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Cow’s Milk (Dairy) Allergy

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Fast Facts Cow's milk allergy (dairy)

  1. More than 2% of infants in Australia and New Zealand have cow’s milk allergy. Allergic reactions range from mild to severe. Quick onset allergic reactions usually occur within 15 minutes, and sometimes up to two hours after having cow’s milk.
  2. Mild to moderate symptoms include swelling of lips, face, eyes, hives or welts on the skin, stomach (abdominal) pain and vomiting.
  3. Severe allergic reactions (anaphylaxis) to cow’s milk can be life threatening. Anaphylactic symptoms include difficult or noisy breathing, wheeze or persistent cough, swelling or tightness in throat, or young children may be pale and floppy.
  4. Delayed allergic reactions usually occur two or more hours after consuming cow’s milk. This may lead to several symptoms including  an increase in eczema (rashes) or delayed vomiting and/or diarrhea, but do not include anaphylaxis.
  5. Not all reactions to cow’s milk are due to allergy to cow’s milk protein. Reactions may also be due to lactose intolerance which does not  cause rashes or anaphylaxis.
  6. Diagnosis of cow’s milk allergy is made by a specialist paediatrician or clinical immunology/allergy specialist. If allergy is confirmed, management of cow’s milk allergy usually involves excluding cow’s milk and other dairy foods from the diet. An alternative source of calcium and protein is needed, to ensure adequate nutrition and growth, until cow’s milk can be safely reintroduced into the diet. Referral to a dietitian may be required.
  7. Cooked or baked cow’s milk in muffins, cakes or biscuits may be tolerated by some people with cow’s milk allergy. This should be discussed with your clinical immunology/allergy specialist.
  8. If not breastfeeding, milk alternatives for infants up to one year of  age include cow’s milk based extensively hydrolysed formula (EHF), soy protein formula, rice protein based formula, or amino acid formula (AAF). Milk alternatives for infants over one year of age include soy milk, and calcium enriched rice, oat or nut milks which have around 120mg/100ml of calcium.
  9. Most people who are allergic to cow's milk will be allergic to other animal milks and foods that are made from these milks. Therefore, cow’s milk derived formula/milk, lactose free formula/milk, goat’s milk formula/milk, sheep's milk formula/milk, camel’s milk, HA formula and A2 formula/milk are NOT suitable for people with cow’s milk allergy, and may cause allergic reactions.

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Allergy & Anaphylaxis Australia and Allergy New Zealand are patient support organisations that provide updates and advice for people with allergies.

© ASCIA 2022

ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand

ASCIA Fast Facts have been developed from ASCIA information, based on published literature and expert review

Content updated July 2022