Milk Allergy Diet - UW Health

Allergy: Milk Allergy DietAllergy to cow’s milk is more common in young children than adults. The majority of childrenoutgrow a milk allergy by age 5, though some may have it a lifetime. Treatment of milk allergyis removing all milk and milk products from the diet.Milk contains many essential nutrients including protein, vitamins A and D, and calcium. Theclosest substitutions for cow’s milk are soy-based infant formulas or fortified soymilk, but thereare many milk substitutes on the market today.Many commercial products have milk or a milk derivative in part of the food. It is important tocarefully read all product labels.Label ingredients that indicate the presence of milk protein are:Butter or butter solidsButter fatButter flavorButtermilkCasein/caseinates (any form)CheeseCottage cheeseCreamCurdsNisinCustardGheeWhey (any form)Lactalbumin (curds and whey)LactoglobulinLactoferrinMalted milkLactoalbumin phosphateMilk protein (all forms)NougatPuddingRennetSodium caseinateHalf and halfSour creamyogurtFoods that may indicate the presence of milk proteinCaramelHigh protein floursLactoseMargarineChocolateLactic acid starter cultureCold cuts, processed meatsNon-dairy products

CAN EATAVOIDBeverages:Protein hydrolysate formulas,fortified soy milk, soy formulas;rice milk, almond milk, fruitjuices, tea, coffee, carbonatedbeverages.Milk-based infant formulas (e.g. GoodStart , Enfamil , Similac , Lactofreeformulas ) Milk; cream; dairy creamers;cocoa made with milk; malted milk;chocolate or cocoa drink mixes; powdereddrink mixes with milk or milk basedingredients. “Non-dairy” creamersor whipped toppings that containcasein, sodium caseinate orother milk proteins.Candy:Plain sugar or honey candy; fruitcandy; jelly beans; licorice;marshmallows.Most commercial candy; caramels;chocolates; fudge; German chocolate;milk chocolate; nougats.Cereal:Enriched and whole grain cereals(cooked or dry) that are preparedand served without milk protein.Cereal mixes containing milk proteins;any cereal cooked or served with milkor cream.Dessert:Fats andOils:Angel food cake; gelatin dessertsand ices made without milk;fruits; any milk-free dessertcontaining soybean milk, fruitjuice, or water as a milksubstitute; carob or plain cocoapowder; sponge cake; some darkbaking chocolate. Icings madewithout milk or milk products.Shortenings; kosher margarine;margarine made without milkprotein; vegetable oils.Any dessert made with dairy products:custard; puddings made with milk;junket; tapioca; whipped creamtoppings; some sherbet; ice cream; cakesand cookies with dairy products;prepared flour mixes; baklava;baking mixes; biscuits; cheesecake;coffee cakes; cream-filled pastries;cream pies; crumb mixtures;doughnuts; pancakes made with milkor butter; pie crusts made with butter;popovers; sweet rolls, breads andpastries glazed with butter.Butter; margarine containing milk;Simplesse (fat substitute).

CAN EATAVOIDFruit:Fresh or canned fruit servedwithout milk, cream, sourcream or whipped cream.Some commercial gelatin dessertscontaining sour cream, whippedcream, or whipped toppings.Meat andmeatsubstitutes:All meat, fish or poultry preparedwithout milk or milk products.Sausage products without milkfiller. Eggs prepared withoutmilk, butter or milk products.Peanut butter. Soy cheese (readlabels, some contain milkprotein) and soy yogurt.Any meat, fish or poultry sautéedin butter or margarine containingmilk. Cold cuts and sausages withmilk fillers. Eggs prepared withmilk or fried in butter. Breaded orcreamed meat dishes. Meatsprepared in white sauces, Morneyor Béarnaise. Quiches, soufflés,fondues. Cottage cheese.Potato orPasta:Potatoes, pasta or rice withoutmilk or cheese.Mashed potatoes made with milk or cheese,creamed or scalloped dishes;pasta made with cheese; lasagna;instant potatoes.Salad andsaladdressings:All fruit and vegetable saladswith dressings not containingmilk or milk products. Realcommercial mayonnaise.Yogurt or sour cream dressings.Cooked dressings containing milk.Salads containing cheese.Sauces: Gravy made with water or broth. Gravy made with milk. Whitesauces; béchamel; Florentinesauce; Morney sauce; Dijonnaisesauce; Hungarian sauce.Seasonings:Salt, spices and herbs; mustard;relishes.Read labels on marinades, dips, appetizers,spreads, sauce mixes, and gravies.

CAN EATAVOIDSoup:Broth soups made without butteror margarine containing milk;bouillon; consume; homemadesoup made without milk ormilk products.Some canned soups; bouillabaisse;chowders; cream soups made withbutter, cream, milk or margarinecontaining milk; all cannedcream soups.Sweets:All sugars (brown, white,powdered). Honey, jam, jellyand syrups.Vegetables:Any canned, frozen or rawvegetable prepared without milkor milk products.Au gratin dishes; creamedvegetables; any vegetable seasonedwith butter, cream, milk,margarine containing milk, orcheese.Formulas or Milk Substitutes Substitute formulas include the soybean formulas: Isomil , Prosobee Protein hydrolysate formulas may be acceptable to use and include: Alimentum ,Nutramigen, Pregestimil . Amino acid based formulas are often used for milkallergies. Neocate and Elecare are widely used amino acid based formulas. Soybean formulas are well accepted by most children, especially if introduced in infancy. The nutritive value of calcium fortified commercial soymilk is almost equal to that ofcow’s milk. The infant soy milk formulas are fortified with the needed vitamins,minerals, and essential fatty acids in specified amounts.Tips and Substitutions Like any other food, soy milk can also cause allergic reactions. A small number of milksensitiveindividuals may also become allergic to soy protein. Avoid buying “deli” meats, because the slicers frequently are used to cut both meat andcheese products. Ask how foods are prepared at restaurants. The meats may have been marinated or thebuns grilled in butter. Blenderize fruit and soy yogurt to make a smoothie. Use applesauce on hot cereal. Use milk-free creamers on cereal. Substitute tofu, a soy product, for sour cream and cheese in pasta dishes. Tofutti ice cream is made with tofu and is available in a variety of flavors. Calcium fortified orange juice has approximately the same calcium content as milk.

Tips to Follow to Prevent an Allergic Reaction1). Avoid foods that cause a reaction. Sometimes just touching foods can cause a severe reaction.2). Read the ingredients lists on food labels to make sure allergy-causing foods are present. Readthe list even if you have had the product before. Ingredients may change.3). If you are traveling, bring along some of your own special foods.4). When eating out, always ask restaurant staff about ingredients in food and how it wasprepared.5). For infants, elemental formulas or formulas with altered protein should prevent foodreactions. Discuss the various formula options with your doctor or dietitian. Do not assumeproducts labeled "hypoallergenic" will not cause a reaction.Other ResourcesFood Allergy Association of Wisconsin- www.foodallergywis.org or 608/575-9535Food Allergy and Anaphylaxis Network – http://www.foodallergy.org or 1-800-929-4040Medline Food Allergy Resource Page - http://www.nlm.nih.gov/medlineplus/foodallergy.htmlKids With Food Allergies- www.kidswithfoodallergies.orgLiving Without Magazine and website- www.livingwithout.comAllergic Child- www.allergicchild.comNutrition recommendations:Age appropriate “milk substitute” beverage:__________________________________________Multivitamin/Calcium Recommendations:____________________________________________The Spanish version of this HFFY is #466Teach Back:What is the most important thing you learned from this handout?What changes will you make in your diet/lifestyle, based on what you learned today?If you are a UW Health patient and have more questions please contact UW Health at one of the phone numberslisted below. You can also visit our website at www.uwhealth.org/nutritionUW Digestive Health CenterNutrition Clinic Room 012750 University Row,Madison, WI 53705(608) 890-5000 appointments(608) 890-5005UW Health West ClinicNutrition Clinic Room 1296451 Junction RoadMadison, WI 53717(608) 262-9181 appointments(608) 265-7526UW Health East ClinicNutrition Clinic Room 21065249 East Terrace DriveMadison, WI 53718(608) 265-7405 appointments(608) 265-0963American Family Children’s Hospital, 1675 Highland Ave, Madison, WI 53792Pediatric Specialty Clinics - Nutrition (608) 263-6420 AppointmentsCopyright 9/2012. University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by theClinical Nutrition Services Department and the Department of Nursing HF#271