Milk may be known for doing a body good, but if you are someone who has a dairy allergy, that’s not the case.

While anyone can have a milk allergy, they are more common in children.  In children younger than the age of three, studies show that two to three percent have allergies.  While around 80 percent of these children outgrow their symptoms before they turn 16, those who don’t need to avoid milk products to stay healthy long term.

In this article, we’ll uncover the truths and myths about milk allergies.  We’ll start by breaking down the differences between lactose intolerance and an allergy, and then give you information on the symptoms, testing, diagnoses, and how to manage the condition in both children and adults.

Milk Allergy vs. Lactose Intolerance

Many people confuse a milk or dairy allergy with lactose intolerance.  In truth, the two may present with similar symptoms in some people, but they are not related conditions.  What is happening inside our bodies is very different when you compare the two.

Your Body’s Response if You Have an Allergy

When our body produces an allergic response, it originates with our immune system.  If an allergen is introduced, it’s treated as a dangerous invader, and we go on high alert.  This triggers the production of antibodies that will neutralize the allergen called immunoglobulin E, or IgE for short.

With milk allergies, the body is typically reacting to one or both of the protein’s found in cows’ milk, casein and whey.  Casein is the substance found in the solid part of milk that has the potential to curdle.  Whey is the liquid part of the content and stays fluid even after it curdles.

Because these milk portions aren’t only found in cow’s milk but can be in some processed foods as well as the milk from other animals, those with allergies need to be vigilant about what they consume to avoid possibly serious health complications.

Allergic reactions can produce many unpleasant side effects like hives or an upset stomach, as well as extremely serious reactions like anaphylactic shock.  

Your Body’s Response if You are Lactose Intolerant

Conversely, someone who is lactose intolerant has issues that originate in their digestive tract.  If you have a deficiency in lactase, the enzyme that lines your small intestine and is one of the primary ingredients needed to metabolize lactose, you’re lactose intolerant.  

The lack of this enzyme is sometimes a temporary condition due to infection.  In children, their systems simply haven’t had enough time to build up the material which is why the allergy often goes away as they get older.

While being lactose intolerant isn’t pleasant, and can result in gas and digestive issues when you ingest dairy, it’s not a life-threatening condition.

How to Determine What You’re Experiencing

Although dairy allergies and lactose intolerance have some symptoms in common, it may be possible to determine which you have based on symptoms alone.

Talk with your doctor about your experiences after consuming dairy for expert advice.  They may advise a skin or blood allergy test to diagnose your condition thoroughly and to give you accurate treatment options.

Below, we will discuss the symptoms of milk allergies in detail, as well as testing and management of the symptoms.

Milk Allergy Symptoms

As one of the most common food allergens in children and adults, it’s crucial to know what the symptoms of and reactions to a milk allergy look like.

Within a short time after consuming animal milk or products that contain milk protein you develop the following symptoms:

  • Hives:  A red, itchy skin rash that typically will go away over time.  In rare cases, they can cause internal swelling in your airway making it difficult to breathe.  Seek immediate medical attention should this occur.
  • Upset Stomach and gas
  • Vomiting
  • Diarrhea and bloody stool, particularly in infants
  • Anaphylaxis: a potentially life-threatening condition that makes it impossible to breathe and can send the body into shock.  Those diagnosed may have access to an auto-injector to help manage the reaction but should seek emergency medical attention should breathing issues present.

Diagnosis

The best way to get a confirmed diagnosis of a milk allergy is to visit an allergist.  As a doctor, they will first obtain a detailed medical history to see if there are any underlying conditions that might also be contributing to your symptoms.

They will then ask more specifically about your allergy.  Be prepared to discuss what you ate or drank, the types of symptoms you experienced, how quickly they occurred and how long they lasted, and any steps you took to alleviate them.

Next, your allergist will likely recommend testing.  There are two common types of allergy tests: a skin prick test and a blood test.  Both look for IgE antibodies in your blood.  These develop when your body is exposed to an allergen and are part of the response when your immune system fights off the irritant.

If your doctor recommends a skin prick test, a solution containing milk or one of the milk protein extracts will be placed on either your forearm or back.  They will prick your skin with a tiny, sterile probe and wait 15 to 20 minutes before reading the results.  If you test positive, you will develop a raised, red welt at the injection site.  

The other way to check for an allergy is with a blood test.  Here, your allergist will draw a blood sample and look for the presence of IgE antibodies which are then reported as a numerical value for analysis and diagnosis.  Blood tests can be precise, and your doctor may look at your risk for reaction to a specific protein.

One additional method some doctors use for testing is an oral food challenge.  In this process, you will ingest small amounts of milk while under medical supervision, and your allergist will observe your reaction.  Because there is a possibility of a severe or dangerous response with this type of testing, you’ll need to do it at a medical facility where they can treat you immediately should one occur.

How to Treat and Manage Milk Allergies

The best and only way to manage a confirmed milk allergy is to avoid it all together.  Not only will you need to be vigilant about not consuming cow’s milk, but you’ll also want to carefully check ingredient labels to ensure you don’t use any products that contain it as an ingredient.  There is a list of products to avoid following this section.

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Fortunately, as one of the most common allergens, milk is one of eight that has specific labeling requirements under the Food Allergen Labeling and Consumer Protection Act of 2004.  According to this law, all packaged food manufacturers who sell products in the U.S. that contain milk need to include messaging on the ingredient label to inform users.

This language usually reads something like “this product contains milk or milk products.”  Companies that process or manufacturer their goods in a factory that also processes milk may also include statements like “may contain traces of milk” on their labels, but that information is not required by law.

Additionally, if your doctor determines you are at risk for a life-threatening reaction to the substance, they may give you a prescription for an auto-injector containing epinephrine in case of emergencies.  Although an expensive option, this can save your life should you ever inadvertently come into contact with the allergen.

Talk with your doctor about you or your child’s potential tolerance, and alternatives for milk in recipes and formulas for babies.

Milk Products

While avoiding traditional cow’s milk if you have an allergy is a no-brainer, there are many other sources of milk products and processed foods that may contain the proteins that will cause a reaction.

Milk from other animals, like sheep, goats, buffalo, and other mammals may also produce symptoms.  Foods that have the same proteins, including all dairy products, and surprising ones like canned tuna, some sausages, and chewing gum, could have similar results.

Here are some common primary sources of milk products to avoid.

  • All milk types: whole, skim, low-fat, buttermilk
  • Dairy-based coffee creamers and half and half
  • Yogurt
  • Dairy-based ice cream and gelato
  • Cheese and any products that include cheese on the ingredients list
  • Yogurt
  • Sour cream and whipped cream

It can be tricky to determine if a processed food has milk as one of its ingredients.  Here are some things to look for on labels to let you know that there may be a hidden source of milk in the package.

  • Whey: Found in hundreds of products ranging from baked goods to protein shakes
  • Casein
  • Any ingredient that has the prefix “lact.”  Sometimes manufacturers use words like lactate or lactose rather than calling it milk.
  • Artificial cheese or butter flavors
  • Protein powder
  • Hydrosolate

Remember, just because a food is labeled “nondairy” does not mean it is without the milk portions that may trigger an allergic reaction.  Read labels carefully to ensure that the product is safe, and if you have questions contact the manufacturer directly.

Eating out can also be a challenge if you have a milk allergy.  Ask your server about how your food is prepared.  Restaurants use tasty tricks, like melting butter on your steak or dredging food through milk and breadcrumbs before placing it in a fryer, that could trigger an allergic response.  While it might seem cumbersome, it’s always better to be safe and not risk a reaction when possible.

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