Cincinnati Children's Blog

Cow’s Milk Elimination Diet – Where to Start

Cow’s Milk Elimination Diet – Where to Start

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.

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