5 surprising facts about cow’s milk allergy

There are 5 very surprising facts about cow’s milk allergy that you should know.

cow's milk allergy
What does milk seem to have against you?

My amazing sister-in-law was recently asked a question about cow’s milk allergy that she passed along to me:

“My child is exclusively breastfed and has a milk allergy.  Do I need to worry about a future allergy to beef?  What about milk alternatives?”

– A friend

 

I LOVE this question.  It’s great because while you may THINK you know the answer right away, but the longer you think about it the more confusing it gets (that’s what we do in allergy, by the way:  we try to keep it confusing.  Job security, I guess):

Beef with a milk allergy
Doesn’t everyone have text battles with their brain?

 

When you look at the big picture of milk allergy, it initially seems straightforward:  avoid milk.

So, for everyone who has already mastered the basics of milk allergy (and if you haven’t, take a moment to become a milk allergy expert), I give you 5 surprising facts about milk allergy.

 

1. There is no concern about a beef allergy (if you have a milk allergy).


Milk allergy is a reaction against certain milk proteins (-lactalbumins, ϐ-lactoglobulins, and caseins).  Beef allergy CAN happen, but is against a protein called galactose-alpha-1,3-galactose (alpha-gal).

The two are NOT cross reactive.

Interesting side fact†:  Beef allergy is on the rise! It’s actually related to the Lone Star Tick, which can bite you and trigger an immune response against alpha-gal… creating a beef allergy!  But that is a blog post for another day.

 

 

2. There ARE allergy concerns about some other sources of milk


The main milk proteins that cause cow’s milk allergy are ALSO found in the goat milk!  In fact, if you have a milk allergy there is a 94% chance you’ll have an allergic reaction to goat milk too!

 

But wait, there’s more…

 

The SAME proteins are also found in buffalo and sheep milk.  Now, I have not yet had an opportunity to use this information clinically and have not had anyone ask me about these milk products.  But I’m ready if they do, and now so are you.

Cow milk allergy reacts to goats milk, buffalo milk and sheep milk
You’re allergic to us because we’re all equally adorable! Except for the buffalo, of course.

 

 

 

3. There are some interesting sources of milk that are OK


If you desperately wanted animal milk, there is some hope!

Drinking Mare’s milk only has a 4% chance of cross reacting with a cow’s milk allergy!  Donkey milk and Camel milk are also ok to drink if you have a cow’s milk allergy!

cows milk allergy does not react to camel milk
We got the good milk!

 

Of course, I’d probably draw the line at Mare, Donkey and Camel milk.  Otherwise you run the risk of a slippery slope toward bad solutions:

Cows milk allergy idea
New milk allergy solution?
different approach to cows milk allergy
Bad milk allergy solution

 

 

4. There are many sources of “milk” that are ok


If you have a cow’s milk allergy and also recognize that cereal is a vastly superior product with milk (oh, and you don’t have mare’s milk or camel milk available) there are non-animal alternatives.

The most common alternative sources are:

  • Soy milk
  • Almond / casher / other nut milk
  • Coconut milk
  • Rice milk
  • Hemp milk (I don’t know what this is, but since I live in Colorado… I figured I should list it)

 

Now, I know that a quick internet search will tell you tons of plusses and minuses of each source (I’m working on a post on that myself).  But for now, just know that if you have a cow’s milk allergy you are able to drink these alternatives (provided you don’t have other allergies, of course).

 

And finally, saving the strangest fact for last…

 

 

5. If your child has a cow’s milk allergy, you should AVOID VEAL!


This fact comes from the “I have to know this for the allergy board exams and for pop quizzes from a grumpy allergy instructor” file, but it’s true:  having a cow’s milk allergy could cause a cross reaction to veal.

In fact, up to 20% of children with cow’s milk allergy can react to veal!

Veal is an adorable baby cow. If you're veal allergic, you're also milk allergic
1 in 5 children with cow’s milk allergy will also have a food allergy reaction to veal.

 

Now, I would imagine this is less of an issue because… look how adorable baby calves are!  But I also understand that not everyone shares my aversion to veal.  So for those of you with cow’s milk allergy and wanting to eat veal:  don’t.  The risk is too high for a cross reaction.

Last interesting side fact†:  if you are allergic to veal, there is a 93% chance that you’ll also have a milk allergy.  Why the difference?  I don’t fully know, but it probably comes back to my earlier point about allergist’s job security.

 

 

Putting it all together


I hope that between my initial article about milk allergy and this one, you have a better understanding of cow’s milk allergy.

 

If it will help, you can download a printable handout and wallet card I created listing the major items to avoid if you have a milk allergy.

 

If you find it useful, leave me a comment or email me and let me know you loved the wallet card (Mostly because I want to use it as a reason to buy an ID card maker… you know, to send a better wallet card and NOT to make a lot of absurd ID cards for myself and my brother-in-law).

 

 

 

† I might keep misusing the word interesting.  For me, as an allergist, this is interesting.  For you… maybe about as interesting as watching paint dry.

Sources:

  1. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-sponsored Expert Panel
  2. The angry milk picture came from an AMAZING google search,  If you have time, check out some really funny drawings here
  3. Other images came from:
    • The goat, sheep and cow was from an adorable mousepad
    • The camel and baby calf were from google images

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