Cows Milk Protein Avoidance

Any form of cows' milk, whether fresh, skimmed, condensed, or evaporated, needs to be avoided. Also forbidden are milk products that contain casein, whey, and nonfat milk solids. Where milk substitutes are required, the choice lies between formulas based on soy protein, casein hydrolysate, or whey hydrolysate. Soya formulas are cheaper, but unsuitable for those who are also intolerant to soya.

Butter, margarine, cream, cheese, ice cream, and yogurt all need to be avoided. Fats that can be used instead include margarines made from pure vegetable fat (e.g., Tomor) and lard. Caution is required with baby foods, as a large number of manufactured products, e.g., rusks, contain milk protein. A common trap is so-called 'vegetarian' cheese, often wrongly believed to be safe for subjects with cows' milk allergy. In fact, it differs from ordinary cheese only in the use of nonanimal rennet and is unsuitable for people with cows' milk allergy. Meat, game, and poultry are all allowed, but sausages and pies should be avoided unless it is known that they are milk free. Intolerance to cows' milk protein is not a reason to avoid beef. Eggs are allowed, but not custard or scrambled egg which may contain milk. Fish is permitted, unless it is cooked in batter (which unless otherwise stated should be assumed to contain milk) or milk. Lemon curd, chocolate spread, chocolate (unless stated to be milk-free), toffee, fudge, caramels, and butterscotch are all unsuitable. All ordinary cereals (e.g., oats) are allowed, but caution is required with manufactured breakfast cereals, some of which contain milk powder.

It is essential to check the list of ingredients on the label of any manufactured foods. There is a special problem with unwrapped foods, because there is no label of ingredients. Examples include bread, sausages, or confectionery.

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