Milk allergy
Milk allergy must be distinguished from lactose intolerance : while with intolerance a certain type of carbohydrate (specifically lactose) causes problems , with allergy certain proteins that are contained in milk are problematic . Milk allergy is an allergy in the classic sense , i.e. the immune system fights against a substance that is actually harmless to the body, and this manifests itself in allergic symptoms.
What symptoms can occur with a milk allergy ?
In the case of a milk allergy, the immune system overreacts to certain protein components of milk (casein or whey protein ). Problems can appear either immediately after consuming milk or with a delay. Symptoms can appear on the lips, mouth, esophagus , nose or lower respiratory tract , or on the skin or eyes. The digestive tract , lungs and cardiovascular system can also be affected . Common reactions include:
- tingling or tingling sensation in the mouth,
- itching and swelling on the mucous membranes along the entire digestive tract (from the lips to the anus ) and on the skin ( hives , eczema may also appear later ),
- sudden shortness of breath ( allergic asthma ),
- allergic shock .
You can read more information about allergic reactions in the article Allergy: what is it?
Milk allergens in food
Proteins in milk are divided into so-called milk protein fractions: thermostable casein and thermolabile whey protein . Most people allergic to milk show an allergic reaction to both protein fractions. A milk allergy that develops in infancy or childhood will, in most cases, disappear again upon starting school.
Milk protein can be found in many foods that are not obviously related to milk. Therefore, read food labels carefully (see the article Mandatory labeling of foods containing allergens ).
Milk protein can be hidden in, among other things, the following foods:
- dairy bread, pies and cakes,
- baking mixes,
- breadcrumbs,
- ice cream,
- mashed potatoes, or potato powder,
- ketchup, mustard, mayonnaise,
- ready meals and sauces.
Labeling of allergens
According to Regulation (EU) No. 1169/2011 of the European Parliament and of the Council on the provision of food information to consumers [1], milk and products derived from it (including lactose ) must be labeled and highlighted in the list of ingredients, e.g. by font type or background color. This extended labeling obligation has been mandatory since December 2014 for both packaged and unpackaged (open, bulk) goods.
You can find more detailed information in the articles Mandatory labeling of foods containing allergens and What the label of a food product tells us .
Calcium
Milk and milk products are an important source of calcium for the human body. Therefore, people suffering from milk allergy should pay particular attention to getting enough calcium from other sources. Calcium is also contained in vegetables (for example, in cabbage , broccoli , fennel , leek or spinach ) and also in various mineral waters. If there is not enough calcium in the food, a suitable dietary supplement can be used .
More information can be found in the article Calcium .
Vitamin A and Vitamin D
Milk also helps cover the need for vitamin A and vitamin D. Both of these vitamins are contained in milk fat and participate in protection against allergies and other diseases. Low-fat dairy products contain less vitamin A and D. People suffering from a milk allergy must therefore ensure a sufficient supply of vitamins A and D, as they are also responsible for bone formation , healthy skin and mucous membranes, blood formation , visual acuity and the proper functioning of the immune system. Your general practitioner can best advise you in this regard .
You can find more information in the articles Vitamin A and Vitamin D.
Proteins
Milk and milk products contain a large amount of protein. People suffering from a milk allergy should therefore ensure a sufficient supply of protein from other sources, such as lean meat, fish and eggs, but also foods of plant origin (e.g. legumes, potatoes or bread).
Only an allergist can determine the exact diagnosis of true milk allergy . If you have any health problems after consuming milk or milk products, do not try to self-diagnose and contact a specialist – otherwise, if you avoid milk unjustifiably, you could be at risk of a lack of certain nutrients or malnutrition . This also applies to children, as milk allergy occurs more often in them.
How is milk allergy treated?
Allergy triggers should be avoided in any case . People suffering from a milk allergy usually show an allergic reaction to both fractions of milk proteins – casein and whey protein, which are usually found together in food products.
Higher fat content improves tolerability
In the case of a casein allergy, one must avoid the consumption of milk of all kinds of animals (including milk products made from it): this applies not only to cow’s milk, but also to sheep’s, goat’s and mare’s milk. Casein is thermostable, so it cannot be destroyed by heat treatment. The fattier the dairy product, the less protein it contains: cream and butter therefore have a lower protein content and many people allergic to casein tolerate these foods relatively well. Rice and soy milk can be used as a substitute for milk of animal origin, as long as they do not cause allergies.
Tip: For people suffering from a casein allergy, whipped cream diluted with water can be a digestible alternative.
In the event of a whey protein allergy, one must avoid exclusively consuming cow’s milk and products made from it, while donkey, goat, sheep, etc. milk (including derived products) may represent a more digestible alternative. Whey protein is thermolabile, so its allergenic effects can be reduced by heat treatment. Therefore, people suffering from a mild allergy to whey protein can tolerate some dairy products, such as full-fat cheese, cottage cheese or long-life milk (i.e. milk treated with UHT heat).
Note: Soy can only be recommended as an alternative to a limited extent, as approximately one quarter of all sufferers have an allergic reaction to it. In addition, soy is botanically related to peanuts, so there is a risk of possible cross-allergies .
Even people suffering from a milk allergy can follow the principles of a balanced diet . You can be inspired by the food pyramid , of course taking into account the existing allergy. For example, a qualified nutritional therapist can help you with creating a balanced diet .
Note: For general information about food allergies , see Food Allergies: Prevention , Diagnosis, and Treatment .
First aid measures in case of emergency
If allergy symptoms appear, the treatment is symptomatic . People suffering from a severe milk allergy should carry an emergency kit with them at all times , which should contain:
- adrenaline auto-injector (first choice!),
- antihistamine ,
- a cortisone-type drug ,
- inhaler .
Relatives of a person suffering from a food allergy should be trained in the use of emergency medications. Special caution is necessary if a severe allergic reaction has occurred in the past.
Infants and milk allergies
Approximately 2.5% of infants suffer from milk allergy. In these children, under the supervision of a pediatrician, it is necessary to switch to artificial infant formula with hydrolyzed milk protein or to a so-called amino acid formula [2]. We do not serve milk and milk products to allergic infants; this applies not only to cow’s milk, but also to the milk of other mammals, and last but not least, to soy milk.
Who can I contact?
If you suspect that you suffer from a food allergy , you can contact your general practitioner, a specialist internist (area of specialization: gastroenterology or even better allergology) or an allergology clinic for a diagnosis and possible treatment.
