Cows' milk allergy is common in young children. It affects about 1 in 50 infants, but is much less common in older children and adults (less than 1 in 1000).
Milk and dairy foods are an important part of our diets, and provide many nutrients including proteins, minerals and vitamins essential for growth and bone health. It is therefore important that if you think you may be allergic to cows' milk, you speak to a health professional about it.
Cows' milk and dairy foods are even more essential in babies and young children. Any child with a potential food allergy must be seen by an Allergy Specialist, in order to ensure the child’s diet remains adequate and the allergy is managed appropriately. See our factsheet Cows’ milk protein allergy - Getting the best help for your baby 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 Powder
- Milk drinks
- All types of cheese
- Ice cream
Food labels that list any of the ingredients below also contain some cows' milk or products in them.
- Hydrolysed casein
- Skimmed milk
- Skimmed milk powder
- Milk solids
- Non-fat milk
- Whey syrup sweetener
- Milk sugar solids
The following are examples of processed foods which may contain milk:
- Breakfast cereals
- 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
Note: This list includes just some of the foods to be avoided in a milk free diet. Before any changes are made to your or your child's diet, seek advice from a dietitian.
Remember, check the labels first.
If you or your child is allergic to the proteins in cow milk, neither goat nor sheep milk will be suitable as a replacement. Your body will recognise the milk as being physically similar and react in the same way as to cows' milk.
Milk intolerance is also common and many patients who are intolerant but not truly allergic to cows' milk may tolerate goats milk or sheeps milk better than cows' milk. If in doubt, you should check with your medical advisor.
Also note that:
- Soya milks available in shops and supermarkets are unsuitable for babies under 12 months.
- In children over 12 months, soya milks can be used during weaning, both as a drink and in recipes to replace cows' milk. Soya milks specially developed for younger children are available, but are not usually recommended in babies under 6 months of age.
Cows' milk is an important source of calcium. If my baby must avoid cows' milk, will he get enough calcium?
Soy 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 soy 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 soy 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.
back to top
This is a relatively common complaint, perhaps one in five people will suffer symptoms suggestive of lactose intolerance. This is not an allergic condition, but an inability to digest lactose (milk sugar) because of 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.
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 this could be rather sensible. If there is no need to exclude foods from a diet then life is a great deal simpler. Your general practitioner (GP) would need to refer you to a specialist in this field, and they would be able to confirm the need for avoidance.
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 bone disease) a dietitian should be consulted. Your GP will be able to 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 a period of time, e.g. a month and no improvement in your symptoms have occurred then it is likely there is some other cause of your symptoms, you can then reintroduce dairy products and observe your condition. If at this stage you are still symptomatic and contemplating an exclusion diet, you should be referred to a dietitian for advice.
back to top
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:
||Daily Calcium Intake
|Pregnant and Nursing Mothers
|Males 20 - 60 yrs
|Females 20 - 45 yrs
|Females over 45 yrs
|Males over 60 yrs
back to top
Non-Dairy Sources of Calcium
The following are foods that have a high calcium content:
||Calcium content per 100g of Food
||13 mg (often has calcium added)
|Chick peas (raw)
|Soya beans (raw)
|Red kidney beans
|Curley kale (boiled)
||150 mg (absorbed as well as milk)
|Okra (cooked / raw)
||160mg / 220mg
|Spring greens (cooked / raw)
||75mg / 210mg
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: March 2012