Food allergies are based on specific food proteins, and are not to be confused with food intolerances (such as lactose). Those suffering from food allergies are advised to read food labels carefully, and always have an EpiPen (a brand of epinephrine injector) handy in case of an incident.
Patients with very sensitive milk allergy can react to even a very small quantity of milk protein, including minor contamination or inhalation of milk powder.
Milk is found in a large variety of processed foods, some obvious and others not. These products include confections, margarine, cheese, and pies (see table below). Cheese and cream contain milk protein and should be avoided. Milk contamination of a product is possible if the same manufacturing equipment is used for multiple products. In addition, patients should be careful when ordering sliced products from outlets that use the same slicers for cutting a variety of foods (e.g., cheese and cold cuts). Lactose, a milk sugar, may contain residual milk protein. Lactose is found in a variety of foods and is also used a filler in medicines such as Benadryl capsules.
Foods that may contain milk protein
- Batter-fried foods
- Biscuits
- Bread
- Breakfast cereals
- Cakes
- Chocolate
- Cookies
- Cream sauces
- Cream soups
- Custard
- Fish in batter
- Gravies and gravy mixes
- Ice cream (and “non-milk” fat)
- Imitation sour cream
- Instant mashed potatoes
- Margarine
- Muesli
- Muffins
- Other baked goods
- Packaged soups
- Pies
- Puddings
- Rusks
- Sausages
- Sherbet
- Soy cheese
- Soup mixes
- Sweets
- Canned soups
- Vegetarian cheese
Hypoallergenic milk formulas have been used as a milk replacement for children with milk hypersensitivity. However, hypoallergenic milk formulas are not nonallergenic, and many children react to these, depending on the particular formula.
Common descriptions on ingredient panels are milk, pasteurized milk, full cream milk powder, dried milk, and skim milk powder (see table below). Extracted milk proteins added to foods retain their antigenicity and may be described as casein, caseinate, whey or whey powder. Many individuals consider skim milk and skim milk powder not to be milk and substitute these for milk. In some instances milk is used in emulsions and can be described as caseinate, emulsifier or protein
Labels that may indicate the presence of milk protein
- Artificial butter flavor
- Butter
- Butter fat
- Buttermilk solids
- Caramel color
- Caramel flavoring
- Casein
- Caseinate
- Cheese
- Cream
- Curds
- De-lactosed whey
- Demineralized whey
- Dried milk
- Dry milk solids
- Fully cream milk powder
- High protein flavor
- Lactalbumin
- Lactalbumin phosphate
- Lactose
- Milk
- Milk derivate
- Milk protein
- Milk solids
- Natural flavoring
- Pasteurized milk
- Rennet casein
- Skim milk powder
- Solids
- Sour cream (or solids)
- Sour milk solids
- Whey
- Whey powder
- Whey protein concentrate Yogurt
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