Allergy: Milk and Soy Elimination Diet

The only known treatment for someone with food allergies or protein intolerance is to avoid foods that contain the allergen. Allergy to cow’s milk is more common in young children than adults. A milk “allergy” can happen very fast. Reactions come on quickly. The symptoms include fussiness, vomiting, wheezing, swelling, hives, itchy skin rashes, and blood in the stool. If the child has milk protein intolerance, the reactions are slower. The infant may be irritable, have reflux, stooling issues (may contain blood), vomiting, gagging, eczema and may refuse food.

If your child has milk protein allergy or protein intolerance, he or she may also have soy protein allergy or intolerance. Most children outgrow milk protein intolerance by 1-2 years old and a milk allergy by age 5. For some, it may last longer. For breastfed infants and children, the mother must watch her own intake as well as her child’s.

Foods now list common allergens, such as milk and soy. You still need to review food labels. Many products may have byproducts of milk or soy. This handout will list foods and ingredients that have milk or soy protein.

Milk or Soy Protein

• Butter or butter solids (milk)

• Butter fat (milk)

• Butter flavor (milk)

• Buttermilk (milk)

• Casein/Caseinate (milk)

• Cheese (milk)

• Cottage cheese (milk)

• Cream (milk)

• Curds (milk)

• Custard (milk)

• Edamame (soy)

• Ghee (milk)

• Half & half (milk)

• Hydrolyzed vegetable protein (soy)

• Kinnoko flour (soy)

• Kyodofu, freeze-dried tofu (soy)

• Lactalbumin (milk)

• Lactalbumin phosphate (milk)

• Lactoglobulin (milk)

• Lactoferrin (milk)

• Malted milk (milk)

• Milk protein, all (milk)

• Miso (soy)

• Natto (soy)

• Nisin (milk)

• Nougat (milk)

• Okara, soy pulp (soy)

• Pudding (milk)

• Rennet (milk)

• Sodium caseinate

• Sour cream (milk)

• Soybeans (soy)

• Soy concentrate (soy)

• Soy curds (soy)

• Soy flour (soy)

• Soy granules (soy)

• Soy grits (soy)

• Soy nuts (soy)

• Soy milk (soy)

• Soy sauce (soy)

• Shoyu sauce (soy)

• Soy sprouts (soy)

• Soy yogurt/cheese (soy)

• Supro (soy)

• Tamari (soy)

• Tempeh (soy)

• Teriyaki sauce (soy)

• Textured soy protein (soy)

• Textured vegetable protein, TVP(soy)

• Tofu (soy)

• Whey, any form (milk)

• Yakidofu (soy)

• Yuba (soy)

• Yogurt (milk)
  

Most people who are allergic to soy can safely eat highly processed soybean oil and soy lecithin. These are common ingredients in processed foods. Soy will be clearly labeled in the ingredient list or just below the list in a “contains statement.” Be sure to ask your doctor or dietitian if you have questions.

Drinks You Can Eat

• Coffee, tea

• Fruit and vegetable juices

• Carbonated drinks

• Rice milk, almond milk, hemp milk, oat milk, flax milk
  

Drinks to Avoid

• Coffee substitutes, drink mixes, non-dairy creamers, soymilk

• Milk or soy-based formulas, cow’s milk

• Cream, dairy creamers, cocoa with milk

• Malted milk, chocolate or cocoa drink mixes, powdered drink mixes with milk or milk-based ingredients.

• “Non-dairy” creamers or whipped toppings that contain casein, sodium caseinate or other milk protein
  

Breads You Can Eat

Breads, crackers, rolls, waffles, and pancakes that do not contain milk or soy flours or milk or soy products

Breads to Avoid

Store bought baked goods that contain soybean flour or soy nuts

Cereals You Can Eat

• Enriched and whole grain cereals (cooked or dry) that are prepared and served without milk or soy protein, such as such unflavored oatmeal or cream of wheat.

• Store bought cereals that do not contain milk or soy protein
  

Cereals to Avoid

Processed breakfast cereals that contain milk or soy protein or are served with milk, soy, or cream

Desserts You Can Eat

• Desserts made without milk or soy products such as: angel food cake, cookies, frostings, fruit pies, gelatin

• Italian ices, pastries, ice or juice-based popsicles, sauces, sorbet, sponge cakes, fruit-based tapioca puddings, and toppings

• Carob or plain cocoa powder
  

Desserts to Avoid

• Any dessert made with milk or soy products: milk chocolate, custard, pudding, junket, milk-based tapioca puddings

• Whipped creams, toppings

• Sherbet, ice cream, cakes and cookies

• Prepared flour mixes, baking mixes

• Baklava

• Biscuits

• Biscuits

• Cheesecake

• Coffee cakes, cream-filled pastries, cream pies, crumb mixtures, doughnuts, pancakes made with milk or butter, pie crusts made with butter

• Popovers, sweet rolls, breads and pastries glazed with butter
  

Fats, Oils, and Dressings You Can Eat

All vegetable oils, most vegetable sprays, milk and soy-free salad dressings

Fats, Oils, and Dressings to Avoid

• Butter, margarine that contains milk

• Store bought salad dressings that contain soy, fats that contain soy protein
  

Fruits You Can Eat

Fresh, cooked, canned, or dried fruits served without milk, cream, sour cream, yogurt or whipped cream

Fruits to Avoid

• Fruits in fritter, cobblers, and dumplings that contain milk or soy

• Fruits in sauces with milk or soy
  

Meat/Substitutes You Can Eat

• Plain meats, poultry, fish and eggs

• All plain nuts and seeds except for soy nuts
  

Meat/Substitutes to Avoid

• Textured vegetable protein, meat/burger extenders

• Soy nuts

• Store bought frozen meat patties

• Lunchmeats, sausage, meat loaf and all cheeses, yogurt, cottage cheese

• Soybeans/edamame, soy cheese, soy yogurt

• Meats prepared in white sauce, Mornay, Bearnaise, Hollandaise sauce

• Quiches, soufflés, fondues
  

Potatoes, Rice, Grains You Can Eat

Potatoes, rice, milk and soy free noodles and pastas

Potatoes, Rice, Grains to Avoid

• Potatoes that contain milk and soy

• Instant potatoes, macaroni, noodles, spaghetti, lasagna or other pasta; store bought pasta in sauces
  

Sauces and Seasonings You Can Eat

• Pure spices and herbs

• Gravy made with water or broth
  

Sauces and Seasonings to Avoid

• Mixed spices that have milk, soy, soy sauce

• Gravy made with milk

• White sauces, béchamel, Florentine sauce, Mornay or Bearnaise sauce, Hungarian sauce
  

Soups You Can Eat

• Homemade broth soups made without butter or margarine

• Noodle soups made without milk and soy free noodles
  

Soups to Avoid

• Many store-bought soups, canned and dry mixes: bouillabaisse, chowders

• Cream soups made with butter, cream, milk or margarine that contains milk

• All canned cream soups and noodle soups

• Miso soup, soups that contain tofu
  

Sweeteners You Can Eat

All sugars, honey, jam, jelly and syrups

Sweeteners to Avoid

None

Vegetables You Can Eat

Fresh, frozen or canned vegetables prepared without milk or soy

Vegetables to Avoid

• Store bought prepared vegetables that are breaded or contain soy sauce

• Canned or frozen Asian style vegetables

• Canned and frozen vegetables in any kind of sauce that contains milk or soy

Infant Formulas or Milk Substitutes

• Protein hydrolysate formulas, such as Alimentum®, Nutramigen®, may be okay to use if your child has a cow’s milk protein intolerance

• Amino acid-based formulas, such as Alfamino Infant®, Neocate® Infant and Elecare® Infant, are often used for milk allergies.
  

Tips and Substitutions

• Avoid buying “deli” meats. The slicers often are used to cut both meat and cheese. Often, they can clean it for you if you ask.

• Ask how foods are prepared at restaurants. Food may be cooked in a pan or on a surface that had butter on it. Ask for a clean pan.

• Orange juice with added calcium has about the same amount of calcium as milk, but not the same nutrients.

• Make sure milk substitutes (almond, oat, or coconut milks) are enriched with calcium and vitamin D.

• Read the ingredient lists on food labels even if you had the product before. Ingredients may change.

• When you travel, bring along some of your own foods.

• Infants may need special formulas. Talk to your doctor or dietician about formula options. Do not assume "hypoallergenic" products are safe.

• Contact food companies if you are unsure of any ingredient on the label.

• If you breast feed, you likely will need to avoid milk and soy in your diet until your doctor says it’s okay to add back in. Talk to your doctor.
  

Soy Substitutes

• For soy flour, use wheat, rice, oat, barley, or potato flour.

• For soymilk, use rice or potato milk or any formula that does not contain milk or soy.

• For soy miso, use barley, plum or rice miso.

• For soy sauce, use pure concentrated beef or chicken broth or flavored salts.
  

For More Tips

• Food Allergy Association of Wisconsin: www.foodallergywis.org

• Food Allergy and Anaphylaxis Network: www.foodallergy.org

• Kids with Food Allergies: www.kidswithfoodallergies.org

• Allergic Child: www.allergicchild.com

Who to Call

If you are a UW Health patient and have more questions, please contact UW Health at 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.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.