- Milk is considered a priority food allergen by Health Canada. Priority food allergens are the foods that cause the majority of allergic reactions.
- Milk allergy is caused by a reaction to the protein in cow’s milk.
- The protein in cow’s milk is very similar to those found in milk from goats, sheep, and other mammals like deer and buffalo. Individuals allergic to cow’s milk will likely experience reactions to other types of milk.
- Some people with milk allergy can consume extensively heated/baked products that contain milk (with the product completely cooked throughout). If you or your child has a milk allergy, please speak to your allergist before consuming any baked products containing milk.
- Many children with a milk allergy may outgrow the allergy within a few years. For others, a milk allergy can be a lifelong condition. If your child has an milk allergy, consult your allergist before reintroducing your child to milk products.
- A milk allergy is different than a milk (or lactose) intolerance. Unlike people with lactose intolerance, individuals with milk allergy have an immune system that reacts abnormally to milk proteins and it can be life-threatening.
- Lactose intolerance occurs when a person cannot digest lactose, a component of milk, because their body does not produce enough of a specific enzyme that breaks down lactose. Symptoms of lactose intolerance include abdominal pain, bloating, and diarrhea after milk ingestion. Lactose intolerance is not an allergy and is not life-threatening.
- If you are unsure whether you have a milk allergy or lactose intolerance, please talk to your doctor.
- If you are managing lactose intolerance, visit this Dietitians of Canada web page.
Allergic reactions to milk
An allergic reaction usually happens within minutes after being exposed to an allergen, but sometimes it can take place several hours after exposure. Anaphylaxis is the most serious type of allergic reaction.
Symptoms of anaphylaxis generally include two or more of the following body systems:
- Skin: hives, swelling (face, lips, tongue), itching, warmth, redness
- Respiratory (breathing): coughing, wheezing, shortness of breath, chest pain/tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing
- Gastrointestinal (stomach): nausea, pain/cramps, vomiting, diarrhea
- Cardiovascular (heart): paler than normal skin colour/blue colour, weak pulse, passing out, dizziness or lightheadedness, shock
- Other: anxiety, sense of doom (the feeling that something bad is about to happen), headache, uterine cramps, metallic taste
However, a drop in blood pressure without other symptoms may also indicate anaphylaxis. It is important to know that anaphylaxis can occur without hives.
If you have an allergy to milk, keep an epinephrine auto-injector (e.g., EpiPen®) with you at all times. Epinephrine is the first-line treatment for severe allergic reactions (anaphylaxis).
Be allergy-aware: How to avoid milk
- Read ingredient labels every time you buy or eat a product. If the label indicates that a product “Contains” or “may contain” milk, do not eat it. If you do not recognize an ingredient, if there is no ingredient list available, or if you don’t understand the language written on the packaging, avoid the product.
- Do The Triple Check and read the label:
- Once at the store before buying it.
- Once when you get home and put it away.
- Again before you serve or eat the product.
- Always carry your epinephrine auto-injector. It’s recommend that if you do not have your auto-injector with you, that you do not eat.
- Check with manufacturers directly if you are not sure if a product is safe for you.
- Be careful when buying products from abroad, since labelling rules differ from country to country.
- Watch for cross-contamination, which is when a small amount of a food allergen (e.g., milk) gets into another food accidentally, or when it’s present in saliva, on a surface, or on an object. This small amount of an allergen could cause an allergic reaction.
Other names for milk
- Ammonium/calcium/magnesium/potassium/sodium caseinate
- Casein/caseinate/rennet casein
- Delactosed/demineralised whey
- Dry milk/milk/sour cream/sour milk solids
- Hydrolyzed casein, hydrolyzed milk protein
- Lactalbumin/lactalbumin phosphate
- Milk derivative/fat/protein
- Modified milk ingredients
- OptaTM, Simplesse® (fat replacers)
- Whey, whey protein concentrate
Possible sources of milk
- Artificial butter, butter fat/flavour/oil, ghee, margarine
- Baked goods and baking mixes
- Brown sugar
- Buttermilk, cream, dips, salad dressings, sour cream, spreads
- Canned turn, e.g. seasoned or mixed with other ingredients
- Caramel colouring/flavouring
- Casein in wax used on fresh fruits and vegetables
- Casseroles, frozen prepared foods
- Cereals, cookies, crackers
- Cheese, cheese curds
- Egg/fat substitutes
- Flavoured coffee, coffee whitener, non-dairy creamer
- Glazes, nougat
- Gravy, sauces
- High protein flour
- Infant baby cereals/infant formula, follow-up formula, nutrition supplements for toddlers and children
- Kefir (milk drink), kumiss (fermented milk drink), malt drink mixes
- Meats such as deli meats, hot dogs, patés, sausages
- Instant/mashed/scalloped potatoes
- Snack foods
- Soups, soup mixes
- Soy cheese
Non-food sources of milk
- Medications and health supplements
- Pet food
Ingredients that do not contain milk protein
- Calcium/sodium lactate
- Calcium/sodium stearoyl lactylate
- Cocoa butter
- Cream of tartar
Note: The above lists are not complete and may change.