Allergies
Dairy foods and allergies
A cow’s milk allergy is an immune reaction to dairy proteins, which can cause serious symptoms. Let’s explore the science behind dairy allergies, their symptoms and how to manage them safely.
Cow’s milk allergy: what you need to know
A cow's milk allergy happens when your immune system reacts to proteins in milk. It's most common in children, affecting about 2%. The good news? Many outgrow it. The not-so-good news? Some don’t, carrying it into adulthood.
People with a true milk allergy will react to even a small amount of these foods. That means even a splash in your coffee or a bite of the wrong biscuit could spell trouble. Elimination from the diet is usually recommended as some symptoms can be serious, even life-threatening.
Diagnosis and management
A medical allergy specialist can diagnose a cow’s milk allergy through tests—no guesswork needed. While most children eventually outgrow the allergy, dairy should only be reintroduced under medical supervision. Repeat allergy testing can help determine if it’s safe to try dairy again. Never attempt reintroduction without a doctor’s guidance.
If cow's milk is the allergy identified, avoid all foods that contain:
- cow's milk
- cow's milk products, including cheese, yoghurt, ice-cream, butter, ghee, buttermilk, cream and cream fraiche
- cow's milk ingredients, such as milk powder, milk solids, casein and whey (these can sneak into processed foods, so always check labels).
People who are allergic to cow's milk are allergic to all types of cow's milk (regardless of milk brand or type of cow) and are often allergic to the milk of other animals such as goat's milk.
If long term exclusion is necessary, patients require an alternative source of calcium and protein and advice from an Accredited Practising Dietitian should be sought.
What happens if dairy is eliminated?
Dairy is the primary source of calcium in the Australian diet and provides other essential nutrients, including protein, vitamin B12, riboflavin, vitamin A, potassium, iodine and phosphorus.
Without proper alternatives, cutting out dairy can lead to low calcium intake, reduced bone density and a higher risk of fractures. To prevent this, it’s important to replace dairy with calcium-rich options and maintain a well-balanced diet.
Choosing the right milk alternatives
Calcium-fortified options like soy, rice, and oat drinks can help fill the gap. Make sure they contain at least 100mg of added calcium per 100ml to support bone health.
For infants under 12 months, plant-based drinks like rice, oat, coconut, or almond milk are not suitable substitutes for breast milk or formula. After 12 months, fortified soy or calcium-enriched plant-based drinks can be introduced under medical guidance, alongside other sources of protein and vitamin B12.
If you’re eliminating dairy, an Accredited Practising Dietitian can help ensure you’re meeting all your daily nutritional needs.
Milk allergy vs intolerance
Not all dairy dilemmas are the same. Milk allergy and lactose intolerance might sound similar and may share some common symptoms but they’re completely different. Intolerance symptoms are usually gastrointestinal (think diarrhoea, gas, bloating) whereas allergic reactions can cause all of the above, plus rash or anaphylaxis.
A milk allergy triggers an immune reaction and can be severe. Lactose intolerance, on the other hand? Uncomfortable, yes. Dangerous? No. People with lactose intolerance can usually tolerate some dairy, especially lactose-free options or small amounts of aged cheese and yoghurt.