Cows’ milk free diet – food shopping guide
Key takeaways
- Management of cows’ milk protein allergy involves elimination of sources of cows’ milk protein from the diet
- Identify ingredients on a food label that contain or may contain cows’ milk protein
- Understand substitute options when eliminating dairy from the diet to ensure nutritional needs are met
Shopping guide for parents of children with cows’ milk allergy
Infants and children diagnosed with cows’ milk protein allergy must avoid all foods containing cows’ milk protein until it is safe to reintroduce. While most of us know that cows’ milk is found in dairy products, other foods containing cows’ milk are not always obvious. Thankfully, there are legislations in place in Australia and New Zealand that requires ‘milk’ to be listed in bold text in ingredient lists on food labels to make it easier to identify allergens. For parents of children with cows’ milk protein allergy it is important to read the labels of all manufactured foods to ensure that they do not contain cows’ milk protein.
The following foods contain cows’ milk protein and must be avoided by children and infants with cows’ milk protein allergy1
| A2 Milk | Dried milk | Low fat milk |
| Acidophilus milk | Dried milk solids | Malted milk |
| Butter | Evaporated milk | Milk |
| Buttermilk | Fat-free milk | Milk derivative |
| Casein/Caseinates | Ghee | Milk powder |
| Cheese | Butter oil | Milk protein |
| Cheese powder | Butter fat | Milk solids |
| Condensed milk | Hydrolysates (casein, milk, protein, whey) | Non-fat dairy solids |
| Cottage cheese | Ice cream | Non-fat milk solids |
| Cream | Infant formula- cows’ milk based including partially hydrolysed (HA) formula | Skin milk |
| Cultured milk | Kefir | Skim milk solids |
| Curds | Lactalbumin | Sour cream |
| Custard | Lactoglobulin | Whey |
| Dairy solids | Lactose-free milk | Yoghurt |
*It is recommended that children with IgE-mediated cows’ milk protein allergy are careful with all coconut products. Coconut itself does not contain cows’ milk protein, however, authorities cannot currently guarantee that sufficient testing has occurred on all coconut products to ensure they are cows’ milk protein free.1
Coconut products made in Australia using Australian grown coconuts are most likely safe, however, it is important to check with manufacturers to ensure they are cows’ milk free.1
**Children with cows’ milk protein allergy will also need to avoid other mammalian milks (like sheep and goat milk) as these contain similar proteins to those found in cows’ milk. These milks may cause an allergic reaction in a child with cows’ milk protein allergy.
The following foods may contain cows’ milk protein. It is important to check the labels on these foods before giving them to your child. If the food contains cows’ milk protein it should be avoided.1:
| Alcoholic cocktails (some) | Breads, breadcrumbs | Caramel or butterscotch desserts |
| Biscuits, cakes, pastry | Breakfast cereal | Chocolate |
| Bottled water that is flavoured or protein enriched | Canned spaghetti | Probiotic drinks |
| Confectionary | Instant mashed potatoes | Processed meats |
| Drinking chocolate | Malted milk powder | Protein shakes |
| Gravy | Margarine | Salad dressings |
| High energy foods and powders with added protein | Milk ice blocks | Snack food |
| High protein fruit juice drinks | Non-dairy creamers | Soy cheese |
| Icing | Nougat | Soups |
| Infant rusks/rice cereals | Pasta sauces | Sports drinks |
Please note that this is not a complete list of all foods containing cows’ milk protein. It is important to check the labels of all manufactured foods before consuming.
Cows’ milk alternatives
Cows’ milk and dairy products provide an important source of calcium, protein, energy and other nutrients for infants and children. If cows’ milk is removed from the diet due to cows’ milk protein allergy, it is important to provide an alternative source of these nutrients. Most of the products listed below are available at large supermarkets, however, for some of the items you may need to visit a health food or specialty store.
| Instead of: | Use: |
| Cows’ milk infant formula for a child less than one to two years of age | Breast milk or appropriate formula as advised by your child’s medical specialist |
| Cows’ milk for children over one to two years of age and adults | Soy, rice, oats, nuts, pea protein-based drinks. Choose one with 120-160mg calcium per 100ml. Calcium fortified soy milk is the preferred option, nutritionally, if tolerated. |
| Yoghurt | Soy yoghurt.
NOTE: Some products contain a small amount of cows’ milk protein. Check the label carefully. |
| Cheese, sour cream | Soy cheese, soy sour cream
NOTE: Some soy cheeses contain cows’ milk protein. Check the label carefully. |
| Ice cream | Soy ice cream, sorbet, milk free gelato. NOTE: Some products contain a small amount of cows’ milk protein. Check the label carefully. |
| Butter and margarine | Oil or milk-free margarine |
| Cream and condensed milk | Soy cream, soy cooking milk, soy condensed milk, rice cream |
| Chocolate | Soy or rice based (milk free) chocolate |
Table adapted from Australasian Society of Clinical Immunology and Allergy ‘Dietary Avoidance- cows’ milk allergy’ 2020.1
This article is not intended to be a substitute for medical advice. Always consult your doctor.
References:
- Australasian Society of Clinical Immunology and Allergy (ASCIA). ASCIA Dietary avoidance – cow’s milk protein (dairy) allergy 2021. Available from: Cow’s milk protein (dairy) – Australasian Society of Clinical Immunology and Allergy (ASCIA) (Accessed June 2021)
