Milk allergy is one of the top food allergies among children in the Philippines. The most common form is cow’s milk allergy which is due to the abnormal reaction of the immune system against proteins in cow’s milk. It appears in infancy and early childhood within the first 12 months of life and gradually resolves with age. The onset of symptoms occurs within minutes to 2 hours after ingestion. Symptoms include:
● Skin: Rashes, Swelling, Redness
● Respiratory: Throat tightness, Difficulty breathing, Coughing, Wheezing
● Gastrointestinal: Abdominal pain, Vomiting, Diarrhea
● Cardiovascular: Dizziness, Confusion, Hypotension
Milk allergy during early childhood may lead to deficiencies in important nutrients such as protein, Riboflavin, Vitamin A, D and Calcium which are needed for optimal growth. Studies have shown that persistent cow’s milk allergy is associated to stunted growth, thus diagnosing true milk allergy from milk intolerance with the help of a physician is important to prevent unnecessary milk restriction. If ever you are diagnosed with milk allergy, it is important to be familiar with Milk-containing foods to avoid, hidden milk ingredients in food labels and alternative food sources of Protein, Calcium and Vitamin D or cow’s milk alternatives.
Milk-containing Foods to Avoid
● Cheese
● Cow’s Milk
● Creamed soups and sauces
● Some gravies
● Cocoa mixes
● Some margarines
● Butter
● Ice cream
● Cakes
● Sherbet
● Many baked items
● Buttermilk
● Baking mixes
● Biscuits
● Yogurt
● Some salad dressings
● Some hotdogs, cold cuts, sausages
● Mashed potatoes made with milk
● Milk chocolate products
● Malted milk
● Nougat
● Puddings
● Some breaded foods
● Custard
● Imitation sour cream (made with buttermilk)
Hidden Milk Ingredients in Food Labels
● Casein
● Caseinate
● Calcium caseinate
● Whey
● Lactalbumin
● Cream
● Non-fat Milk Solids
● Lactoglobulin
● Half and Half
● Curds
● Whey powder
Alternative Food Sources of Protein, Calcium and Vitamin D or Cow’s Milk Alternatives
● Calcium and Vit. D Supplements
● Fortified soy formulas
● Soy cream
● Soy beverages
● Milk-free whipped toppings
● Milk-free margarines
● Kosher hotdogs, cold cuts
● Products labeled “Parve” or “Pareve”
● Protein hydrosylate formula for infants (consult your doctor)
● Nut milks like almond milk
● Some non-dairy creamers
● Most French Bread
● Foods prepared without milk or butter
● Tofu desserts, Taho
● Puddings with fruit juice
For infants and children, they may outgrow their milk allergy as they grow older. Milk tolerance can be tested by 1 year of age with baked milk in the form of baked goods or pastries with milk as an ingredient. Baking involves high temperature that destroys the original structure of milk proteins that the immune system responds to - thus, more tolerated as compared to other milk preparations. Ultimately, human breastmilk is still the best milk for infants and children.
/AET
References:
Hill, D. J., Hosking, C. S., Zhie, C. Y., Leung, R., Baratwidjaja, K., Iikura, Y., ... & Hsieh, K. H. (1997). The frequency of food allergy in Australia and Asia. Environmental Toxicology and Pharmacology, 4(1-2), 101-110.
Flom, J. D., & Sicherer, S. H. (2019). Epidemiology of cow’s milk allergy. Nutrients, 11(5), 1051.
Jamorabo-Ruiz, A., Serrano-Claudio, V. & Exevea-de Castro, Esperanza (2011). Medical Nutrition Therapy for Filipinos, 6th ed. Manila: Merriam & Webster Bookstore, Inc.
Dupont, C., Chouraqui, J. P., Linglart, A., Bocquet, A., Darmaun, D., Feillet, F., ... & Briend, A. (2018). Nutritional management of cow's milk allergy in children: An update. Archives de Pédiatrie, 25(3), 236-243.
