Allergy diet - milk free

Aim

To provide a diet that excludes milk protein and all foods that may contain milk protein.

Characteristics

No milk or milk-derived ingredients, or traces of milk. This diet eliminates mammalian milk, ie milk from cows, goats, sheep or buffalo. Cheeses are not allowed.

Indications

Milk allergy or intolerance.

Nutritional adequacy

Nutritionally adequate.

Precautions

It is not possible to provide a full list of all permitted commercial products; the following are general guidelines only. Care should be taken to read all product ingredient lists to look for ingredients derived from milk, eg butter, ghee, cheese, cream, buttermilk, milk or dairy solids, non-fat dairy solids, yoghurt, casein, caseinate, whey, curds, lactoglobulin and lactalbumin. All packaged food with milk ingredients must carry a mandatory warning statement under Standard 1.2.3 of the Food Standards Code and should therefore be able to be identified on food labels.

Many savoury flavour ingredients include a milk base, and may be present in commercial products such as processed meats, soups and sauces.

Paediatrics

Suitable for use in paediatrics when combined with an age-appropriate diet.

Specific menu planning guidelines

	Allowed	Not allowed
Hot main dishes	All plain cooked meat, poultry, fish, eggs, and legumes Other dishes made without milk, cheese, cream, butter, yoghurt or regular margarine	Any dishes containing milk, cheese, cream, sour cream, yoghurt, butter or regular margarine, eg quiches, omelettes, frittatas, mornays, macaroni cheese, lasagne
Sauces, gravies	Sauces made with milk-free margarine, e.g. tomato sauce – check labels	White sauces made with milk, cream, butter or regular margarine Commercial gravy mixes
Starchy vegetables / pasta / rice	Steamed and jacket potato Mashed, pureed potato made with milk-free margarine and water Plain rice and pasta	Any dishes made with milk, cheese, butter or regular margarine, e.g. scalloped potato, regular mashed potato
Vegetables	All others	Any vegetables made with milk, cheese, butter or regular margarine (e.g. cauliflower au gratin)
Soups	Other soups made with milk-free margarine – check labels	Any soups made with milk, cream, butter or regular margarine, eg most cream soups Many commercial soups will have added milk solids or casein – check label
Sandwiches	Sandwiches made with milk-free bread and margarine	Cheese, mayonnaise, regular margarine or butter Any meats with milk-derived additives
Salads, dressings	Others – check labels	Cheese, mayonnaise Any meats with milk-derived additives
Breads, cereals	Milk-free breads Rice cakes Breakfast cereals without milk ingredients (e.g. rolled oats prepared with water, Weet-Bix™, Corn Flakes®, All-Bran®, some mueslis – check label)	Regular bread, including rolls Hot breakfast cereals prepared with milk Breakfast cereals with milk ingredients, eg Coco Pops® – check labels
Spreads	Milk-free margarine Jam, honey, Vegemite™, peanut butter	Butter, regular margarine Cheese spreads
Hot breakfast choices	All others	Scrambled eggs, omelettes
Fruit	All fresh, canned and dried fruits	-
Yoghurt	Soy yoghurt	All milk-based yoghurts and Frûche®
Desserts	Jelly Soy-milk custard or creamy rice Some sorbets – check label Tapioca and sago made without milk	Milk-based desserts, e.g. custards, ice-cream, mousses, cheesecakes Cakes, pastry-based and crumble desserts, unless carefully checked Cream
Milk and cheese	Soy milk Milk-free soy cheese – check label	All cow’s milk (full and low fat) All cheeses (including cottage cheese)
Beverages	Tea, coffee, cordial, soft drinks, fruit juice	Milk, flavoured milk Milo®, Aktavite®, Ovaltine®
Biscuits	Milk-free biscuits only	Many commercial biscuits – check label
Miscellaneous	Plain nuts	Many nutritional supplements, unless carefully checked (eg Resource® Fruit Beverage, Resource® Plus, Sustagen®, Ensure®) Chocolate

References

1. Food Standards Australia New Zealand. Ingredients to avoid if you are allergic to milk.
2. Royal Prince Alfred Hospital Allergy Unit. Allergy information sheets. [accessed 26 April 2010];.
3. Dietitians Association of Australia. Nutrition manual. 8th ed. Canberra: DAA; 2009.
4. Australasian Society of Clinical Immunology and Allergy. Cow’s milk (dairy) allergy.
5. American Dietetic Association. Nutrition care manual. Chicago: ADA; 2009. [accessed 17 March 2010];
6. Anaphylaxis Australia. Allergen cards. 2007.
7. Maher AK, editor; Iowa Dietetic Association. Simplified diet manual. 10th ed. Ames: Blackwell; 2007