals that contain
milk or soy protein or are served with
milk, soy, or cream.
Dessert Desserts made without milk or
soy products including: Angel
food cake, cookies, frostings, fruit
pies, gelatin, Italian ices, pastries,
ice or juice based popsicles, sauces,
sorbet, sponge cakes, fruit based
tapioca puddings, and toppings.
Carob or plain cocoa powder.
Any dessert made with milk or soy
products: milk chocolate, custard;
puddings made with milk; junket; milk
based tapioca puddings; whipped cream
toppings; sherbet; ice cream; cakes and
cookies; 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
Fats, Oils &
Salad Dressings
All vegetable oils, most vegetable
Milk and Soy-free Salad dressings.
Butter; margarine containing milk;
Commercial salad dressings that contain
soy; Fats containing soy protein.

Food Group Can Eat Avoid
Fruit Fresh, cooked, canned, or dried
fruits served without milk, cream,
sour cream, yogurt or whipped
Fruits in fritter, cobblers, and dumplings
containing milk or soy; fruits in sauces
with milk or soy.
Meat & Meat
Plain meats, poultry, fish and eggs;
All plain nuts and seeds except for
soy nuts.
Textured vegetable protein; meat
extenders; soy nuts. Commercial frozen
meat patties, hamburger extenders,
lunchmeats, sausage, meat loaf and ALL
cheeses and yogurt. Soy
beans/Edamame, soy cheese, soy yogurt.
Meats prepared in white sauces, Morney
or Béarnaise. Quiches, soufflés, fondues.
Cottage cheese.
Potato & Pasta Potatoes; rice; milk and soy free
noodles and pastas.
Milk and Soy containing potatoes,
instant potatoes, macaroni, noodles,
spaghetti, lasagna or other pasta;
commercial pasta in sauces.
Sauces &
Pure spices and herbs.
Gravy made with water or broth.
Mixed spices containing milk, soy, soy
Gravy made with milk. White sauces;
béchamel; Florentine sauce; Mornay or
Bearnaise sauce; Hungariansauce.
Soups Homemade broth soups made
without butter or margarine; noodle
soups made with milk and soy free
Many commercial soups, canned and dry
mixes: bouillabaisse; chowders; cream
soups made with butter, cream, milk or
margarine containing milk; all canned
cream soups and noodle soups; miso
soup; soups containing tofu.
Sweets All sugars; honey, jam, jelly and

Vegetables Fresh, frozen or canned vegetables
prepared without milk or soy.
Soy sprouts. Commercially prepared
vegetables that are breaded or contain
soy sauce; canned or frozen Asian style
vegetables; canned and frozen vegetables
in any kind of sauce that contains milk or

Infant Formulas or Milk Substitutes:
ξ Protein hydrolysate formulas may be okay to use for cow’s milk protein intolerances.
These include: Alimentum®, Nutramigen®. Ask a health care provider.
ξ Amino acid based formulas are often used for milk allergies. These include: Alfamino
Infant®, Neocate® Infant and Elecare® Infant.

Tips and Substitutions:
ξ Avoid buying “deli” meats, because the slicers often are used to cut both meat and cheese
ξ Ask how foods are prepared at restaurants. The meats may have been marinated or the
buns grilled in butter.
ξ Calcium fortified orange juice has about the same calcium content as milk.
ξ Make sure milk substitutes such as almond or rice are enriched with calcium and vitamin
ξ Read the ingredient lists on food labels to make sure allergy-causing foods are not
present. Read the list even if you have had the product before. Ingredients may change.
ξ If you are traveling, bring along some of your own special foods.
ξ Infants may need protein hydrolysate or elemental formulas to prevent food reactions.
Discuss the formula options with your doctor or dietitian. Do not assume products labeled
"hypoallergenic" will not cause a reaction.
ξ Contact food companies if you are unsure of any ingredient on the label.
ξ The breast feeding mother, who has no allergies of her own and has a child with “cow’s
milk protein intolerance,” may use products that have no added milk. They may be
labeled with a “produced in a factory with milk” statement. For example, she may eat
dark Belgium chocolate.

In cooking, you can use these substitutes for soybean products:
ξ For soy flour, use wheat, rice, oat, barley, or potato flour.
ξ For soymilk, use rice or potato milk or any formula that does not contain milk or soy.
ξ For soy miso, use barley, plum or rice miso.
ξ For soy sauce, use pure concentrated beef or chicken broth or flavored salts.

Other Resources:
ξ Food Allergy Association of Wisconsin: www.foodallergywis.org
ξ Food Allergy and Anaphylaxis Network: www.foodallergy.org
ξ Kids With Food Allergies: www.kidswithfoodallergies.org
ξ Living Without Magazine and website: www.livingwithout.com
ξ Allergic Child: www.allergicchild.com

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 © 9/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Clinical Nutrition Services Department and the Department
of Nursing. HF#580