Milk Allergies – Back To Basics

November 25, 2009 · Posted in Ask A Dietitian, Dairy-Free, Food Allergy Basics, dairy-learn-more

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We have had many questions emailed to us by visitors asking the following, “What exactly causes a milk allergy?” So, we asked Registered Dietitian, Vincci Tsui to help us out with the answers.

What exactly causes a milk allergy?
As mentioned in my previous article, an allergy is an immune response to a protein that our body incorrectly recognizes as harmful to our bodies. The two main protein-containing components in cow’s milk are casein and whey. However, even if you do know whether you are allergic to casein protein or whey protein, people with milk allergy symptoms are advised to avoid all products containing milk or milk proteins as cross-contamination is very common.
It is estimated that 1% of adults and 3% of children have milk allergies, with 85-90% of children with milk allergies outgrowing it by the age of three. An allergic reaction can be triggered with just a small amount of milk protein and can affect different body systems. Milk allergy symptoms may show up in a variety of ways with about half of reported allergic reactions involving the digestive system (abdominal pain, vomiting, diarrhea), about one-third to two-thirds related to skin conditions (rash, eczema, hives), and approximately one-fifth to one-third affecting the respiratory tract (trouble breathing, coughing, wheezing).

What are some foods/ingredients that people with milk allergies or milk intolerance need to watch out for?

Obviously, dairy products (milk, cheese, yogurt, cream, etc.) should be avoided, but milk and its many byproducts are often added to processed foods as well. Some ingredients to watch out for:
•   Artificial butter flavor, butter fat, and butter oil
•   Casein and caseinates (in all forms)
•   Cheese flavour
•   Curds
•   Ghee (clarified butter)
•   Hydrolysates (casein, milk protein, protein, whey, whey protein)
•   Lactalbumin, lactalbumin phosphate, lactoglobulin, lactoferrin, lactulose
•   Nougat
•   Rennet, rennet casein
•   Recaldent™, used in tooth-whitening chewing gums
•   Simplesse®
•   Whey (in all forms)
The following ingredients do not contain milk proteins and are safe for people with milk allergies (also called milk protein allergy):
•   Calcium lactate
•   Calcium stearoyl lactylate, sodium stearoyl lactylate
•   Cocoa butter
•   Coconut milk
•   Cream of tartar
•   Lactic acid
•   Oleoresin
•   Sodium lactate

What are some nutritional implications of having a milk allergy?
Although the traditional diets of some cultures are devoid of dairy, in North America, dairy products remain a primary source of calcium, potassium, vitamin A and vitamin D in our diets. While it is easy to meet our potassium and vitamin A needs with a diet rich in vegetables and fruit, calcium and vitamin D may be a little harder to come by, and supplementation may be recommended. Milk alternatives, like soy milk, rice milk, almond milk or hemp milk are usually fortified with calcium and vitamin D to levels similar to those in milk, but there are also plenty of non-dairy sources of calcium, such as tofu, canned fish with bones, broccoli, Chinese cabbage (bok choy) and almonds. Vitamin D is actually not naturally found in milk; food sources of vitamin D include fatty fish, like salmon, sardines, tuna, herring and trout and eggs. We can also get vitamin D through unprotected exposure to sunlight.
Ask your allergist or doctor to refer you to a registered dietitian who can help you assess whether your diet is adequate and give you appropriate recommendations.
Where can I find more information on milk allergies?
Almost all the major allergy/anaphylaxis networks (i.e. Allergy/Asthma Information Association, Anaphylaxis Canada, Asthma and Allergy Foundation of America, Food Allergy and Anaphylaxis Network, Food Allergy Initiative, etc.) have information sections and support groups for people with milk allergies.
Go Dairy Free is an informational website for people with milk allergies, lactose intolerance, or who just want to eliminate dairy from their diet for other reasons. The author, Alisa Fleming, provides great information on health, grocery shopping, and dairy-free recipes. She has also written a book called Go Dairy Free, which has lots of great information.

Check your local Whole Foods store too, they may have a seminar in your local area about milk alternatives and ideas about foods you can eat.

This article was written by Vincci Tsui, a Registered Dietitian based in Calgary, Alberta, Canada. She obtained her Bachelor of Science in Nutritional Sciences from McGill University, where she also completed her dietetic internship, which included placements in Montreal, Calgary and Hong Kong. She is currently practicing in a collaborative care clinic where she meets with clients with a variety of health and nutrition issues, including food allergies and sensitivities.Vincci is as passionate about food as she is about healthy eating and nutrition, and she strives to provide solutions that are healthy, yet tasty and easy to incorporate into busy lifestyles.