Do you stay away from milk or milk products because you think you have a milk allergy or lactose intolerance? Find out the difference, and learn what to do if you really are allergic to milk
What is the difference between a milk allergy and lactose intolerance?
A milk allergy is a reaction to the proteins found in milk. Your body’s immune system reacts to the milk proteins and then triggers a variety of symptoms.
Lactose intolerance describes your body’s reaction to the natural sugar (called lactose) found in milk. It is not an allergy and does not involve your immune system. If you are lactose intolerant, your body doesn’t have enough lactase which is an enzyme needed to help break down lactose.
Your health care provider can help determine whether you have a milk allergy or lactose intolerance.
What are the symptoms of a milk allergy?
The symptoms of a milk allergy can start either right away or hours after drinking milk or eating a food that contains milk. Some of the common symptoms are:
- stomach cramps, gas (flatulence), diarrhea, vomiting, nausea
- rash, hives, eczema, red and itchy skin
- runny nose, nasal congestion, coughing, wheezing (trouble breathing)
- swelling of the eyes, face, lips, throat and tongue
In rare cases, a milk allergy can be life-threatening.
Lactose intolerance also causes stomach cramps, gas, diarrhea and vomiting. But rash, hives, runny nose, coughing and swelling are NOT symptoms of lactose intolerance.
Will my child outgrow their milk allergy?
Up to 4% of infants are allergic to milk, and many of them will grow out of a milk allergy by the time they are three years old
What should I look for on a food package if I have a milk allergy?
Stricter Canadian guidelines require that milk-containing products are clearly labeled. The ingredient list will say “contains: milk” if it contains this ingredient. Reading the ingredients on a food package is another good way to make sure that you don’t eat foods that contain milk or other hidden sources of milk
AVOID eating the food if you read:
- “milk” in the ingredients list
- the words “may contain milk” or “may contain traces of milk” on the food package
Avoid any of these other names for milk and milk ingredients:
- casein, caseinate, rennet casein
- curds
- delactosed or demineralized whey
- hydrolyzed casein, hydrolyzed milk protein
- lactalbumin, lactalbumin phosphate
- lactate/lactose
- lactoferrin
- lactoglobulin
- Opta™, Simplesse® (fat replacers)
- whey, whey protein concentrate
Be aware of these foods that contain or may contain milk or milk protein.
- Brown sugar
- Candy
- Caramel colouring/flavouring
- Casein in wax coated fresh fruits and vegetables
- Crackers
- Egg substitutes
- Flavoured coffee, coffee whitener, non-dairy creamer
- Glazes, nougat
- High protein flour
- Meats – like canned tuna, deli meats, hot dogs, pâtés, sausages
- Potatoes – like instant, mashed, or scalloped potatoes, French fries, potato chips
- Seasonings
- Snack foods – like fruit bars, granola bars
- Tofu
How can I get enough calcium and vitamin D without milk?
You can get calcium and vitamin D from other food sources. For example, you can drink fortified soy beverage. One cup of fortified soy beverage contains as much calcium and vitamin D as a cup of milk. Drink at least 2 cups of fortified soy beverage every day to get enough vitamin D. Try making a smoothie with soy beverage, like this fun ground up frog smoothie with berries and spinach. Eat other calcium-containing foods such as almonds, canned salmon (with the bones), beans and bok choy. See Food Sources of Calcium for a list of more calcium-containing foods.
You could also consider taking a calcium and vitamin D supplement. Speak to a dietitian to determine if a supplement is right for you.
Can I drink goats or sheep milk if I have a milk allergy?
The type of protein found in goats and sheep milk is similar to the protein found in cow’s milk, so most people with a milk allergy will also react to these types of milk. Speak to your allergist if you are not sure.
Tips on following a milk-free diet
- Read the ingredient labels every time you shop. Food manufactures may occasionally change their recipe or use different ingredients.
- Call the manufacturer if you have questions about their products. Many food packages have a telephone number on them.
- Be informed. Sign up for the Canadian Food Inspection Agency’s (CFIA) free email “Food Recalls and Allergy Alerts” notification service.
- Don’t take any chances. Avoid products that do not have an ingredient list or those that contain ingredients that you do not recognize.
- Watch out for cross-contamination which can happen when a small amount of milk gets into food when cooking or handling other food products.
- Foods labelled as “vegan” are milk-free, but always read the label to make sure. Look for vegan soups and sauces.
- When eating out, make sure to inform servers of your allergy. Call ahead to find out which dishes are milk-free.
How can a dietitian help?
A dietitian can work with you to plan meals and snacks that are allergen-free and nutritious. If you have a milk allergy, a dietitian can make sure you are getting enough calcium and vitamin D. If your baby or child has a milk allergy, a dietitian can give you guidance on weaning and which milk alternative to offer your child to support their growth and development. Connect with a dietitian today!
Bottom line
You can still eat a nutritious and balanced diet if you have a milk allergy. Make sure you are eating other foods that contain calcium and vitamin D. If you aren’t sure if a product contains milk or milk ingredients, don’t take any chances. Reading the ingredient list every time is important to avoid having an allergic reaction to milk.
For more information:
Food Allergies and Intolerances
Managing Lactose Intolerance
Calcium and Kids
Understanding Non-Dairy Beverages
Do I Need a Calcium Supplement
This article was written and reviewed by dietitians from Dietitians of Canada.
Last Update – January 27, 2022