Milk Allergy
Overview
Cow’s milk allergy is one of the most common food allergies in babies and young children. It usually appears in the first year of life. Many children grow out of it during childhood, but for some, it can persist into the teenage years or even adulthood. Adult-onset milk allergy is rare but possible.
Reactions can range from mild to severe. While many people only experience skin or tummy symptoms, a small number may be at risk of serious reactions.
Types of Milk Allergy
- Immediate (IgE-mediated) — reactions appear quickly, often within minutes to two hours after milk or dairy. These can range from mild hives to severe reactions.
- Delayed (non-IgE-mediated) — symptoms appear hours or even days later, mainly affecting the gut and skin.
Other milk-related conditions exist (like FPIES, EoE, or lactose intolerance), but these are different and don’t always involve the immune system.
Symptoms
Immediate (quick) reactions:
- Itchy rash or hives
- Swelling around the mouth, lips, or eyes
- Tummy pain, sickness, or vomiting
- In severe cases, anaphylaxis
Delayed reactions:
- Tummy pain or bloating
- Diarrhoea or constipation
- Skin rashes or eczema flare-ups
- Reflux or feeding difficulties in babies
Risk factors
You may be at higher risk of serious reactions if:
- You’ve had severe symptoms before (especially involving breathing or circulation)
- You have asthma, particularly if it’s poorly controlled
- You react to even tiny amounts of milk or dairy
Diagnosis
Immediate allergy can often be diagnosed with skin prick tests, blood tests, or a supervised food challenge.
Delayed allergy is usually diagnosed through an elimination diet (cutting out milk for a few weeks, then reintroducing under guidance).
Always see your GP or ask for referral to an allergy clinic if milk allergy is suspected.
Living with Milk Allergy
- Shopping: Milk must legally be highlighted on UK food labels, but recipes can change — always check the ingredients.
- Eating out: Restaurants and cafes must provide allergen information, but always double-check with staff.
- Cross contact: Even small splashes or inhaling heated milk (like in coffee shops) can cause symptoms for very sensitive people.
- Dietary support: A dietitian can help make sure you or your child still get enough protein, calcium, and iodine from safe alternatives.
Emergency Action
Mild reactions can usually be managed with antihistamines.
For severe reactions (difficulty breathing, throat swelling, sudden dizziness), call 999 and use an adrenaline auto-injector immediately if prescribed.
In the UK, the common auto-injectors are:
- EpiPen®
- Jext®
Always carry two devices and make sure you and those around you know how to use them.
Outgrowing Milk Allergy
Most children eventually outgrow milk allergy, often by school age. Delayed milk allergy is usually outgrown earlier than immediate allergy.
Reintroduction is sometimes done gradually, using a “milk ladder” — starting with baked milk (less allergenic) and moving slowly towards fresh milk — but this should always be done with professional guidance.
Future Treatments
Research is ongoing into oral immunotherapy for milk allergy, which aims to build tolerance by giving small, increasing amounts of milk protein under medical supervision. It shows promise, but is not yet standard practice.