A milk allergy is one of the eight most common food allergies in the United States, and it is the most common food allergy among infants and young children.
Managing Milk Allergies
Strict avoidance and reading food labels is the only form of managing food allergies. Thankfully, reading labels for hidden sources of milk has become much easier since the Food Allergen Labeling and Consumer Protection Act (FALCPA) went into effect in 2006. Since then the top eight allergens, which includes milk, must be declared on all product labels in simple terms within the ingredient statement. Still, educating yourself on the unexpected sources of allergens is another way to prevent exposure and/or a reaction.
Avoid foods that contain milk or any of these ingredients:
- Butter, butter fat, butter oil, butter acid, butter ester(s).
- Casein hydrolysate.
- Caseinates (in all forms).
- Cottage cheese.
- Lactalbumin, lactalbumin phosphate.
- Milk (in all forms, including condensed, derivative, dry, evaporated, goat’s milk and milk from other animals, low-fat, malted, milkfat, non-fat, powder, protein, skimmed, solids, whole).
- Milk protein hydrolysate.
- Rennet casein.
- Sour cream, sour cream solids.
- Sour milk solids.
- Whey (in all forms).
- Whey protein hydrolysate.
Milk is sometimes found in the following:
- Artificial butter flavor.
- Baked goods.
- Caramel candies.
- Lactic acid starter culture and other bacterial cultures.
- Luncheon meat, hot dogs, sausages.
- Nondairy products.
Unexpected Sources of Milk
- Sliced deli meats–if a meat slicer is used for both meat and cheese, the milk in the cheese may cross-contaminate the meat, potentially causing a reaction.
- Canned tuna may contain casein, a milk derivative.
- Many meats items such as hot dogs contain casein as a binder.
- Melted butter, which can be found on grilled foods like steaks.
- Many non-dairy products contain casein.
What Foodservice Operators Must Keep in Mind for Milk Allergies
Many non-dairy food products contain casein, which is a milk derivative and is considered a food chemical according to food labeling laws, thus allowing the product to still be labeled as non-dairy. However, individuals allergic to milk need to avoid products containing casein because it is a milk derivative and can cause an allergic reaction. It is always best practice to read the entire ingredient statement to ensure the product does not contain milk. Even though casein doesn’t fall under the “Food Ingredient Labeling Law,” it does fall under the “Food Allergen Labeling Law” and must be identified as milk (therefore milk will still be listed as a common allergen when casein is included).
Milk Substitutions to Consider
Enriched soy, almond and/or rice milk are the common fluid milk replacements for those allergic to cow’s milk. These enriched alternatives often provide the same nutrients as dairy milk, certainly easing concerns about nutritional inadequacy. Also, when it comes to cooking or baking, milk is very simple to replace and can be substituted with water (or juice in certain cases) in equal amounts.
What is the Difference Between a Milk Allergy and an Intolerance?
Someone allergic to milk must avoid it in all forms and quantities. A lactose intolerant individual can generally handle lactose in small quantities and certain forms of foods, such as hard cheeses. Remember, a true allergy can be life-threatening and will produce an immune system response, while an intolerance is not life-threatening (though it still will damage the body) and generally will produce gastrointestinal symptoms.
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