Allergy to Cow's Milk

Allergy to Cow's Milk: Overview

Although cow's milk allergy and cow's milk intolerance (lactose intolerance) are two different terms, they are often used interchangeably, resulting in confusion both in clinical practice and in research reports.  Cow's milk allergy is an immunologically mediated reaction to cow's milk proteins that may involve the gastro-intestinal tract, skin, respiratory tract, or multiple systems, i.e. systemic anaphylaxis.

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Its prevalence in the general population is probably 1 to 3%, being highest in infants and lowest in adults.

Treatment and Prevention

Living with a milk allergy in a dairy-oriented culture is not as difficult as you might think.  There are a lot of nondairy foods you can substitute for milk or milk products.  You can try calcium-enriched rice milk or soy milk – these now come in vanilla and other flavors.  Goat's milk isn't a good alternative; its protein is similar to that in cow's milk and may cause the same allergic reaction.

People are usually understanding when it comes to food allergies: nobody wants to have to call an ambulance!  When eating out, order the simplest foods and ask detailed questions about menu items.  At a friend's house, explain your situation and don't be embarrassed to ask questions if you're staying for a meal.

Having a milk allergy doesn't mean you can't still enjoy eating.  In fact, some people think that some of the milk substitutes – like vanilla soy milk – taste better than regular cow's milk.  As with any specialized diet, you'll probably find avoiding milk gives you the opportunity to explore and discover some great foods that you'd never have found otherwise!


Even though it can cause severe morbidity and even fatality, dietary elimination is associated with good prognosis.

Signs, symptoms & indicators of Allergy to Cow's Milk:

Symptoms - Allergy

Above average sneezing frequency or frequent sneezing / attacks

"Allergy to cow's milk proteins has been defined as any adverse reaction mediated by immunological mechanisms to one or several of these proteins.  Reactions to cow's milk have been classified according on their onset as immediate (< 45 min) or delayed-type (from 2 hours to days).  In the challenge test, 10 hours after milk intake the patient presented serous rhinorrea, sneezing and nasal blockade." [J Investig Allergol Clin Immunol, 1998 Jul, 8: p.4]

Symptoms - Head - Nose

Symptoms - Metabolic

Frequent colds/flus

"Symptoms of milk-protein allergy include cough, choking, gasping, nose colds, asthma, sneezing attacks..." [Annals of Allergy, 1951; 9]

Symptoms - Respiratory

Recent/chronic productive cough

Respiratory symptoms of milk-protein allergy can include coughing, choking, gasping, nose colds, asthma and sneezing attacks. [Annals of Allergy, 1951; p.9]

Conditions that suggest Allergy to Cow's Milk:



"Symptoms of milk-protein allergy include cough, choking, gasping, nose colds, asthma, sneezing attacks..." [Annals of Allergy, 1951; 9]


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Allergy to Cow's Milk suggests the following may be present:



Lactose Intolerance

One study found that of 24 milk-allergic individuals studied, half were found to be lactose intolerant.

Allergy to Cow's Milk can lead to:



Recommendations for Allergy to Cow's Milk:


Plant-Based Nutrition

Vegan foods, which can be bought at health food stores and many other places, are made without any animal products, such as eggs or milk.  Be careful to read the labels of soy cheeses, though.  They may say "milk-free," but they could contain milk protein.  For your sweet tooth, soy- or rice-based frozen desserts, sorbets, and puddings are good substitutes for ice cream, as are ice pops.  For baking, milk substitutes work as well as milk and some even come out better.  Dairy-free margarine works as well as butter for recipes and spreading on a bagel.  You might also want to look for foods labeled "parve" or "pareve": they are usually made without milk products according to kosher dietary laws.  Kosher foods that are marked with a "D" are dairy and shouldn't be eaten.  Those marked with "D.E."  were made using dairy equipment and shouldn't be risked either.

Fried Foods Avoidance

Try to avoid fried and battered foods, because even if the batter doesn't contain milk products, the oil used to fry the foods may have been used to fry something that did contain milk.

Digestive Aids


Oral administration of probiotic bacteria has been shown to stabilize intestinal integrity, promote local IgA production and reduce intestinal inflammation in atopic individuals with cow's-milk allergy.

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