This handout explains what a milk allergy is and lists other food and drink options.
An allergy to cow’s milk is more common in young children than adults. Most children outgrow a milk allergy by age 5, though some may have it a lifetime. Blood and skin tests can help figure out when and if your child will outgrow their milk allergy. To treat a milk allergy, all milk and milk products are removed from the diet.
Milk has many essential nutrients. These include protein, vitamins A and D, and calcium. The closest substitution for cow’s milk is soy-based infant formula or fortified soymilk. There are many milk substitutes on the market. Some are low in protein and calories, which can be a problem for toddlers and small children as they grow.
Many products have milk or a milk byproduct in part of the food. Read all product labels closely. The Food Allergen Labeling and Consumer Protection Act of 2004 makes companies clearly list the eight most common food allergens on product labels. They must use the common name for the allergen. For example, “milk” must be used instead of “casein.” You will see this in the ingredient list or just below in “contains statement.”
Ingredients on the label that point out the presence of milk protein (the label should clearly state milk in common terms):
Butter or butter solids
Casein/caseinates (any form)
Cream (and half and half)
Whey (any form)
Foods that may point out the presence of milk protein (the label should clearly state if the food contains milk). If in question, call the company.
Cold cuts, processed meats
High protein flours
Lactic acid starter culture
Ingredients That Do Not Contain Milk Protein
Calcium stearoyl lactylate
Cream of tartar
Lactic acid (starter culture may contain milk)
Sodium stearoyl lactylate
What to Look for When You Read a Food Label
Is the allergen’s name in the ingredient list?
Is the word “contains” followed by the name of the allergen—example,
Does the ingredient list have the name in parentheses? For example, when the ingredient is a less common form of the allergen such as casein (milk).
“May Contain” Statements
Food companies put warnings on food labels. These include phrases like “may contain,” “processed in a facility that also processes” or “made on equipment with.” These warnings are often found after the ingredient list at the lower part of the food label. There are no laws that require these statements, when to include them and what to write.
Drinks You Can Eat
Protein hydrolysate formulas
Fortified soy milk
Drinks to Avoid
Milk based infant formulas (ex: Good Start, Enfamil, Similac, Lactose free)
Cocoa made with milk
Chocolate or cocoa drink mixes
Smoothies made with milk or yogurt
Powdered drink mixes with milk or milk-based ingredients
Whipped toppings that contain casein, sodium, caseinate, or other milk proteins
Candy You Can Eat
Plain sugar or honey candy
Candy (jellybeans, licorice)
Candy to Avoid
Cereals You Can Eat
Enriched and whole grain cereals (cooked or dry) that are prepared and served without milk protein
Cereals to Avoid
Cereal mixes that contain milk protein
Any cereal cooked or served with milk or cream
Desserts You Can Eat
Angel food cake
Gelatin desserts and ices without milk
Any milk-free dessert that contains soy milk, fruit juice, or water as a milk substitute
Carob or plain cocoa powder sponge cake
Some dark baking chocolate
Icings made without milk or milk products
Dessert to Avoid
Any dessert made with dairy
Pudding made with milk (junket, tapioca)
Whipped cream topping
Cakes and cookies with dairy
Prepared flour mixes
Cream-filled pastries, cream pies and crumb mixtures
Pancakes made with milk or butter
Pie crusts made with butter
Popovers, sweet rolls, breads and
Pastries glazed with butter
Fats and Oils You Can Eat
Margarine made without milk protein
Fats and Oils to Avoid
Margarine that contains milk
Simplesse (fat substitute)
Fruit You Can Eat
Fresh or canned fruit served without milk, cream, sour cream or whipped cream
Fruit to Avoid
Some store-bought gelatin desserts that contain sour cream, whipped cream or whipped topping
Meat/Meat Substitutes You Can Eat
All meat, fish or poultry prepared without milk or milk products
Sausage products without milk filler
Eggs cooked without milk, butter or milk products
Soy or rice cheeses (read labels)
Soy, almond, coconut yogurts
Meat/Meat Substitutes to Avoid
Any meat, fish, or poultry cooked in butter or margarine that contains milk
Cold cuts and sausage with milk filler
Eggs cooked with milk or fried in butter
Breaded or creamed meat dishes
Meats in white sauces (Mornay or Béarnaise)
Quiches, soufflés, fondues
Potato/Pasta You Can Eat
Potatoes, pasta, rice without milk or cheese
Potato/Pasta to Avoid
Mashed potatoes made with milk or cheese
Creamed or scalloped dishes
Pasta made with cheese (ex: lasagna)
Salad and Dressings You Can Eat
All fruit and vegetable salads with dressings that do not contain milk or milk products
Salad and Dressings to Avoid
Yogurt or sour cream dressings
Cooked dressings that contain milk
Salads that contain cheese
Sauces You Can Eat
Gravy made with water or broth
Sauces to Avoid
Gravy made with milk
White sauces (Béchamel, Florentine, Mronay, dijonnaise, Hungarian, alfredo
Pasta sauces that contain cheese
Seasonings You Can Eat
Salt, spices and herbs
Seasonings to Avoid
Read labels on marinades, dips, appetizers, spreads, sauce mixes, and gravies
Soups You Can Eat
Broth soups made without butter or margarine that contains milk (Bouillon, consume)
Homemade soup made without milk or milk products
Soups to Avoid
Some canned soups (bouillabaisse chowders, cream soups made with butter, cream, milk or margarine that contains milk
All cream soups
Sweets You Can Eat
All sugars (brown, white, powdered)
Honey, jam, jelly and syrups
Sweets to Avoid
Vegetables You Can Eat
Any canned, frozen or raw vegetable cooked without milk or milk products
Vegetables to Avoid
Au gratin/scalloped dishes
Any vegetable seasoned with butter, cream, milk or margarine that contains milk, or cheese
Formulas or Milk Substitutes
Substitute formulas include soybean formulas such as Isomil® and Prosobee®. Protein hydrolysate formulas may be okay to use and include: Alimentum®, Nutramigen® and Pregestimil®. Amino acid-based formulas are often used for milk allergies. Neocate® and Elecare® are widely used amino acid-based formulas.
Soy formulas are well accepted by most children, especially if started when they are a baby. The nutrients in calcium fortified soymilk is almost equal to that of cow’s milk. The infant soymilk formulas are fortified with needed vitamins, minerals, and essential fatty acids. There are many other good milk substitutes for people with a milk allergy. Most are fortified with vitamin D and calcium. Talk with your doctor or dietitian about other options for you.
Some milk-sensitive people may also become allergic to soy protein.
If you buy “deli” meats, ask what other products are cut on the slicers to reduce cross-contamination.
Be clear about your allergy and ask how foods are prepared at restaurants. Ask if they have a separate grilling space or fryer. Ask if your item will be cooked near or in an area where milk might be used. If you are not sure it is safe, do not order the food. Choose a restaurant that is better able to meet your needs.
Blend fruit and non-dairy yogurt to make a smoothie.
Use applesauce on hot cereal.
Use a milk substitute on cereal.
Look for non-dairy substitutes for sour cream and cheese. Tofutti® and Daiya® are two common brands.
Calcium fortified orange juice has nearly the same calcium content as milk but does not have all the other nutrients that milk offers. It is not a good substitute for milk.
How to Prevent an Allergic Reaction
Avoid foods that cause a reaction. Sometimes just touching foods can cause a severe reaction. Be sure to wash your hands if you touch foods with milk.
Read the ingredients lists on food labels each time you buy them to make sure ingredients have not changed as they often can.
If you travel, bring some of your own foods. Make sure to wipe the area where you eat to avoid cross-contamination.
When you eat out, always ask restaurant staff about ingredients in food and how it is prepared. Tell them about your allergy. It may be best to ask to speak with the manager as well.
For infants, elemental formulas or formulas with broken down proteins should prevent food reactions. Talk about formula options with your doctor or dietitian. Do not assume products labeled "hypoallergenic" will not cause a reaction.
Be careful with imported products. Food labeling rules vary by country. Imported foods should follow domestic food labeling laws, but do not always do so.
“Milk substitute” drink: __________
Food Allergy Association of Wisconsin
Food Allergy and Anaphylaxis Network
Medline Food Allergy Resource Page
Kids With Food Allergies
Who to Call
If you are a UW Health patient and have more questions, please call 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.