Reading every label in detail becomes second nature with a milk allergy in the house.

n the two years since my son Ryan, now four, was diagnosed with a severe milk allergy, we've learned a lot. Maintaining a milk-free diet isn't easy, and the misperceptions of people around us haven't helped.
Now we're vigilant consumers of food, from grocery-store items to fast food. Even if you don't have a child with a milk allergy, understanding what it is and management strategies might be useful if your child has an allergic friend.

Many people confuse a cow's milk allergy with lactose intolerance. Lactose intolerance is the inability to digest the "milk sugar" in milk. In these cases milk sugar enzymes (lactase) may be prescribed to aid in the digestive process.
A cow's milk allergy, on the other hand, happens when the actual proteins in the milk are absorbed as antigens which the body tries to fight. The result of this battle is severe hives; swelling eyes, mouth, or throat; severe vomiting and diarrhea; and incredible emotional and behavioral disturbances.
For allergy sufferers, avoiding milk protein is key to maintaining a healthy body. Unfortunately, this is a huge task since variations of milk products appear in baby formula (making nursing the safest choice by far), many foods, and even in some medicines.

Since my son was diagnosed very early, he had not had much ice cream, chocolates, and cake. This made establishing a milk-free diet a bit easier. It was the people around him that I had to educate, and at times convince about the facts of milk allergies. Many times I heard, "A little won't hurt him," or, "Don't worry, I checked the ingredients and it didn't say 'milk' anywhere." I have even heard, "Here give him this pill and then he can eat as much ice cream as he wants." I realize that keeping my son healthy is my primary duty, so I don't rely on anyone else to check items for us. At pre-school one day, the teacher cut apples into pieces and offered one to Ryan. He politely asked the teacher, "Does this have milk in it?" He would only eat if I confirmed that it was safe to eat. Although Ryan is very young, he does know how incredibly sick he becomes if he is exposed to milk. History is enough for him not to take any chances.

Common Grocery Items to Check and Double Check! Margarine: Most people think that margarine does not contain "milk products." This is a huge myth. 99% of all margarines contain milk. I have found three that do not. I was thrilled to find out that "Fleichman's Unsalted Margarine" contains no milk products. In my area, it is a bit cheaper than the others. Check the label carefully to make sure you have the correct product. HINT: Look for the word "Parve," which means no dairy. Breaded Chicken Battered Fish Sausages Wieners Sorbet Granola Bars Pudding White/Brown Bread Cookies Crackers (animal crackers, digestive cookies too) Pies Chocolate: Candy bars, anything with chocolate in it (Cocoa does NOT contain milk, if you find a chocolate bar that contains cocoa, but does not contain "milk chocolate" it is safe) Salad Dressings Imitation Maple and other syrups (there are some with no milk, look carefully--obviously, 100% pure maple syrup from the tree is okay) Cold Cereals Instant Cereals Coffee Whitener Spice mixes (lots contain whey powder) Soup (watch out for caramel) Cake Mixes Pancake Mixes

Because I can make items that taste good and look like what his friends are eating, gatherings are a pleasure, rather than a constant chorus of "No, that's got milk in it"--"Why don't you have this delicious fruit instead of some brownies?" By using copycat ingredients, we can bring treats to share. Birthday parties, school snacks, and outings are more fun when no one is worrying about a possible reaction to food.

In order to make foods that Ryan can enjoy, I had to eliminate unsafe foods. Determining what a milk-allergic person can safely eat gets complex when you notice that "milk products" are not necessarily called MILK PRODUCTS. I'm a grocery store detective now, scanning labels for hidden milk proteins [0]. Don't automatically eliminate foods if you find milk products in one brand. Other brands of the same item may not contain them. Unfortunately, manufacturers will frequently change ingredients [0] without notice to the consumer. Check labels on a regular basis. We make most of our meals and snacks from scratch so that we know EXACTLY what the ingredients are. It's easier, more healthful, and often less expensive than processed food items.

Soy is a wonderful product for families like ours, but it's not a panacea. By nature soy is very high in protein (it is a bean, after all), but it is low in fat and calcium. Other sources have to provide these. If you find a soy beverage that you want to use for baking or drinking, be sure it is high enough in fat and calcium. Low fat soy doesn't work in baking. Many soy drinks are marketed as low-fat diet items and contain next to no fat or calcium. I have found that "So Good" soy beverage is high in fat, and contains just as much calcium as cow's milk.

We use the unflavored variety and add our own (homemade) chocolate syrup. I find that the chocolate flavored variety has too much sugar, and I'd rather regulate that for my son. I also use it in baking. You can find wonderful soy cheese products, including sliced cheese, "mozzarella" cheese, etc. Unfortunately, you must check the label very carefully. Often, manufacturers use casein, a milk product, in soy cheese.

We enjoy dining out, but whether we're eating at a white-tablecloth restaurant or one that hands the food out a window, I have to screen what I feed Ryan. Even if a restaurant says they provide a milk-free dinner, ask how it's cooked. It's simple for servers to forget butter or margarine, but you need to know. Carrying a pre-printed card makes it easy to provide the clerk/waitress/cook all the terms for "milk products," as a restaurant employee will usually look for the word "milk" on a label. Many fast food outlets put milk products in items such as: Hamburger and hot dog Buns; the hamburgers themselves; hot dogs; french fries (many put whey powder on the fries); fried chicken; cookies; and pies.

Authentic Chinese restaurants are usually a good bet for safe eating, as milk use is uncommon. Some other ethnic restaurants may also use low or no milk products. As always, check and double check. I am happy to say that my son can eat at McDonald's. Their "Happy Meal" contains absolutely NO MILK PRODUCTS.
I recently asked a Kentucky Fried Chicken outlet for an ingredient list. It was wonderful to see how extensively they broke down each menu item. I discovered that although the majority of their chicken dishes are deep-fried with batter, they do not all have the same ingredients. My son could safely have the "Chicken Strips" as well as their french fries. But that was all.
Consider writing to thank restaurants and chains when they make it safe for those with milk allergies to eat there. And of course, it's easier to check out a restaurants without children in tow. Knowing ahead of time where and what to avoid saves disappointment.

Food and drink pose the greatest risk to the milk-allergic, but for those allergic to milk, prescriptions and over the counter medications can be dangerous. Ask your pharmacist about ingredient lists and warn him/her about the presence of a milk allergy so that s/he can be aware of this BEFORE filling out a prescription or recommending an over the counter medication.

Vigilance is the price of safety for those with milk allergies. Through educating yourself and those around you, it's possible to have both a happy child and a varied diet.

Hidden Milk Products Main Categories of Milk Products Milk Ingredients: Butter, sour cream, half and half, cheese (all forms--even "soy" cheese), yogurt, cheese curds, egg nog, cottage cheese. Modified Milk Ingredients: All forms of milk (i.e., buttermilk, condensed milk, evaporated milk, Acidophilus milk, malted milk) Casein (specific milk protein most commonly used): Casein, Caseinate, Potassium Caseinate (if you see the word "casein" AVOID) Lactose (ingredients that begin with "lact"): Lactose, lactate, lactalbumin, lactoglobulin, etc. Whey (another specific protein that has many forms): ALL FORMS OF WHEY. Ready Sponge (a preservative): Investigation has shown that this preservative contains milk proteins as well as lactose. Those with allergies and lactose intolerance should avoid any products with this ingredient. Caramel: This surprises many people. Unfortunately it is next to impossible to determine whether a product that contains "caramel" uses brown sugar and water, or if they also add milk products. Due to this confusion "caramel" is a highly suspicious ingredient. Many brown breads use caramel to make the bread look "more brown". Some store-bought breads use molasses instead of caramel, and are a much safer choice.

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© 1999-2005 Lisa Solonynko, used by permission.