Milk is the most common food allergy in children, affecting up to 2% of American youth. An allergy to milk is not to be confused with lactose intolerance. When someone is lactose intolerant, they can’t properly digest the sugar found in milk and dairy products. Symptoms include bloating, cramps and stomach pain. A milk allergy, on the other hand, is an immune system reaction to milk protein that can be life-threatening. Symptoms may include hives, vomiting and difficulty breathing.
“Since reactions to a milk allergy can be quite severe, you’ll want to make sure that your child avoids milk products of any kind,” said Tracy Rife, RN, BSN, AE-C, asthma and easy breathing program coordinator at Akron Children’s Hospital. “Always read the entire ingredient label of every food. Additionally, look for the statement ‘Contains: Milk’ that may appear beneath the list of ingredients. Unfortunately, food manufacturers are not required to include advisory statements such as ‘may contain milk’ or ‘made in a facility with milk.’”
Be aware of foods made with milk protein that do not necessarily include the word “milk.” Some milk products to watch for include:
- Butter, including artificial butter and butter flavoring
- Casein and caseinates
- Cheeses of all kinds
- Cream and half & half
- Custard and pudding
- Dairy product solids
- Lactates and lactose of all types
- Nisin preparation
- Simplesse® (a fat substitute)
- Sour cream, including imitation sour cream
Milk is also sometimes found in various flavoring, high-protein flour, lactic acids and “non-dairy” products (which may contain casein) and rice and soy cheeses. Products regulated by the FDA must include the word “milk” on the label. Be aware that foods can be labeled nondairy even if they contain casein, a milk protein.
When your child must avoid milk, she may miss nutrients essential for bone growth. These nutrients include calcium, protein, riboflavin, phosphorus and vitamins D, A and B12. Your child will need to eat foods or take supplements to replace these lost nutrients.
While protein is easy to replace by eating meats, poultry, eggs, fish, nuts and legumes, it’s trickier to consume enough calcium. For example, a cup of leafy greens contains as much calcium as 4 ounces of milk, but a typical child probably wouldn’t gobble up an entire cup of leafy greens.
If your child is a baby or toddler and takes a specialized milk-free formula, he may not need dietary supplements. Children over 1 year old can usually use a fortified milk alternative, such as:
- Soy milk
- Nut milk (like almond or cashew milk)
- Rice milk
- Coconut milk
- Grain or seed milk (like oat or flax milk)
Watch the below video to help decide which “milk” is right for your family. Also, make sure these milk substitutes are fortified with calcium and other nutrients. Check the package’s nutrition information to make sure the product has at least 8 grams of protein per 8-ounce serving. Calcium-fortified juice can provide additional calcium but is not a good source of other nutrients.
Besides leafy greens and milk substitutes, look to other foods to provide additional calcium for your child. Some high-calcium items include:
- Canned salmon
- White beans
Ask your healthcare provider about meeting with a dietician to ensure that your child’s appropriate nutritional needs are being met. For more ideas on adding calcium-rich foods to your child’s diet, visit the website of The American Academy of Allergy, Asthma and Immunology (AAAAI).