Cow's Milk Allergy
AllergyExpert.US
people with cow's milk allergy will outgrow their food allergy, but it can take many years.   According to a study
published in 2007 in the
Journal of Allergy and Clinical Immunology, milk allergy resolved in 19% of children at
age 4, in 42% by 8 years of age, in 64% by age 12, and in 79% by 16 years of age.  It is thus important to re-
Lactose intolerance is not due to an allergy to cow's milk, but results from difficulties in digesting milk proteins.

The majority (90%) of cow's milk allergic individuals will also have an allergy to goat's milk but soy milk and Rice
milk are usually well tolerated in cow's milk allergic individuals.   

90% of infants with cow's milk allergy will tolerate specially formulated cow's milk formula that are "extensively
hydrolysed".  This means that the milk particles are broken down into small pieces that the body may not recognize
as cow's milk.   Extensively hydrolyzed formulas include Pregestimil, Nutramigen and Alimentum.  

If extensively hydrolyzed formulas are not tolerated, you can use "elemental amino acid" formulas, where the cow's
milk proteins are broken into even smaller particles.    Elemental formulas include Neocate and EleCare. They are
usually very well tolerated, but can be very expensive.    

For baking:  You can substitute cow's milk with water, soy milk, rice milk, or almond milk. You can substitute butter
with milk free margarine, vegetable shortening, or soy butter.


Cow's Milk Avoidance

Avoid foods that contain:

  • Artificial butter flavor
  • Butter
  • Butter fat
  • Butter oil
  • Buttermilk
  • Casein
  • Caseinates
  • Cheese
  • Cream
  • Condensed milk
  • Cottage cheese
  • Curds
  • Custard
  • Ghee
  • Goat’s milk
  • Half and Half
  • Lactalbumin
  • Lactoglobulin
  • Lactose
  • Lactulose
  • Milk (whole, low fat, non-fat, skimmed)
  • Milk derivative
  • Milk powder
  • Milk protein
  • Nougat
  • Pudding
  • Rennet Casein
  • Sour cream
  • Sour cream solid
  • Sour milk
  • Whey
  • Yogurt


These foods may contain cow's  milk:

  • Bavarian cream
  • Biscuit
  • Brown sugar
  • Caramel flavoring
  • Cake
  • Caned tuna
  • Coconut cream
  • Cookies
  • Cream sauce
  • Cream soup
  • High protein flour
  • High protein powder
  • Ice cream
  • Instant mashed potatoes
  • Luncheon meat, hot dogs, sausages
  • Margarine
  • Muffins
  • Packet soups
  • Pies
  • Puddings
  • Sausages
  • Sherbet
  • Whipped cream

Watch out for contamination from:

  • Deli meat slicers used for both meat and cheeses
  • Pareve labeled foods.   Food products labeled as pareve may contain trace amounts of cow's milk.    There
    are at least 3 case reports of children with cow's milk allergy who developed allergic reactions after eating
    pareve labeled foods.  


Cow's milk substitutes:
Each option below equals 1 cup of cow's milk:   
  • 1 cup of soy milk
  • 1 cup of rice milk + 1 egg yolk
  • 1 cup of water + 1 egg yolk
  • 1 cup of coconut milk
  • 1 cup of fruit juice

Butter replacement:
Each of the following equals 1 stick (8 tablespoons) of butter:
  • 8 tablespoons (1 stick) of Fleischmann's unsalted margarine
  • 8 tablespoons of vegetable or olive oil
  • 6 tablespoons of unsweetened apple sauce + 2 tablespoons of one of these: olive oil, vegetable oil,
    fleischmann's unsalted margarine

If you don't want to make your own milk substitute, or do not like the taste of soy milk (or you are also allergic to
soybean), you may want to try
Vance's DariFree milk alternative.  It's made from potatoes (it is milk, soy, rice,
gluten free), and patients tell me that it works very well as a milk substitute for cooking.

Make sure to check out the
coping with food allergies page  for school and traveling tips,  and useful links including
sites that sell allergy safe foods, medic alert bracelets.  There's even a link to a website that will translate food allergy
words in just about any language you can imagine!

The AllergyExpert.US does not provide medical advice, diagnosis or treatment.  Read more on disclaimer and terms of use.
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Symptoms of food allergies

Diagnosis of food allergies

Treatment of allergic reactions

Coping with food allergies

Food allergies and vaccines


Common Food Allergies

Cow's milk allergy

Egg allergy

Fish allergy

Peanut allergy

Sesame seed allergy

Shellfish allergy

Soy allergy

Tree nut allergy

Wheat allergy


Other Food Related Disorders

Atopic Dermatitis (eczema)

Eosinophilic Esophagitis and
Gastroenteritis


Non Allergic Food Reactions

Celiac disease (gluten sensitivity)

Food Intolerance: the Basics

Lactose Intolerance

Sulfite Intolerance

Scombroid Poisoning