Milk allergy

When food causes an allergic reaction, it isn't always easy to find out what food is to blame. To evaluate whether you or your child has milk allergy, your health care provider may:

• Ask detailed questions about signs and symptoms
• Perform a physical exam
• Have you keep a detailed diary of the foods you or your child eats
• Have you eliminate milk from your diet or your child's diet (elimination diet) — and then have you add back the food to see if it causes a reaction

He or she may also recommend one or both of the following tests:

• Skin test. In this test, your skin is pricked and exposed to small amounts of the proteins found in milk. If you're allergic, you'll likely develop a raised bump (hive) at the test location on your skin. Allergy specialists usually are best equipped to perform and interpret allergy skin tests. Keep in mind that this type of test isn't completely accurate for detecting milk allergy.
• Blood test. A blood test can measure your immune system's response to milk by measuring the amount of immunoglobulin E (IgE) antibodies in your blood. But this test isn't completely accurate in identifying milk allergy.

If your examination and test results can't confirm milk allergy, your health care provider might administer an oral challenge, in which you are fed different foods that may or may not contain milk in increasing amounts to see if you react to the ones that contain milk. It's a good idea to have allergy tests administered by an allergist who's been trained to manage serious reactions.

If your provider suspects that your symptoms are caused by something other than a food allergy, you may need other tests to identify — or rule out — other medical problems.

The only way to prevent an allergic reaction is to avoid milk and milk proteins. This can be difficult because milk is a common ingredient in many foods. Also, some people with milk allergy can tolerate milk in some forms, such as milk that's heated in baked goods, or in some processed foods, such as yogurt. Talk to your health care provider about what to avoid.

If you or your child has a serious allergic reaction (anaphylaxis), you may need an emergency injection of epinephrine (adrenaline) and a trip to the emergency room. If you're at risk of having a severe reaction, you or your child may need to carry injectable epinephrine (EpiPen, Adrenaclick, others) at all times. Have your provider or pharmacist demonstrate how to use this device so that you're prepared for an emergency.

Having a serious allergy or being the parent of a child with a potentially life-threatening allergy can be stressful. Talking to others in similar situations can be helpful. Besides offering support and encouragement, they may also provide useful coping tips, such as how to deal effectively with school officials to ensure your child's medical needs are met. Ask your health care provider if there are any support groups in your area, or contact the Asthma and Allergy Foundation of America.

You're likely to start by seeing your family health care provider or your child's pediatrician. However, you may then be referred to a doctor who specializes in allergic disorders (allergist-immunologist).

Here's some information to help you get ready for your appointment and to know what to expect.

What you can do

• Be aware of any pre-appointment restrictions. When you make the appointment, ask if there's anything you need to do in advance. For example, if you're going to have allergy testing done, your provider will want you or your child to stop taking antihistamine medications for a certain time period before the test.
• Write down any symptoms you or your child has experienced, including any that may seem unrelated to milk allergy.
• Make a list of any medications, vitamins and supplements you or your child is taking.
• Write down questions to ask your provider.

Preparing a list of questions can help you make the most of your time with your provider. For milk allergy, some basic questions to ask include:

• Do you think this is milk allergy or lactose intolerance?
• Are there tests to diagnose milk allergy? Do these tests require preparation?
• Is it possible to outgrow this allergy?
• Are there treatments?
• Is it necessary to avoid milk and milk products?
• What foods are likely to contain milk products?
• Is it necessary to stay away from others who are drinking milk?
• What do I need to tell people at my child's school about this allergy?
• How can milk allergy best be managed with other conditions?
• Are there brochures or other printed materials that I can take? What websites do you recommend?
• Do I need to carry injectable epinephrine at all times?

Don't hesitate to ask any other questions you may have.

What to expect from your doctor

Your provider is likely to ask you a number of questions, including:

• When did you or your child first react to milk?
• Can you describe the reaction?
• Does this happen every time you or your child drinks milk or eats something made with milk?
• How soon after consuming milk or milk products do symptoms begin?
• How severe are the symptoms?
• Does anything seem to improve the symptoms, such as allergy medication or milk avoidance?
• What, if anything, appears to worsen the symptoms?
• Have you or your child tried any of the products made for people with lactose intolerance? If yes, did those help?
• Is anyone else in your family allergic to milk?

What you can do in the meantime

If you're having mild allergy symptoms from eating something that contained milk, taking an antihistamine medication may lessen your discomfort. Watch for more-severe symptoms that might require medical attention. If you or your child has symptoms of anaphylaxis, seek emergency medical care.