Milk and Dairy Allergy
Amherst College Dining Services can assist with avoiding dairy products.
Ask for the Lead Cook or Manager of Dining Services for assistance with your allergies. If you would like to set
up an appointment please call 542-2220 or email valentine@amherst.edu.
It’s strongly recommended that you make an appointment with Health Services if you have not done so already
and inform them of your medical condition.
When in Valentine Dining Hall, be aware to look at the signage at each food
station:
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Avoid any breaded products as they may have traces of milk protein or may have been deep fried in a
vat that may have contained dairy products. Some examples are french fries, chicken cutlets or any
other items that have breading.
Avoid baked goods as they may contain dairy products in the mix. Vegan desserts are dairy free and are
available during lunch and dinner. Fresh fruit is also available and dairy free.
Breads may contain dairy products. Be sure to read the ingredients of each type of bread to see if you
can eat it. Manufacturers can change the formulation of a product and we may not be aware of it.
Soy milk, Rice milk, and Lactaid Milk are available at Valentine.
Following a milk free diet can be difficult. Milk and milk related products can show up on a label under
many different names.
Symptoms
Typical symptoms are gastrointestinal, dermatological and respiratory. These can result in: skin rash, hives,
vomiting, and gastric distress such as diarrhea, constipation, stomach pain or flatulence). The clinical spectrum
extends to diverse disorders: anaphylactic reactions, atopic dermatitis, wheeze, infantile colic, gastroesophageal
reflux (GER), oesophagitis, allergic colitis headache/migraine and constipation.
The symptoms may occur within a few minutes after exposure in immediate reactions, or after hours (and in
some cases after several days) in delayed reactions.
Difference between milk allergy and lactose intolerance
Milk allergy is a food allergy, an adverse immune reaction to a food protein that is normally harmless to the
non-allergic individual. Lactose intolerance is a non-allergic food sensitivity, and comes from a lack of
production of the enzyme lactase, required to digest the predominant sugar in milk. Lactose intolerance is not
actually a disease or malady. Adverse effects of lactose intolerance occur at much higher milk consumption
than adverse effects of milk allergy.
Difference from milk protein intolerance
Milk protein intolerance (MPI) is delayed reaction to a food protein that is normally harmless to the nonallergic, non-intolerant individual. Milk protein intolerance produces a non-IgE antibody and is not detected by
allergy blood tests. Milk protein intolerance produces a range of symptoms very similar to milk allergy
symptoms, but can also include blood and/or mucus in the stool. Treatment for milk protein intolerance is the
same as for milk allergy. Milk protein intolerance is also referred to as milk soy protein intolerance (MSPI).
Treatment
Currently the only treatment for milk allergies is total avoidance of milk proteins. Products in addition to milk
itself to be avoided include yogurt, butter, cheese, and cream. Goats' milk products may also need to be avoided.
Ingredients that also denote that food product contains dairy milk include whey, casein, caseinate, butter flavor,
lactic acid (lactic acid derived from dairy products), natural or artificial flavors such as milk or butter flavor,
and sodium caseinate. It is commonplace for milk or milk derivatives to be included in processed foods such as
bread, crackers, cookies, cakes, prepared meats, "soy cheese", soups, gravies, crisps, margarine, and products
labeled "non-dairy", such as whipped topping and creamer (non-dairy simply means less than 0.5% milk by
weight)
Also, many processed foods that do not contain milk may be processed on equipment contaminated with dairy
foods, which may cause an allergic reaction in sensitive individuals.
Milk avoidance and replacement for infants
Since milk protein may be transferred from a breastfeeding mother to an allergic infant, lactating mothers are
put on a dairy elimination diet. For formula fed infants, milk substitute formulas are used to provide a complete
source of nutrition. Milk substitutes include soy based formulas, hypoallergenic formulas based on partially or
extensively hydrolyzed protein (such as Nutramigen, Alimentum, and Pregestimil), and free amino acid-based
formulas (such as Neocate, EleCare, and Nutramigen AA).
Soy based formula does have a risk of allergic sensitivity, as some infants who are allergic to milk may also be
allergic to soy.
Hydrolyzed formulas come in partially hydrolyzed and extensively hydrolyzed varieties. Partially hydrolyzed
formulas (PHFs) are characterized by a larger proportion of long chain peptides and are considered more
palatable. However, they are intended for milder cases and are not considered suitable for treatment of moderate
to severe milk allergy or intolerance. Extensively hydrolyzed formulas (EHFs) are comprised of proteins that
have been largely broken down into free amino acids and short peptides. Casein and whey are the most
commonly used sources of protein in hydrolyzed formulas because of their high nutritional quality and their
amino acid composition.
Non-milk derived amino acid-based formulas, also known as elemental formulas, are suitable for the treatment
of mild, moderate, and severe milk allergy in infants that exhibit allergic reactions to partially and extensively
hydrolyzed formulas.
Milk substitution for children and adults
There are many replacements for milk such as rice milk, soy milk, oat milk and almond milk, but aren’t suitable
nutrition for infants. However, special infant formula based on soy, rice, almonds or carob seeds are available.
Some fruit juices are supplemented with calcium which may provide an alternative for adults and children with
milk allergy. If on an avoidance diet, it is important substitute the source of calcium to prevent the longer term
risk of calcium deficiency and osteoporosis. Very good dietary sources of calcium are sesame seeds, hemp
seeds and some kinds of tofu.
Accidental exposure
Treatment for accidental ingestion of milk products by allergic individuals varies depending on the sensitivity
of the person who’s allergic. Frequently medications such as Epinephrine or an Antihistamine such as Benadryl
are prescribed by an allergist in case of accidental ingestion. Milk allergy can cause anaphylaxis, a severe, life
threatening allergic reaction.
Like many food allergies milk allergy may be outgrown eventually by children, although a percentage of
children do not outgrow their allergy. Milk allergy is more likely to be outgrown than peanut allergy.
Hidden Dairy Ingredients
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Bechamel Sauce
Butter, butter solids
Butter Fat
Butter flavor
Buttermilk
Casein
Caseinates
Cheese of any kind
Cream
Curds
Custard
Dried Milk
Evaporated Milk
Ghee
Half and Half
High protein flour
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Ice cream
Lactate solids
Lactoglobulin, lactalbumin
Lactose
Malted Milk
Margarine
Milk (any kind, except soy & rice)
Milk protein
Milk solids
Non-fat dry milk
Nougat
Pudding
Rennet
Sodium casein
Sour or whipping cream
Whey
Yogurt (any kind, except for soy)