The Milk Allergy Diet Guide

milk-free diet
No milk for me!. PhotoAlto/Laurence Mouton/Photo Alto Agency/Getty Images

Cow’s milk allergy –-a common food allergy in children—occurs in about 2.5% of all children. Odds are that 80% of children with milk allergy will see this allergy resolve by age 5 although more recent studies indicate about half of children will still have a milk allergy at age 8. By the teen years, most kids will have outgrown milk allergy. Current research is underway to test milk oral immunotherapy as a way to develop tolerance to milk protein.

Symptoms of Cow's Milk Allergy

Symptoms associated with a cow’s milk allergy occur fairly quickly, with most individuals reacting within minutes to two hours after drinking milk or eating foods made with milk.

Symptoms may include:

  • Skin reactions such as rash, hives or eczema.
  • Gastrointestinal symptoms like nausea, stomach pain, vomiting, or diarrhea.
  • Airway symptoms including wheezing, coughing, or a runny nose.
  • Swelling, also known as angioedema, of the lips, tongue, or face.
  • Severe reactions, called anaphylaxis, may occur, causing multiple organ systems to be involved.

What It’s Not

Cow’s milk allergy is not a condition called lactose intolerance, where the milk sugar (lactose) found in milk is not digested well or tolerated, resulting in gas, bloating, gastrointestinal cramping, and diarrhea. Symptoms of lactose intolerance may occur immediately after drinking milk or eating food containing milk, like ice cream or cheese, or it may have a delayed onset, of up to 12 hours after ingestion.

If you have lactose intolerance, you may tolerate cow’s milk with the lactose removed, such as Lactaid milk, or by using Lactaid pills to help digest the lactose. Some individuals with lactose intolerance may tolerate yogurt containing live, active cultures, or even small amounts of milk baked in products.

Individual tolerance to lactose is highly variable. On the contrary, a person with cow’s milk allergy would not be able to tolerate any lactose-free milk because the allergy is to the cow’s milk protein component, not the carbohydrate source (lactose).

Treatment for Cow's Milk Allergy

Avoidance of milk and products made with milk is the gold standard for treatment of a milk allergy. While scientists are looking for a cure, none exists at this time. Immunotherapy for milk allergy is one area of research in this endeavor.

How to Avoid Cow's Milk

As mentioned, all cow’s milk (skim milk, 1% milk, 2% milk and whole milk) must be eliminated from the diet to avoid an allergic reaction. Equally important is to avoid all foods made with milk, like cheese, and other products that use milk in processing such as crackers, cereals, baked goods, and more. Hidden milk can be a surprise, so avoid accidentally consuming milk by reading the ingredient label on food products. The food allergy labeling law (FALCPA) insists manufacturers list milk as a potential allergen ingredient for the consumer.

Not only will you find this information in the ingredient list, but it will also be on the package. Some products won’t call out dairy based ingredients on the label. There are two things you can do in this situation: call the manufacturer and inquire about the specific ingredients contained in the product, and/or skip eating the product.

More Helpful Tips

Avoiding milk for a milk allergy means eliminating a whole food group from your diet. Whenever you have to do this, you must make an effort to replace the important nutrients offered by the eliminated food group. This way, you can keep your diet nutritionally sound. For instance, in the case of milk allergy, you will need to find replacements (food or supplements) for calcium and vitamin D.

For young children, be on the lookout for problems with weight gain and growth. Researchers have found that kids with milk allergy and/or multiple food allergies may be more likely to experience growth problems due to their restricted diet.


Food Allergy Research and Education (FARE) website (

Boyce JA et al. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report from the NIAID-sponsored Expert Panel. J Allergy Clin Immunology. 2010.

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