Milk Allergy

Cows’ milk allergy - affects around 2-5% of (2-5 in every 100) infants and young children who usually start to have symptoms in their first few months. This causes many health problems and is frequently not diagnosed, or takes many months to be diagnosed.

Most children outgrow milk allergy by five years of age so only about 1 in 1000 older children and adults have true milk allergy.


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Milk and dairy foods are an important part of our diet, providing many nutrients including proteins, minerals and vitamins essential for growth, bone and dental health. It is therefore important that if you think that you or your baby may be allergic to cows’ milk, you speak to a GP or Health Visitor about it.

Cows’ milk and dairy foods are essential in babies and young children. Any child with a potential food allergy must be seen by an Allergy Specialist for an accurate diagnosis and to ensure the child’s diet remains adequate and the allergy is managed appropriately. See our factsheet Does my child have a Cows' Milk Allergy for more information.

 

Cows' milk-free diet

If a child or adult needs to avoid cows’ milk, remember that it may be present in many foods, such as:

  • Milk
  • Milk Powder
  • Milk drinks
  • All types of cheese
  • Butter
  • Margarine
  • Yogurt
  • Cream
  • Ice cream

Food labels that list any of the ingredients below also contain some cows’ milk or products in them.

  • Casein
  • Caseinates
  • Hydrolysed casein
  • Skimmed milk
  • Skimmed milk powder
  • Milk solids
  • Non-fat milk
  • Whey
  • Whey syrup sweetener
  • Milk sugar solids
  • Lactose

The following are examples of processed foods which may contain milk:

  • Breakfast cereals
  • Soups
  • Baby foods
  • Processed meats, e.g. sausages
  • Pasta and pizzas
  • Instant mashed potato
  • Sauces and gravies
  • Baked goods, e.g. rolls
  • Pancakes, batters
  • Ready made meals
  • Puddings and custards
  • Cakes, biscuits, crackers
  • Chocolate/confectionery
  • Crisps

Note: This list includes just some of the foods to be avoided in a milk free diet. Before any changes are made to you or your child's diet, seek advice from a dietitian.

Cows' milk is an important source of calcium. If my baby must avoid cows' milk, will he get enough calcium?

Soya baby milks are fortified with calcium, and one pint will provide about 60% of the daily requirement for calcium for babies under one year.The balance of the calcium must be obtained from milk free foods at weaning. Occasionally, calcium supplements may be necessary if a baby is not taking a sufficient amount of soya baby milk and calcium rich solids. If you are concerned about your baby's calcium intake, ask your dietitian or doctor for advice.

We prefer a vegetarian diet. Can we give our baby a soy formula instead of a formula based on cows milk?

Yes, although soya formula is mainly given to babies with cows’ milk intolerance, it is free from animal products. So, parents who prefer to give their babies a vegetarian diet can use it.

A small number of children will react to soya formula and thus will need to be prescribed a non-milk, non-soya formula for feeding. If you suspect this, please contact your general practitioner or specialist.

If you or your child is milk allergic then specialist advice is required because although some children do "outgrow" their allergy not all will. If one has had a serious reaction, then potentially another could occur. If in doubt contact your specialist or GP. Pure lactose does not contain any milk protein and therefore will not produce any allergic reaction.

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Lactose Intolerance

This is a relatively common condition, up to one in ten Eurasian people will suffer symptoms suggestive of lactose intolerance, although it is present in the majority of some African and Asian populations. This is not an allergic condition, but an inability to digest lactose (milk sugar) because the body produces low levels of lactase, the enzyme responsible for digesting lactose. It can affect both children and adults, and the common symptoms are diarrhoea, bloating, discomfort. Lactose intolerance may occur temporarily following a bout of gastroenteritis, with diarrhoea being the main symptom. Lactose is present in cow’s milk, goat’s milk and sheep’s milk in similar quantities As with all intolerances the only solution is avoidance of the offending food until one can once again tolerate it, which may be weeks, months or longer.

For some people there is a dose related response, that is one may be able to tolerate milk in tea, but a glass of milk would cause symptoms. There is a test available for the diagnosis of lactose intolerance, called a lactose challenge, and for small babies and children is especially advisable.  If there is no need to exclude foods from a diet then life is a great deal simpler. Your general practitioner (GP) can refer you to a gastroenterologist, who would give an accurate diagnosis.

In adults an exclusion diet would probably be adequate, and this can be easily attempted at home. If your diet is already restricted or you have a family history of osteoporosis (brittle bones) a dietitian should be consulted. Your GP can refer you to a state registered dietitian on the National Health Service. If there is no history of gastroenteritis causing your symptoms, then it may be necessary for milk to be permanently excluded from the diet, provided it is a well balanced diet this should not have any significant effects on your health. A list of other foods high in calcium has been provided.

If, having excluded dairy products from your diet for 3-4 weeks, with no improvement in your symptoms, it is likely there is some other cause of your symptoms, so you can then reintroduce dairy products and observe your condition. If you are contemplating a permanent exclusion diet, you should be referred to a dietitian for advice.

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Calcium

It is recommended that older people have a calcium intake of 1500 mg per day. The daily recommended calcium intake according to age, as recommended by the National Osteoporosis Society, is as follows:

Age Daily Calcium Intake
Children 800mg
Teenagers 1000mg
Pregnant and Nursing Mothers 1200mg
Males 20 - 60 yrs 1000mg
Females 20 - 45 yrs 1000mg
Females over 45 yrs 1500mg
Males over 60 yrs 1500mg

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Non-Dairy Sources of Calcium

The following are foods that have a high calcium content:

Food Calcium content per 100g of Food
Soya milk 13 mg (often has calcium added)
Chick peas (raw) 160 mg
Soya beans (raw) 240 mg
Tofu 510 mg
Red kidney beans 100 mg
Curley kale (boiled) 150 mg (absorbed as well as milk)
Okra (cooked / raw) 160mg / 220mg
Spring greens (cooked / raw) 75mg / 210mg
Watercress 170mg
Parsley 200mg
Apricots (Cooked) 92mg
Currants 53mg
Figs (dried) 250mg
Almonds 240mg
Brazil Nuts 78mg
Hazel Nuts 140mg
Treacle (black) 500mg
Tahini 680mg
Sesame seeds 670mg

Herbs and spices contain useful amounts, but obviously only small quantities are used.

If you require any further information about calcium in your diet or you would like some more information about osteoporosis, please contact the National Osteoporosis Society on 01761 47 27 21.

Last updated: December 2013             Next review date December 2015
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