Milk Allergies

Patients with very sensitive milk allergy can react to a very small quantity of milk protein, including minor contamination and even inhalation of milk powder.

Milk may be found in a large variety of processed foods (some obvious and others not), including confections, margarine, cheese, and pies (Table III) . 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 various products. There is also a carryover effect when one product is used in the manufacture of another. 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 meat). Lactose, which may contain residual milk protein, may be found in foods and as a filler in the manufacture of medicines such as Benadryl capsules (United States).

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'' (Table IV) . Extracted milk proteins added to foods retain their antigenicity and may be described as casein, caseinate, whey, or whey powder. In our community, 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.

Soy products are often purchased by those specifically avoiding cow's milk, with the assumption that a soy-based product is free of cow's milk protein. This is not true. Vegetarian cheese may contain cow's milk protein. This term simply means that the rennet used in its manufacture is of vegetable origin.

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Foods that may contain Milk Protein
Batter-fried foodsMargarine
BiscuitsMuesli
BreadMuffins
Breakfast CerealsOther Baked Goods
CakesPackaged Soups
ChocolatePies
CookiesPuddings
Cream SaucesRusks
Cream SoupsSausages
CustardSherbets
Fish in batterSoy Cheese
Gravies & Gravy MixesSoup Mixes
Ice CreamSweets
Imitation Sour CreamCanned Soups
Instant Mashed PotatoesVegetarian Cheese
Labels that may Indicate the presence of Milk Protein
Artificial Butter Flavor Lactabumin Phosphate
Butter Lactose
Butter Fat Milk
Buttermilk Solids Milk Derivative
Caramel Color Milk Protein
Caramel Flavoring Milk Solids
Casein Natural Flavoring
Caseinate Pasteurized Milk
Cheese Rannet Casein
Cream Skim Milk Powder
Curds Solids
De-lactosed Whey Sour Cream
Dried Milk Sour Milk solids
Dry Milk Solids Whey
High Protein Flavor Whey Powder/Protein
Lactabumin Yogurt