Milk allergy

A milk allergy is a reaction of the immune system to proteins in milk, mainly casein and whey. It is most common in babies and young children, and many grow out of it, but adults can have it too. It is different from lactose intolerance, which is a problem digesting the milk sugar. A doctor should diagnose a milk allergy and give you a plan.

Milk from goats, sheep and buffalo has very similar proteins, so most people with a cow's milk allergy have to avoid those too.

Substitutes

• Plant milks such as oat, soy or rice milk. Choose plain, unsweetened ones for cooking.
• Coconut milk or a plant-based cream for cream.
• Oil or a plant-based block for butter.
• Plant milk with a spoonful of lemon juice in place of buttermilk.

For a baby or young child, do not change milks or formula on your own. Talk to a doctor or dietitian first.

Common mistakes

• Using lactose-free milk. It contains the same proteins.
• Using ghee or clarified butter. Most of the protein is removed, not all.
• Trusting "non-dairy". In the US, products sold as non-dairy can contain caseinate, a milk protein.
• Missing milk in bread, crackers, sausages, chocolate, mashed potatoes, batters, and anything brushed with butter.
• Picking cheese off a dish. The protein stays on the food.

In recipes

Milk is a labeled allergen in both the EU and the US:

• In the EU and the UK, milk is one of the 14 allergens and must be emphasized in the ingredients list. Lactose counts as milk.
• In the US, milk is one of the nine major allergens and must be named in the ingredients or a "Contains" statement.

Other names to watch for: whey, casein, caseinate, milk solids, milk powder, butterfat, curds, cream, cheese, yogurt and lactose. A recipe marked dairy-free is the one to look for. Read labels every time you buy, because recipes change, and ask your doctor what to do if you eat milk by accident.