Milk SubstituteMilk allergy is a reaction to a protein in cow's milk (most likely the casein, but it could be one of the whey proteins). As a result, you have to read labels and see whether they list anything that could contain milk protein. These include:

  • Milk, cow's milk
  • Milk solids
  • Casein
  • Whey
  • Whey protein

The symptoms

As happens with any allergy, the body recognizes a foreign protein and essentially tries to fight it off. It doesn't take much. Some or all of the symptoms return (often within a few minutes) when even a few drops of that protein are consumed:

  • Vomiting
  • Abdominal discomfort or pain
  • Diarrhea
  • Rash
  • Runny nose
  • Irritability in infants

The Confusion

Even if someone doesn't have a true allergy, milk can increase mucus production. Milk fat can trigger gallbladder symptoms (for those who should be on a low fat diet) and can slow stomach emptying, making some quite uncomfortable and nauseous. Milk and milk products, particularly cheese, can be constipating.And whole milk (which has 4% fat) can raise cholesterol and add to calories, which is why health organizations suggest even children as low as 18 months begin drinking 2% milk and that older children who are at risk of becoming overweight switch to 1% milk.


No one needs cow's milk. But they do need the protein, calcium and phosphorous that milk provides. Additionally, cow's milk is supplemented with Vitamin D--a nutrient that most of us don't get in the quantity we need. There are substitutes that call themselves milks that are drinks with a milky consistency and that have some of the nutrients that cow's milk does (see link below). Organic milk and lactose-free milk do not work as substitutes for someone with milk allergy, however, because they still contain the proteins that body is reacting to. Goat's milk is available but it is severely folate deficient and is often unpasteurized.Unpasturized products can pose serious risks because tuberculosis or other infections will not be killed and can pass from infected animals to affect dairy lovers.

The difference between milk allergy and lactose intolerance, is that milk allergy is a reaction to a milk protein (most likely the casein but it could be one of the whey proteins), while lactose intolerance is a usually milder reaction to the sugar in milk.

As a result, with milk allergy, you have to read labels and see whether they list anything that could contain milk protein.  These include:

Babies with milk and soy allergies, and some babies with the potential for allergies need formula where the protein isn't going to cause them more problems. They need the amino acids that make up the proteins for their nutrition--but sometimes the intact protein can cause allergies or intestinal bleeding. So the formula protein has to be broken down (already digested or hydrolyzed) in order for these babies not to have a reaction.

Some infants and children continue to have diarrhea after an intestinal infection (gastroenteritis).  Their fever breaks and their vomiting subsides, but the diarrhea continues for days or even weeks.

You may not know it, but most people in the world can't drink milk--not without suffering the consequences of diarrhea, discomfort or gas. They have lactose intolerance. It's hereditary. So at least one of their parents has the same problem. They may not recognize the problem, because over the years they've learned to shy away from milk products. They don't like ice cream or milk, because instead of feeling good when they lick their ice cream cones, they feel bloated and uncomfortable within a few hours.

By Seth Marcus, MD

Dr. Marcus, Medical Director of the SouthEast Eosinophilic Disease (SEED) Center has kindly expanded on dietary relationships in this increasingly common disorder. Previously, he has written about Eosinophilic diseases and their treatment. (Do see those very instructive posts). We are grateful for his involvement with Nutrition4Kids Dr. Stan