Milk Allergy

Food allergies are based on specific food protiens, and are not to be confused with food intolerances (such as lactose). Those suffering from food allergies are advised to read food labels carefully, and always have an EpiPen (a brand of epinephrine injector) handy in case of an incident.

Milk

Patients with very sensitive milk allergy can react to even a very small quantity of milk protein, including minor contamination or inhalation of milk powder. Milk is found in a large variety of processed foods, some obvious and others not. These products include confections, margarine, cheese, and pies (see table below). Cheese and cream contain milk protein and should be avoided. Milk contamination of a product is possible if the same manufacturing equipment is used for multiple products. In addition, patients should be careful when ordering sliced products from outlets that use the same slicers for cutting a variety of foods (e.g., cheese and cold cuts). Lactose, a milk sugar, may contain residual milk protein. Lactose is found in a variety of foods and is also used a filler in medicines such as Benadryl capsules.

TABLE III -- Foods that may contain milk protein
Batter-fried foods Biscuits Bread Breakfast cereals Cakes Chocolate Cookies Cream sauces Cream soups Custard	Fish in batter Gravies and gravy mixes Ice cream (and ``non-milk'' fat) Imitation sour cream Instant mashed potatoes Margarine Muesli Muffins Other baked goods Packaged soups	Pies Puddings Rusks Sausages Sherbet Soy cheese Soup mixes Sweets Canned soups Vegetarian cheese

Hypoallergenic milk formulas have been used as a milk replacement for children with milk hypersensitivity. However, hypoallergenic milk formulas are not nonallergenic, and many children react to these, depending on the particular formula.

Common descriptions on ingredient panels are milk, pasteurized milk, full cream milk powder, dried milk, and skim milk powder (see table below). Extracted milk proteins added to foods retain their antigenicity and may be described as casein, caseinate, whey or whey powder. Many individuals consider skim milk and skim milk powder not to be milk and substitute these for milk. In some instances milk is used in emulsions and can be described as caseinate, emulsifier or protein

TABLE IV -- Labels that may indicate the presence of milk protein
Artificial butter flavor Butter Butter fat Buttermilk solids Caramel color Caramel flavoring Casein Caseinate Cheese Cream Curds De-lactosed whey	Demineralized whey Dried milk Dry milk solids Fully cream milk powder High protein flavor Lactalbumin Lactalbumin phosphate Lactose Milk Milk derivate Milk protein	Milk solids Natural flavoring Pasteurized milk Rennet casein Skim milk powder Solids Sour cream (or solids) Sour milk solids Whey Whey powder Whey protein concentrate Yogurt