Milk Free Diet

Why Follow a Milk Free Diet?

A milk free diet may be necessary if you have a milk allergy. A milk allergy is an
immune reaction to the protein in milk that occurs when milk or milk products are
eaten and symptoms can range from mild to severe.

Symptoms of a Milk Allergy

Symptoms of a milk allergy include abdominal pain, diarrhea, nausea, vomiting,

gas, bloating, a stuffy runny nose, or skin conditions such as eczema or hives.

Do I have to Avoid Milk Forever?

It is best to identify if it is a true milk allergy by eliminating milk and milk products
in the diet for at least 4 weeks. Some people try a “challenge test” where they
introduce a small amount of milk to see how much, if any, they can tolerate after
four weeks of eating milk free. In certain individuals, highly processed foods
containing small amounts of cooked milk may be tolerated. Speak to your dietitian
on how to determine if you can tolerate any milk or milk products
 Milk Free Diet: Which foods are safe to eat?
Type of food Foods allowed Foods to avoid
Grain  All plain grains, flours and  Any manufactured food
products starches containing ingredients indicating
 Bagels that the foods are derived from
 Breads and baked goods made milk
without milk or milk products  Baked products made with milk or
 French or Italian bread milk products such as breads,
 Pasta without cheese or milk- crackers, biscuits, doughnuts,
containing sauce muffins, pancakes
 Plain cooked, or ready to eat  Cereals containing milk or milk
cereals solids
 Some whole wheat bread  Commercial baking mixes
 Some rye bread containing milk
 Soda crackers
Milk and  Coconut milk  All cow’s milk (whole; 2%; 1% skim;
Alternatives  Milk-free soy bean cake Lactaid® Lacteeze® or other
 Milk free creamers (Ex: So Lactose- free or lactose-reduced
Delicious Almond Creamers®) milk; Acidophilus milk)
 Nut milks  All milk derivatives (cream, half-
 Potato starch-based drinks and-half; whipping cream; light
 Rice beverages cream; sour cream; ice cream)
 Soy beverages  All milk products (buttermilk;
 Seed milks yogurt; quark; kefir; cheese of all
 Milk free cheese (Ex: GO Veggie types)
vegan cheese®, Daiya dairy  Any manufactured product
free cheese®) containing ingredients indicating
milk such as: casein, caseinates,
lactose, lactalbumin, lactoglobulin,
milk solids, whey
 Milk from all animals (goat, sheep,
buffalo, mares, other)
Type of Food Foods Allowed Foods to Avoid

Vegetables  All vegetables and their juices Vegetables prepared as:

except those listed in the
restricted column  Breaded or battered
 Butter/margarine added
 Creamed
 Instant potatoes
 Mashed with butter and/or
milk
 Prepared or frozen vegetables
with milk, cream, or butter
sauces
 Scalloped

Fruit  All pure fruits and pure fruit  Any with cream, milk or butter as
juices additional ingredients, toppings
or sauce
Meat,  All fresh or frozen meat, poultry  Commercially prepared meat,
poultry, fish or fish poultry or fish that is:
 Kosher processed meats (may o battered
be called “parve” or “pareve”) o breaded
 Meat, poultry and fish canned o creamed
without milk or milk products  Commercially produced meat
 Processed meats made without products containing milk
milk or milk products ingredients such as meat loaf,
hot dogs, cold cuts and sausages
Eggs  Omelette or scrambled eggs  Any egg dish containing milk
made without milk or cheese ingredients such as:
 Plain, boiled, fried or poached o cheese
o commercial mayonnaise
o cream
o milk
Legumes  All plain legumes such as dried • Any prepared with milk
beans, dried peas; lentils; dals ingredients such as:
 Soy beans and soy milk  cream
containing products  cheese
 Milk-free; casein-free tofu  milk
 Peanut butter
 Type of Food Foods Allowed Foods to Avoid
Nuts and • All plain nuts and seeds  Any nut or seed candies or
seeds confectioneries containing milk
ingredients
 Nuts, seeds and nut and seed
mixtures with coatings
containing milk or lactose
Fats and oils  Gravy made without milk  Butter
 Lard  Cream
 Milk-free butter/margarine  Cream cheese
such as:  Margarine containing whey or
o Becel Vegan® milk
o Earth Balance®  Salad dressings with milk or milk
 Meat dripping products
 Non-dairy dessert topping  Sour cream
 Pure vegetable oils  Whipped topping
 Real mayonnaise
 Shortening
 Milk-free mayonnaise
o Earth Balance®
o Hain Celestial®
Spices and • All pure spices and herbs • None
herbs
Sweets and  All pure sugar, syrup, honey  Any item made from milk or milk
sweeteners  Any item made from allowed products
ingredients  Milk chocolate and candies made
 Sugar Twin® with foods to avoid (toffee,
caramels, chocolates)
 Sugar substitutes containing
lactose
Beverages  Alcoholic beverages, except  Diet drinks that contain lactose
cream-based liqueurs  Cream-based liquers
 Clear coffee, tea and herbal tea.
 Fruit juices and drinks
 Mineral water
 Soft drinks
 Vegetable juices
How can I make sure I am choosing milk free foods?
Step 1: Look for a “ Contains” or “May Contain” statement

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. If there is not a “contains” statement
then follow step 2.

Step 2: Read the ingredient list

Any food that has “milk” in its name should be avoided. The following lists include
terms that indicate that a product may contain milk. Be careful with imported
products as ingredient lists are not always accurate. Errors can occur as a result of
incomplete translation or as a result of printing errors.

Terms that indicate cow’s milk is present

Acidophilus milk Curd Milk (skim, 1%, 2%, 3.25%,
Ammonium/calcium/magnes Delactosed whey lactose free)
ium/potassium caseinate Demineralized whey Milk powder
Artificial butter flavour Dried milk/cream/sour Milk solids
Butter cream Modified milk
Buttermilk Evaporated milk Feta Natural butter
Buttermilk solids Half-and-half flavour
Butter fat Hydrolysed casein Potassium caseinate
Butter flavored oil Hydrolysed whey Processed cheese
Butter solids Ice cream Quark
Calcium caseinate Ice milk Rennet casein
Casein Lactaid® milk Ricotta
Casein hydrolysate Lactalbumin Sherbet
Cheese Lacteeze® milk Sodium caseinate
Cottage cheese Lactoferrin Sweet dairy whey
Cream Lactoglobulin Whey
Cream cheese Lactose Whey hydrolysate
Condensed milk Lactulose Light cream Whey powder
Cultured milk Malted milk Whey protein

Ingredients that may contain milk protein

Brown sugar flavoring Flavoured coffees Margarine
Caramel flavor Coffee whitener Natural flavor
Chocolate High protein flour Opta/Simplese TM
 Getting Good Nutrition without Milk
With some changes to the foods you offer you eat, you can still have a healthy
diet without milk and milk products. The key nutrients to be aware of are calcium
and vitamin D. Incorporate the foods listed below into your diet on a daily basis to
help meet your calcium and vitamin D needs. Your dietitian will be able to
determine if a nutritional supplement is needed. Sources of Calcium

Food Group Calcium Vitamin D

Vegetables and fruit  Green leafy vegetables  Fortified orange juice
 Fortified orange juice
Milk alternatives  Fortified soy, rice, or almond  Fortified soy, rice, and
beverage almond beverage
 Soy or almond yogurt
Meat and  Canned seafood with bones  Egg yolk
alternatives (salmon, sardines, mackerel)  Seafood
 Tofu
 Beans
 Tahini/sesame seed butter
Fats and oil  Margarine
 Cod liver oil
Additional Tips
Eating at a Restaurant

 Call ahead during non-peak restaurant hours and ask to speak with the chef or
restaurant manager and inform them about your food allergy
 Avoid complex dishes and desserts with multiple ingredients or sauces as these
may have hidden allergens
 Avoid foods that are fried in a deep-fat fryer that may have been used to fry
other foods with milk ingredients
 Be aware that cross-contact is likely in salad bars and buffets as serving utensils
may be shared, and foods can spill and splash
 If you are at risk for a severe allergic reaction, and you plan on eating at a
restaurant, take your emergency treatment medication with you

Safe food preparation to prevent cross contamination

 Wash your hands before preparing foods and after touching any product
containing milk
 Before preparing food, clean all cooking and food preparation surfaces,
cooking equipment, and utensils with hot soapy water
 Prepare milk-free foods first
 Cover and remove them from the cooking area before cooking foods that
contain milk

Shopping tips

 Read product labels each time you purchase an item, even if you have
purchased the item before. Ingredients may change at any time without
notification.
 Delicatessens slice various types of luncheon meats and sometimes even
cheese on shared slicers. Luncheon meats may contain milk ingredients.
Choose instead a safe, packaged luncheon meat, or ask your delicatessen to
slice your order first thing in the morning on a clean machine and set it aside
for you to pick up.
 Kosher delicatessens will carry meat products without milk ingredients, and
they do not use shared equipment for meat and cheese products
 Nonfood items (including lotions, soaps, cosmetics, sunscreens, medications,
and pet food) may contain milk ingredients. These products are not covered
under the food allergen-labeling act. Read ingredient lists carefully.
Recipe Substitutions

 When substituting for milk in a recipe, use equal amounts of juice, water, or an
alternative “milk” beverage, such as rice, soy, oat, hemp, or almond milk
 When baking, choose a stick-form of milk-free margarine to replace butter.
Stick margarine contains less water and produces a better baked product than
tub margarine.
 In recipes requiring sour cream, substitute 4 tablespoons of starch (corn starch,
rice starch, or potato starch) mixed with 3⁄4 cup of water and 1⁄4 cup of
vinegar for each cup of sour cream required
 Desserts that are traditionally made with milk, such as tapioca, sago and rice
puddings, can be made with milk alternatives such as rice, soy, or almonds
milk, or fruit juice instead
 In sauces for meat or fish, substitute bouillon (meat, fish, or vegetable broth)
when the recipe calls for milk

References

1. Academy of Nutrition and Dietetics (2013): Milk Allergy

2. Academy of Nutrition and Dietetics: Tips for managing a milk allergy
3. Alberta Health Services (2010). Infant Formulas for Healthy Term Infants
4. Dietitians of Canada (2009): Milk-free diet
5. Dietitians of Canada (2011): Milk free eating guidelines for children with a milk
allergy
6. Health Canada (2012). Vitamin D and Calcium: Updated Dietary Reference
Intakes