what is a dairy allergy
Dairy Allergy, also known as Milk allergy, is an immune response to one or more proteins in cow’s milk or food items that contain cow’s milk. Some proteins in dairy are casein and whey (whey is also known as lactalbumin and lactoglobulin, these are components of whey protein). It is one of the most common allergies among children and most children grow out of this allergy by age 2 or 3. Symptoms usually occur within a few minutes to an hour; however, sometimes it can take a day or two for symptoms to appear.
Eczema (a red, itchy rash), is a skin condition often associated with dairy allergy. If the allergy is outgrown, eczema may replace the allergy symptoms during and after adolescence.
A dairy allergy is not the same as lactose intolerance. There is no immune reaction when you have intolerance, therefore the symptoms are different and require other methods of treatment. Lactose intolerance (can also be referred to as dairy intolerance or milk intolerance) occurs when the body does not make enough of the enzyme lactase. Lactase is the intrinsic enzyme that breaks down lactose, a sugar found in dairy products.
A dairy allergy is caused when the immune system treats proteins in milk as a threat to the body. It signals the release of antibodies to attack the protein. After the initial consumption the body becomes sensitized to those specific proteins, and releases histamine and other chemicals with each subsequent exposure. The release of these chemicals causes the allergic symptoms.
- Dairy allergy symptoms:
- Skin rash (note: eczema is a common skin condition often associated with food allergies, see your doctor for proper diagnosis)
- Loose stools
- Runny nose
- Anaphylaxis: when the throat swells making breathing difficult because the airways constrict. Other symptoms may include a rapid pulse, dizziness, shock, and lightheadedness. This is life threatening and needs to be treated with a shot of epinephrine (adrenaline). The person should also be taken to the emergency room.
Lactose intolerance (also called dairy intolerance or milk intolerance ) symptoms:
- Stomach cramping
how to test and diagnose
Food Diary: If you think you have a food allergy track your diet and symptoms. Keep a diary of the foods you are eating and what signs and symptoms you are experiencing after eating those foods.
Elimination Diet: Remove the suspected allergen from your diet for 2-3 weeks. After 2-3 weeks gradually reintroduce those foods into your diet and see how your body reacts. You can use www.foodfacts.com as a guide for ingredients to avoid or substitutions. If your symptoms are relieved during the time the food is eliminated, you may be allergic to that food. See your doctor for proper diagnosis.
Skin Test: See your doctor or an allergist and get tested. Your doctor can perform a skin test. A tiny amount of food(s) that can possibly cause an allergy is applied to your skin. Your skin is then pricked to allow that amount of food to get below the skins surface to see if you have a reaction. If you are allergic a rash may develop or another type of reaction can occur on the area that the food was applied.
Blood Test: A blood test can determine the amount of immunoglobulin E (IgE) antibodies in your blood. Your blood is sent to a lab where they test foods with your blood to see if a particular food causes you to have high amounts of IgE. If you have high amounts of IgE then you are allergic to that food.
how to manage
Avoidance is the only way to prevent symptoms from a food allergy. Be careful to read food labels to avoid your allergen and educate yourself on the names of the ingredients that may indicate your allergen is present. There are many substitutions that you can use for the foods you need to avoid.
If you are lactose intolerant you should limit the amount of dairy consumed. Since each person reacts differently you can try eating foods with lower amounts of lactase, such as swiss and cheddar cheeses. After consumption, wait a few minutes to see if a reaction occurs. Furthermore, certain foods may be digestible if consumed with other solids. Your safest solution is to avoid all dairy products or use a lactase enzyme supplement to help with digesting dairy (if you have a dairy allergy a lactose pill will not prevent a reaction).
Wear a Medical Alert bracelet to alert others to be aware of your allergy in case there is an emergency.
Be sure to tell family, friends, co-workers, teachers etc. of your allergy if there should be an emergency.
Carry an epinephrine autoinjector as directed by your doctor. If you have a severe allergy, and in the event that anaphylaxis occurs, this is advisable. This requires a prescription from your doctor. Your doctor may also prescribe other antihistamines. Antihistamines may be used; however, it is not as effective.
ingredients to avoid
- Milk and milk solids
- Skim, non-fat, powdered, evaporated milk
- Whey and whey products
- cream cheese
- sour cream
- cheese powder
- cheese sauce
- cottage cheese
- artificial butter
- butter flavor
- lactalbumin phosphate
- Sodium caseinate
common foods that contain dairy
- cake mix
- custard, nougat
- Coffee creamers
- Mashed potatoes
- Foods made “Au gratin”
- Creamed or scalloped foods, cream sauces
- Ice cream, sherbet
- Margarines (be sure to check labels)
- Salad dressings
- Non-dairy ice cream, chocolate, yogurt, and cheese (be sure to check labels on non-dairy products to make sure it doesn’t contain casein or whey)
- Soy milk
- Rice milk
- Almond milk
- Coconut milk
- Brazil nut milk
- Pine nut milk
- Goat’s milk
- Goat’s/sheep cheeses and yogurts
- Oat milk
- Kosher foods labeled “Parve” or “Pareve”
- For a sauce substitute: sautéed pureed onions, carrots, and/or turnips
- If you have a Dairy Intolerance (Lactose Intolerance), there are Lactaid milks, and Lactase enzyme supplements in chewable or swallow form to help with digesting dairy ingredients.
Suggestions for Cow’s Milk cooking substitutions
- Fruit juices can be substituted in many recipes requiring milk
- Blenderized banana and almond
- Cooked potato
- Soft tofu blended with water and lemon and/or sea salt is an excellent substitute for soft cheese.
- Cooked, blended beans with lemon juice and seasoning make a tasty cream cheese alternative.
Suggestions for Cow’s Milk / Dairy-free Eating
- Fresh vegetable or fruit juice or fresh fruit
- Hot whole grain cereals, such as cream of rice, oatmeal, cream of wheat, or cream of barley served with goat rice, soy, almond, or oatmeal milk
- Any of the cold cereals with appropriate milk substitutes
- Whole grain pancakes, waffles, or muffins made with the milk substitute of choice like goat’s milk
- Organic eggs or vegetable omelet, made with non-diary milk
Lunch and Dinner
- A basic meal of cooked low carbohydrate vegetables, beans or fish, chicken, or turkey, grain, or root crop
- Bean soups with cooked vegetables
- Stir-fry vegetables with meat or tofu
- Seafood with wheat-free pasta
- Grain casseroles like Indian millet with currants and sunflower seeds or roasted pecans with wild rice
- Bean dishes, such as twice-cooked beans wrapped in corn tortillas or red lentil dhal or vegetarian chili
- Poultry, such as fresh chicken-vegetable soup or baked, roasted, or stir-fried chicken
- Any meal can be spiced up with a whole foods substitute for family favorites, such as baked French fries or baked sweet potato chips, vegetables with active-culture yogurt dips, and jello made of agar agar or pure Knox gelatin with fruit juice sweetener if desired.
- Fresh fruits
- Fresh nuts and seeds
- Rice or other whole grain crackers with almond butter
- Hummus and crackers or rice cakes
- Soy yogurt
- Goat yogurt with fruit
- Vegetables with wholesome dips
Food Allergies and Food Intolerance: A Complete Guide To Their Identification and Treatment
Jonathan Brostoff, M.D., Linda Gamlin
JeanMarie Ceravolo, Certified Health Counselor
Above article written Feb. 2009, JeanMarie Ceravolo, CHC