Milk-Free Diet

Some children and adults are allergic to the proteins found in cow's milk. Their reaction may include any combination of uncomfortable symptoms in the digestive tract ("colic", constipation, nausea, fat malabsorption, vomiting, diarrhea, abdominal pain), skin (rash), or respiratory system (coughing, asthma, runny nose, sinus symptoms).

The only ay to avoid an allergic reaction is to completely avoid eating or drinking milk, milk products, or anything made with milk or milk products. You will need to eliminate all fresh, evaporated, condensed, dried powdered milk, cream cheese, butter, margarine made with milk solids and all foods containing any of these ingredients.

Following is a list of ingredients to look for on a food label, and avoid.

Avoid
Artificial butter flavor Butter Butter fat Butter oil Buttermilk Casein Calcium caseinate Sodium caseinate Cheese (of any kind) Chocolate	Cream (of any kind, including heavy, light and sweet) Curds Custard Dry milk solids, regular and non-fat Ghee Half-n-half Ice cream, ice milk Lactose Lactalbumin Lactoglobulin	Margarine (as an ingredient on a label you cannot know if it contains milk solids or not) Milk (of any type) Milk powder Pudding Sherbet Sour cream Yogurt Whey

The following ingredients may also contain milk

• Caramel color and caramel flavoring. Call the manufacturer to find out for sure.
• Foods with the term "non-dairy" on label. "Non-dairy" foods may still contain milk protein and you need to read the label to decide if your child should eat the food.

What About Calcium?

Milk and food from milk are the main sources of calcium in our diets. Calcium is needed for strong, growing bones and teeth. Children may not get enough calcium if they can't eat milk and milk products.

To provide more calcium, serve the following foods instead:

• Broccoli
• Cooked, dried beans
• Blackstrap molasses
• Dried figs
• Beverages labeled "fortified with calcium" such as orange juice, enriched soy milk, or enriched rice milk
• Tofu
• Rhubarb
• Brazil nuts, almonds
• Canned salmon or sardines (with bones)
• Greens, such as spinach, collard greens, kale, beets, mustard, and dandelion

Check with your child's doctor about using a calcium supplement. Acceptable forms are calcium carbonate, gluconate, lactate and citrate. Avoid dolomite or bone meal supplements due to their risk related to lead poisoning.

Food Group Guidelines

Milk and milk products are used in preparing foods in every food group. Following is a list of foods that are okay, and foods to be avoided.

Milk

Allowed	Avoid
Milk substitutes: soy milk, rice milk, oat milk Soy-based infant formulas: Isomil, Prosobee Hydrolyzed protein infant formulas: Nutramigen, Pregestimil, Pepdite One Plus, Alimentum, Neocate, Peptamen Jr., Neocate Jr., Elecare, Next Step Toddler Soy Formula	Milk: Whole, low fat, 2%, skim, chocolate, malted, dried, buttermilk, condensed, evaporated Eggnog Lactase-treated milk (i.e., Lactaid drops or tablets) Lactaid milk Cheeses of any type Goat's milk

Cream Substitutes

Allowed	Avoid
Creamer: Coffee Rich, Farm Rich Whipped topping: Rich's Whipped Topping	Creamer: Cremora, Coffee Mate, Instant blend and other non-dairy creamers which contain milk protein Whipped topping: Cool Whip

Eggs

Allowed	Avoid
Any eggs prepared without milk or milk products	Any eggs prepared with milk or milk products, i.e., cheese omelet, souffles, and custards

Meat, Fish, Poultry, and Meat Substitutes

Allowed	Avoid
Plain: beef, lamb, veal, pork, ham, chicken, turkey, fish, shellfish, liver and organ meats Kosher: meat and poultry products, luncheon meats, hotdog's, bologna and salami Dried beans and peas Peanut butter Tofu Oscar Meyer All-Beef Franks	Cheese of any type Breaded, frozen meat products, such as chicken patties, fish sticks, pot pies, etc. Creamed meats Luncheon meats and cold cuts (read label)

Breads and Cereals

Allowed	Avoid
Breads and rolls without added milk products - Italian, French, Kosher and pareve breads may be acceptable (read the label) Cereal: Plain hot cereals and most cold cereals such as: Corn Flakes, Rice Krispies, Puffed Wheat, Cheerios, Wheaties, 40% Bran Flakes Crackers: Ritz crackers, Nabisco saltines, Keebler Honey Grahams (read the label)	Most commercial breads and rolls Doughnuts Crackers and breads made with butter and/or enriched with milk solids Zwieback Frozen pancakes, waffles, and french toast Cereals: Instant hot cereals with cream flavoring and cold cereals with milk protein ingredients such as Golden Grahams, Granola, Cocoa Krispies Triscuit crackers

Potato or Substitutes

Allowed	Avoid
White and sweet potatoes Rice Pasta, macaroni, noodles Frozen french fries if no milk ingredients are included (read the label)	Potatoes cooked with milk and/or butter Rice, potato and noodle mixes Frozen french fried, processed potato mixes Canned spaghetti and pasta Macaroni and cheese

Fruit and Fruit Juices

Allowed	Avoid
All (Calcium-fortified juices improve calcium intake)	Commercial frozen fruits may have lactose added

Fats

Allowed	Avoid
Vegetable oils Kosher (K/pareve) margarine may be acceptable (check the label) Lard, bacon Real mayonnaise Salad dressings made without milk solids/products	Butter Margarine with milk solids Cream: sweet, sour, heavy, whipped or light Half-n-half Cream cheese Commercial gravies Canoleo margarine

Soups

Allowed	Avoid
Broth and bouillon Broth-based soups to which no milk protein ingredients have been added (read the label)	Cream-based soups Commercial soups containing margarine Milk-based chowders Dried soups with added milk products

Desserts/Sweets

Allowed

Avoid

Gelatin Water ice and popsicles Angel food cake Milk-free cookies: gingersnaps, graham crackers Cake, cookies, pies and other desserts made without added milk products. Soy "ice cream" such as Tofutti, Tofu Lite, Rice Dream frozen dessert, Imagine Foods Pudding Nature Valley Oats 'N Honey Granola bar Plain cocoa powder Sweeteners such as sugar, honey, syrup Jams and jellies Pure sugar candy, such as marshmallows and gumdrops Homemade cake frosting without added milk

Most commercial baked goods Cream pies Ice cream and sherbet Custard and puddings Milk chocolate, most chocolate candy and fudge Commercial pie crust Cool Whip and whipped cream Candies made with milk or dairy products, such as butterscotch, caramels, toffee, peppermints, coated candies Commercial frostings Artificial sweeteners, including Equal and Sweet 'n Low

Beverages

Allowed	Avoid
Carbonated drinks Kool-Aid Tea Fruit juices Unsweetened chocolate Nestles' chocolate or strawberry Quik syrups	Cocoa mixes Instant coffee blends Powdered flavoring mixes Cocoa malt Ovaltine Eggnog Some powdered soft drink mixes may contain milk protein (read the label) Hershey's syrups

Miscellaneous

Allowed	Avoid
Most condiments: mustard, ketchup, spices, soy sauce, vinegar, and molasses Pickles and pickle relish Pure cocoa powder Carob powder Gravy without added milk Snacks: potato chips, corn chips, pretzels, and plain popcorn	Cream sauces and gravies made with milk products Party dips Pizza Snacks: corn curls, cheese-flavored chips and snacks

Additional Resources

• Try www.foodallergy.org for information and membership.