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Food and Nutrition

Milk - One of the ten priority food allergens

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2012

Cat. No.: H164-156/4-2012E-PDF
ISBN: 978-1-100-21152-7
HC Pub.: 120124

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Allergic reactions

Allergic reactions are severe adverse reactions that occur when the body's immune system overreacts to a particular allergen. These reactions may be caused by food, insect stings, latex, medications and other substances. In Canada, the ten priority food allergens are peanuts, tree nuts (almonds, Brazil nuts, cashews, hazelnuts, macadamia nuts, pecans, pine nuts, pistachio nuts and walnuts), sesame seeds, milk, eggs, seafood (fish, crustaceans and shellfish), soy, wheat, sulphites (a food additive) and mustard.

What are the symptoms of an allergic reaction?

When someone comes in contact with an allergen, the symptoms of a reaction may develop quickly and rapidly progress from mild to severe. The most severe form of an allergic reaction is called anaphylaxis. Symptoms can include breathing difficulties, a drop in blood pressure or shock, which may result in loss of consciousness and even death. A person experiencing an allergic reaction may have any of the following symptoms:

  • Flushed face, hives or a rash, red and itchy skin
  • Swelling of the eyes, face, lips, throat and tongue
  • Trouble breathing, speaking or swallowing
  • Anxiety, distress, faintness, paleness, sense of doom, weakness
  • Cramps, diarrhea, vomiting
  • A drop in blood pressure, rapid heartbeat, loss of consciousness

How are food allergies and severe allergic reactions treated?

Currently there is no cure for food allergies. The only option for managing the risk is to completely avoid the specific allergen. Appropriate emergency treatment for anaphylaxis (a severe food allergy reaction) includes an injection of epinephrine, which is available in an auto-injector device. Epinephrine must be administered as soon as symptoms of a severe allergic reaction appear. The injection must be followed by further treatment and observation in a hospital emergency room. If your allergist has diagnosed you with a food allergy and prescribed Epinephrine, carry it with you all the time and know how to use it. Follow your allergist's advice on how to use an auto-injector device.

Frequently asked questions about milk allergies

I have a milk allergy. How can I avoid a milk-related reaction?

Avoid all food and products that contain milk or milk derivatives which contain milk protein. These include any product whose ingredient list warns it "may contain" or "may contain traces of" milk.

Can a milk allergy be outgrown?

Studies suggest that while up to four percent of infants are allergic to milk, for many of these infants the allergy will disappear within three years. A severe milk allergy, though, can be a lifelong condition. Consult your allergist before reintroducing your child to milk products.

What is the difference between milk allergy and lactose intolerance?

A milk allergy occurs when a person's immune system reacts abnormally to milk proteins; it can be life-threatening. Intolerance to lactose occurs when a person can't digest lactose, a primary component of milk, because their body doesn't produce enough of a specific enzyme. Symptoms of lactose intolerance include abdominal pain, bloating and diarrhea after milk ingestion. Lactose intolerance is not an allergy. If you are unsure whether you have a milk allergy or lactose intolerance, consult an allergist.

Does the source of the milk make a difference?

The proteins in cow's milk are very similar to those found in milk from goats, sheep and other ruminants (such as deer or buffalo). Therefore, people who are allergic to cow's milk may also experience reactions to the milk of other ruminants. Consult your allergist before consuming milk or products made from the milk of goats, sheep or other ruminants.

How can I determine if a product contains milk or milk derivatives?

Always read the ingredient list carefully.

If milk is part of the product formulation, it must be declared in the list of ingredients or in a separate "contains:" statement immediately following the list of ingredients.

What do I do if I am not sure whether a product contains milk or milk derivatives?

If you have a milk allergy, do not drink or eat or use the product. Get ingredient information from the manufacturer.

Does product size affect the likelihood of an allergic reaction?

Product size does not affect the likelihood of a reaction; however, the same brand of product may be safe to consume for one product size but not another. This is because product formulation may vary between different product sizes of the same product.

Avoiding milk and milk derivatives

Make sure you read product labels carefully to avoid products that contain milk and milk derivatives. Because of its high protein content and its value as an emulsifying and texturizing agent, milk is common in many processed foods. Avoid food and products that do not have an ingredient list and read labels every time you shop. Manufacturers may occasionally change their recipes or use different ingredients for varieties of the same brand.

Other names for milk

In the past, some products have used other names for milk on their labels. These names are not permitted without the word milk also appearing on the label, based on the enhanced labelling requirements for food allergens, gluten sources and added sulphites. However, if you have a milk allergy and see one of the following in the list of ingredients on a product you should not eat it.

  • Beta-lactoglobulin
  • Casein, rennet casein
  • Caseinate (ammonium caseinate, calcium caseinate, magnesium caseinate, potassium caseinate, and sodium caseinate)
  • Delactosed or demineralized whey
  • Hydrolyzed casein
  • Lactalbumin and lactalbumin phosphate
  • Lactoferrin, lactoglobulin
  • Whey and whey protein concentrate

Avoid food and products that do not have an ingredient list and read labels every time you shop.

Common sources of milk

  • Butter, Buttermilk
  • Cheese, curds
  • Cream, ice cream
  • Ghee and butter fat
  • Kefir (milk drink)
  • Kumiss (fermented milk drink)
  • Sour cream
  • Yogourt

Food and products that contain or often contain milk

  • Artificial butter, butter flavour or butter oil
  • Dark chocolate
  • Baked goods (including some type of breads) and baking mixes
  • Battered and fried foods
  • Broth and bouillons
  • Caramel colouring or flavouring
  • Casseroles, frozen prepared foods
  • Cereals, cookies and crackers
  • Chocolate bars
  • Desserts, for example, custards, frozen yogourts, ice creams and puddings
  • Dips and salad dressings
  • Egg and fat substitutes
  • Fat replacers, for example, Opta™ and Simplesse®
  • Glazes
  • Gravies and sauces
  • High-protein flour
  • Malt-drink mixes
  • Margarine
  • Pâtés and sausages
  • Pizza
  • Potatoes (instant, mashed and scalloped potatoes)
  • Seasonings
  • Soups and soup mixes, cream soups
  • Soy cheese

Other possible sources of milk

  • Canned tuna, for example, seasoned or mixed with other ingredients for flavour
  • Candy, fruit and granola bars, for example, those containing caramel or chocolate
  • Flavoured coffee, coffee whitener and non-dairy creamer
  • Some french fries (made from potato mixture or mashed potatoes)
  • Some hot dogs, deli and processed meats
  • Nougats
  • Seasoned chips, for example, sour cream and onion
  • Waxes on some fruit and vegetables

Non-food sources of milk

  • Cosmetics
  • Medications
  • Pet food

Ingredients that do not contain milk protein

  • Calcium/sodium lactate
  • Calcium/sodium stearoyl lactylate
  • Cocoa butter
  • Cream of tartar
  • Oleoresin

Note: These lists are not complete and may change. Food and food products purchased from other countries, through mail-order or the Internet, are not always produced using the same manufacturing and labelling standards as in Canada.

What can I do?

Be informed

See an allergist and educate yourself about food allergies. Contact your local allergy association for further information.

If you or anyone you know has food allergies or would like to receive information about food being recalled, sign up for the Canadian Food Inspection Agency's (CFIA) free Next link will take you to another Web site e-mail "Food Recalls and Allergy Alerts" notification service. When you sign up you will automatically receive food recall public warnings.

Before eating

Allergists recommend that if you do not have your auto-injector device with you that you do not eat. If the label indicates that a product "contains:" or "may contain:" milk or milk derivatives, do not eat it. If you do not recognize an ingredient or there is no ingredient list available, avoid the product.

Watch out for allergen cross contamination!

Cross contamination is the transfer of an ingredient (food allergen) to a product that does not normally have that ingredient in it. Through cross contamination, a food that should not contain the allergen could become dangerous to eat for those who are allergic.

Cross contamination can happen:

  • during food manufacturing through shared production and packaging equipment;
  • at retail through shared equipment, e.g., cheese and deli meats sliced on the same slicer; and through bulk display of food products, e.g., bins of baked goods, bulk nuts, etc.; and
  • during food preparation at home or in restaurants through equipment, utensils and hands.

What is the Government of Canada doing about food allergens?

The Government of Canada is committed to providing safe food to all Canadians. The CFIA and Health Canada work closely with municipal, provincial and territorial partners and industry to meet this goal.

The CFIA enforces Canada's labelling laws and works with associations, distributors, food manufacturers and importers to ensure complete and appropriate labelling of all foods. The CFIA recommends that food companies establish effective allergen controls to prevent the occurrence of undeclared allergens and cross-contamination. The CFIA has developed guidelines and tools to aid them in developing these controls. When the CFIA becomes aware of a potential serious hazard associated with a food, such as undeclared allergens, the food product is recalled from the marketplace and a public warning is issued. The CFIA has also published several advisories to industry and consumers regarding allergens in food.

Health Canada has worked with the medical community, consumer associations, and the food industry to enhance labelling regulations for priority allergens, gluten sources and sulphites in pre-packaged food sold in Canada. Health Canada has amended the Food and Drug Regulations to require that the most common food and food ingredients that cause life-threatening or severe allergic reactions are always identified by their common names on food labels, allowing consumers to easily recognize them.

More information on the regulations to enhance the "labelling of food allergens", gluten sources and added sulphites can be found on the Health Canada website.

If you come across a food that you think is improperly labelled, contact the CFIA and provide information about the product.

Next link will take you to another Web site Report a food safety or labelling concern.

Where can I get more information?

For more information on:

  • food allergies; and
  • subscribing to the "Food Recalls and Allergy Alerts" e-mail notification service,

visit the Next link will take you to another Web site CFIA Website or call 1-800-442-2342/TTY 1-800-465-7735 (8:00 a.m. to 8:00 p.m. Eastern time, Monday to Friday).

For information on this and other Government of Canada programs and services call

  • 1-800-O-Canada (1-800-622-6232)
  • TTY 1-800-465-7735

Below are some organizations that can provide additional allergy information:

Developed in consultation with Allergy/Asthma Information Association, Anaphylaxis Canada, Association québécoise des allergies alimentaires, Canadian Society of Allergy and Clinical Immunology and Health Canada.