Cow’s milk is a common ingredient in many popular foods. Milk is also an ingredient commonly known to cause allergic reactions and is part of the Top 9 allergens identified by the Food and Drug Administration (FDA). For the thousands who manage a milk allergy, foods that so many get to enjoy like yogurt, cheese, ice cream, and butter, must be strictly avoided for risk of life-threatening reaction. However, avoidance is no longer the only option. A solution to milk allergies exists!
Read on to learn how everything you need to know about milk allergies and Food Allergy Institute’s revolutionary milk allergy treatment!
What is a Milk Allergy?
About 1.9% of children in the US have a milk allergy. In a survey of adults with food allergies, milk allergy was the second most common allergy. Those with milk allergies have an overactive immune system that identifies milk proteins as threats. To fight these threats (milk proteins) an antibody called Immunoglobulin E (IgE) triggers an immune response which can result in itching, redness, swelling, and other symptoms. The result can range from small, localized reactions (one symptom in one place) to life-threatening, anaphylactic reactions (multiple symptoms impacting at least two systems or a drop in blood pressure). Those with milk allergies should always carry epinephrine autoinjectors in the event that anaphylaxis should occur.
Baked Milk Tolerance
Some people with milk allergies can tolerate baked milk. Studies suggest that potentially 75% of children with a cow’s milk allergy can tolerate baked cow’s milk. Carefully monitored oral food challenges done under an allergist can test if a patient with a milk allergy can tolerate baked milk. However, testing this at home is never a good idea as it does come with risks of anaphylaxis.
Milk Labeling
The US produced about 226.6 billion pounds of milk for human consumption in 2022. Under the Food Allergen Labeling and Consumer Protection Act of 2004 (FALCPA), milk is considered to be a top allergen in the US and must be clearly labeled for consumers on packaged food products. In the Code of Federal Regulations Title 21, volume 2, the FDA defines milk as “the lacteal secretion, practically free from colostrum, obtained by the complete milking of one or more healthy cows.” This is notable as oftentimes, those with cow’s milk allergies will react to other types of milk like goat or sheep’s milk. These types of milk may not need to be labeled as clearly as cow’s milk in the US due to the FDA’s definition of milk.
Casein vs Whey Explained
Casein and whey are both major proteins found in milk. Milk has several types of proteins in it, but those with milk allergies are most likely to react to one of these two proteins. It’s possible to be more sensitive to one or the other, but sensitivity to one of the major proteins means that a patient will likely react to dairy products no matter what. While some food labels may mention “casein” or “whey,” it is legally required in the US that the word “milk” must be written either in parentheses next to these protein names or clearly at the bottom of the label. Labels don’t have to name the milk proteins used specifically.
Cross Reactivity Potential
Mammal milk has similar shared proteins across different species, so it is not uncommon to have someone who is allergic to one type of milk to be allergic to another. This is known as cross-reactivity. Studies have shown that around 90% of those with a cow’s milk allergy will react to goat or sheep milk. Only about 5% react to mare or donkey milk. If you are diagnosed with a cow’s milk allergy, consult with your primary care provider to see if you are sensitive to other types of milk. At the Food Allergy Institute, treatment plans* for dairy involve using cross-reactivity in a patient’s favor by having patients dose milk that they are least allergic to in order to build a better tolerance for those that they are anaphylactic to.
*Please note all TIP milk allergy treatment plans are custom-made to address a patient’s specific immune system and will vary case by case.
Milk or Dairy?
Milk and dairy are often used interchangeably, but they mean slightly different things. Dairy products, by definition, are “foods that are made from milk, such as cream, butter, and cheese.” Traditional milk comes from the mammary glands of mammals like cows, goats, and sheep. Milk is an ingredient in dairy products. Those who are allergic to milk will react to other dairy products as well. So if you are allergic to milk, you will likely react to yogurt, cheese, cream, etc. It’s notable to add that eggs are dairy products.
Plant-Based Milk Products
With the rise in allergy-friendly and vegan options in grocery stores, non-dairy plant-based “milks” are becoming more popular. While the word milk is associated with plant-based alternatives, typically, dairy is used specifically in reference to animal-derived products. In theory, plant-based alternatives should be dairy free. The liquid produced from nuts, seeds, and other plants is not related to the liquid that comes from mammals. Be aware that just because something is plant-based or vegan does not mean it is automatically safe for allergies. Vegan products can still come with cross-contamination risks, so read every label carefully. With the rise of genetically engineered food, it’s also possible that vegan products can actually have milk proteins that are man-made and not directly sourced from an animal. This is something new but may be a part of the future of veganism. Someone with a milk allergy can still react to manufactured versions of dairy proteins and should never make assumptions about anything without reading labels first.
Milk Allergy Vs. Lactose Intolerance
Milk allergies and lactose intolerance are often confused, but they are very different conditions that involve different systems in the body. Milk allergies are often IgE-mediated and are a result of an overactive immune system. The result of this response can be deadly.
About 30 to 50 million Americans have lactose intolerance. Those with lactose intolerance lack the enzyme lactase, which helps the body break down lactose, a sugar found in milk. When someone with lactose intolerance drinks regular milk, it can cause several uncomfortable symptoms such as gas, bloating, nausea, and diarrhea. While it can be an unpleasant experience, consuming lactose as someone who is intolerant is not deadly. Milk allergies are far more serious and require far more strict avoidance.
Understanding Anaphylaxis
Up to 5% of the US population has experienced anaphylaxis. Anaphylaxis is a life-threatening allergic reaction that requires immediate medical attention. By definition, anaphylaxis is a multi-system reaction that involves two or more systems in the body. A steep drop in blood pressure alone is also considered anaphylaxis. While fatal anaphylaxis constitutes less than 1% of total mortality risk and is quite rare, every reaction should be taken seriously . Acting fast and using epinephrine right away is key for ensuring a safe recovery from anaphylaxis. That’s why it is so important to always carry two epinephrine autoinjectors with you at all times. Antihistamines don’t act quickly enough to handle anaphylaxis on their own, so using an epinephrine auto-injector to treat anaphylaxis at the early stages is key to survival. Some of the signs of anaphylaxis include:
- Trouble breathing, wheezing, or asthma
- Feeling dizzy, dazed or confused
- Redness or swelling on the face or body
- Stomach upset like diarrhea or vomiting
- Itchy throat, mouth, eyes, nose, or skin
- Rashes or hives
- Increased anxiety or sense of doom
The Food Allergy Institute creates individualized emergency kits for their patients in the event of a reaction.
Milk Allergy Treatment at FAI
Living with a milk allergy can be challenging, but a life of milk avoidance is not the only way. An effective milk allergy treatment exists!
At Food Allergy Institute, patients with milk allergies can successfully reach remission (“Food Freedom”) from their food allergies. Patients who enter the Tolerance Induction Program ™ (TIP) can reach food freedom through a highly individualized treatment plan that retrains the body to tolerate allergens safely over time. This means a life full of eating ice cream, yogurt, milkshakes, and any other milk products in any amount without reaction. Schedule a free consultation below or check out our Tolerance Induction Program™(TIP) Guide to learn more!