Dairy-Free Decoded: A Comprehensive Guide to Navigating and Thriving …

Most people understand that a diet which is dairy free means avoiding products that contain cow’s milk, but strictly speaking being dairy free can also include milk from other animals. People who avoid dairy either have an allergy or intolerance to milk and its derivatives like cheese, yogurt and ice cream.

What is the difference between a milk allergy and a milk intolerance?

Milk allergies are usually caused by an allergy to cow’s milk proteins like casein and whey. 

Intolerances are usually caused by lack of the lactase enzyme which helps the body to digest milk sugars. People can lose their lactase enzymes as they age so they may have been able to tolerate cows milk products when they were younger. 

Reactions and Symptoms related to dairy

There are different types of reactions you can have to dairy that range from mild to, comparatively rarely, life threatening. 

Allergic reactions can be rapid onset (usually within 15 minutes) or they can be delayed (2 or more hours after ingestion). 

Symptoms of a rapid reaction range from mild to severe. Mild reactions include itching, hives, swelling of eyes, lips, and face, stomach pain and vomiting. Severe reactions (anaphylaxis) are rare, and will have symptoms including noisy breathing or wheeze, throat swelling, or turning pale. 

Symptoms of a delayed reaction include worsening eczema, vomiting or diarrhea. These reactions do not progress to life threatening anaphylaxis. 

Children will typically grow out of their cow’s milk allergy as they grow older. 

Lactose intolerance is different from an allergy. Symptoms of this include diarrhea, vomiting, stomach pain, and gas or bloating. While uncomfortable, it is not life threatening and does not result in anaphylaxis. This is diagnosed via an elimination test. 

How can you diagnose a cow’s milk allergy?

The diagnosis of a cow’s milk allergy should always be made in consultation with a certified clinical immunologist/allergist. Your doctor will often make a diagnosis based on your medical history and with the use of skin or blood allergy tests. 

Living with a milk allergy or intolerance - what should you look out for?

Treatment includes excluding all forms of cow’s milk and milk from other mammals (sheep, buffalo, horse, camel, or goat) from your diet. For breastfed infants, the mother should eliminate all dairy products from her own diet.

Foods that may contain dairy include yogurt, cheese, butter, cream, buttermilk, ghee, rennet, kefir, sour cream and some coffee whiteners. Processed foods like some breads and baked products, confectionaries, and snack foods may also contain milk. 

Other ingredients to watch out for include calcium caseinate, casein, lactalbumin, lactose, lactoglobulin, and ingredients containing whey. 

This list is not exhaustive and you should always read nutritional labels. 

So what can you use as a substitute for dairy?

For milk allergic infants younger than 6 months, exclusive breastfeeding is recommended. The mother should eliminate dairy from her own diet. 

For infants older than 6 months, talk to your doctor about which formula is best for your child. These formulas are often extensively hydrolyzed protein or amino acid-based formulas. 

For children over 2 years of age soy milk, calcium enriched rice, oat or nut milks may be recommended by your doctor. These milks enriched with calcium must contain 120mg/100mL to be a suitable replacement along with adequate levels of protein and fat.  

To discover a wide variety of dairy free options, visit www.myWellabee.com 


Australian Society for Clinical Immunology and Allergy 

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