Cow's milk protein allergy: foods to avoid

Cow's milk protein can be present in fresh milk, powdered milk, cream, butter, cheese, yoghurt, ice cream and many desserts. It may also appear in baked goods, sauces, processed foods and infant products. Check the ingredient list for milk, whey, casein, caseinate, milk solids and milk powder. Lactose-free milk is not automatically safe because it can still contain the relevant proteins. Goat's and sheep's milk may also cause reactions because their proteins are similar.

Read every label, including familiar products, and ask about ingredients when eating outside the home. Preventing cross-contact matters: separate utensils, chopping boards and storage can reduce transfer from milk-containing food. Do not remove dairy from a child's diet without advice about a suitable nutritional replacement. A dietitian or allergy clinician can help with calcium, protein and vitamin needs and explain whether an elimination trial or supervised reintroduction is appropriate.

Swelling of the lips, tongue or throat, trouble breathing, wheezing, repeated vomiting, faintness or sudden widespread symptoms can signal anaphylaxis. Use a prescribed adrenaline auto-injector if instructed, call emergency services and follow the person's written action plan. An itchy throat can be an early warning sign, especially when it follows eating a suspected food.

Ask which ingredients and medicines need checking, whether an adrenaline device is appropriate, how to manage school or nursery meals, and when reassessment or supervised food testing should happen.