Children & Adolescents Clinic

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Clinical Reference Systems: Pediatric Advisor 10.0

Cow's Milk Allergy Diet

Avoid All Sources of Cow's Milk

In very young children, cow's milk is the leading cause of allergic reactions. Once you know your child has a cow's-milk allergy, all milk and milk products must be completely removed from the diet. Not even small amounts should be eaten.

Avoid buying "deli" meats because the slicers may be used to cut both meat and cheese products. Also, some deli meats contain milk.

Another problem that is increasing is the presence of cross contaminants in processed foods. For example, recently three children have experienced allergic reactions after eating tofu ice cream. The ice cream had significant levels of cow's milk protein in it. Tofu ice cream is not made with milk, but much of it is made in dairy plants, and the batch in question had been contaminated. To combat this problem, sensitive tests to detect small amounts of food proteins are being developed and will be useful in making sure that safe foods are really safe.

Read Food Labels

Knowing how to read a food label will help you avoid problems caused by cow's milk in foods.

 
Terms that mean the product does contain cow's milk protein:
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ammonium caseinate         custard                 milk solids
artificial butter flavor   delactosed whey         potassium caseinate
butter                     demineralized whey      rennet caseinate
butter fat                 dry milk solids         sodium caseinate
butter solids              ghee                    sour cream
buttermilk                 half & half             sour cream solids
calcium caseinate          lactalbumin             sour milk solids
casein                     lactalbumin phosphate   whey protein
cheese                     lactose                      concentrate
cream                      magnesium caseinate     yogurt
curds                      milk protein 
cottage cheese             milk derivative
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Terms that may mean the product contains cow's milk protein: 
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high protein flour        natural flavoring 
caramel flavoring 
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Use Soy Formula and Soy Milk

If your baby is allergic to cow's milk, your doctor may recommend that you give a soy-based or casein-hydrolysate formula that will provide the nutrients usually found in milk and milk products. Some soy-based formulas are Isomil, Prosobee, Nursoy, and I-Soyalac. Casein-hydrolysate formulas contain milk protein that has been extensively broken down so it isn't as likely to cause an allergic reaction as regular milk. Some casein-hydrolysate formulas are Alimentum, Nutramigen, and Pregestimil.

In most cases, don't use Good Start; it's a partial whey hydrolysate, which means it contains some whole milk protein.

Soy-based infant formulas are fortified with nutrients. If your child is currently on a milk-free infant formula, continue to use it as long as your child willingly drinks it. There is no need to stop using soy milk as your child gets older.

Provide Missing Nutrients

Milk is normally the main source of calcium and vitamin D in a child's diet. These nutrients are needed to build strong bones. If your child is on a diet without milk and is not drinking a formula, ask your doctor about calcium and vitamin D supplements. Calcium supplements include Biocal, Caltrate, Neocalglucon, Oscal, Rolaids, Titralac, and Tums. You can also use a calcium-fortified orange juice, which has approximately the same calcium content as milk.


Provided by the Food Allergy Network, a national nonprofit organization. For more information write: FAN, 10400 Eaton Place, Suite 107, Fairfax, VA 22030 or go to www.foodallergy.org. Copyright 1999 The Food Allergy Network