Cow’s Milk Elimination Diet – Where to Start

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There are many reasons why your child’s doctor may advise you to remove milk and milk products from his or her diet. The most common reason for milk elimination is food allergy or intolerance to milk.

Food allergies come in different shapes and sizes. Some children with food allergies develop immediate symptoms, such as hives or swelling, when eating or drinking milk products. Others have more delayed types of symptoms, such as severe vomiting several hours after eating. Eosinophilic Esophagitis (EoE), is another form of food allergy which may also require patients to avoid cow’s milk or foods containing milk in their diets.

The information below will guide you on how to safely remove milk from your child’s diet when he or she has EoE or other food allergies.

Which foods to avoid?

Cow’s milk as well as goat, sheep and other animal milks should also be avoided, as their proteins are similar to cow’s milk.

Someone on a milk-free diet should not eat the following foods:

  • Cow’s milk (fresh, long-life milk or milk on the shelf)
  • Buttermilk
  • Condensed milk
  • Cream/artificial cream
  • Evaporated milk
  • Butter, butter oil
  • Ghee
  • Margarine
  • Cheese
  • Fromage Frais
  • Ice Cream
  • Yogurt
  • Sour Cream
  • Some versions of low fat/low calorie mayonnaise and some salad creams

Milk is often included as an ingredient that may not appear to be milk containing. Someone on a milk-free diet should also exclude foods containing the following ingredients:

  • Casein (curds), Hydrolyzed casein
  • Caseinates, calcium or sodium caseinate
  • Lactoglobulin
  • Lactoalbumin
  • Lactose
  • Milk powder, Skimmed milk powder
  • Milk protein
  • Milk sugar
  • Milk solids, Non-fat milk solids
  • Modified milk
  • Whey, Whey solids, Hydrolyzed whey, Hydrolyzed whey protein, Whey protein, Whey syrup sweetener

Reading food labels

To determine if the any of the above listed ingredients are in a food, you must read the food product label. There are two ways MILK may be indicated on a product label:

1. Within the ingredient list in parenthesis ( ) or BOLD:

Parenthesis:

INGREDIENTS: CASEIN (MILK), DIPOTASSIUM PHOSPHATE, NATURAL FLAVOR

Bold:

INGREDIENTS: MILK CASEIN, DIPOTASSIUM PHOSPHATE, NATURAL FLAVOR

2. As a separate statement after the ingredient list: 

INGREDIENTS: CASEIN, DIPOTASSIUM PHOSPHATE, NATURAL FLAVOR

CONTAINS: MILK

Now that we’ve covered the basics of what is NOT included in a milk free diet, now read how to incorporate nutritious milk-free foods that your child CAN eat and will love too!

Editor’s note: Carina is a dietitian in the Cincinnati Center for Eosinophilic Disorders, click to learn more about the clinical program and the research the EoE team is doing.

 

Carina Venter, PhD, RD

About the Author: Carina Venter, PhD, RD

Carina Venter is a Research Associate/Dietician at Cincinnati Children's Hospital Medical Center with the Cincinnati Center for Eosinophilic Disorders. She has published in international journals and has authored book chapters in food hypersensitivity, pregnancy, lactation, weaning and allergy prevention. Carina is also co-editor of the book, Food Hypersensitivity: Diagnosing and Managing Food Allergies and Intolerances.

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Comments

  1. Fumblina November 11, 09:09
    Hi, it's great to see a Peadiatric Dietician with an interest / knowledge of cmpa. My dietician's referral to the allergy specialist for my breastfed cmpa girl stated lactose intolerance. Although I see her still with both my children as we don't get much choice on the NHS it has certainly reduced my faith in her! I don't know if ingredients are different in the US but here (UK) a lot of ordinary mayo is dairy free. The low fat versions often (but not always) have cream powder in but all full fat mayo I have seen does not contain milk. A surprising number of people think eggs are dairy and tell us we can't have mayo when trying to eat out. In my view having it in your list of dairy products when it is just another product that may have milk as an ingredient - like muffins, sauces etc - might add to that confusion.
    • Carina Venter, PhD, RD
      Carina Venter, PhD, RD Author November 20, 14:08
      thanks for highlighting this: Some Home-made recipes contain milk, but it is mainly some of the low fat/low kcal versions or mayonnaise or salad cream/dressing. We have now amended the text. Our next blog on eating with food allergies during the holidays will be out soon!
  2. Jo November 12, 05:32
    Great blog thanks. I was surprised by the addition on Mayonaise as we find it depends on the brand. Some modern mayo or "light" versions contain milk but homemade or authentic mayo contains oil and eggs. Have I missed something? Thanks. ???? Ps looking forward to the next blog.
    • Carina Venter, PhD, RD
      Carina Venter, PhD, RD Author November 20, 14:08
      thanks for highlighting this: Some Home-made recipes contain milk, but it is mainly some of the low fat/low kcal versions or mayonnaise or salad cream/dressing. We have now amended the text. Our next blog on eating with food allergies during the holidays will be out soon!