The need for a dairy-free diet should be reevaluated every six months by testing<unk> -containing products low on the "milk ladder", such as fully cooked, i.e., baked foods, containing<unk> , in which the<unk>  proteins have been denatured, and ending with fresh cheese and<unk> . Desensitization via oral immunotherapy is considered experimental. Treatment for accidental ingestion of<unk>  products by allergic individuals varies depending on the sensitivity of the person. An antihistamine, such as diphenhydramine (Benadryl), may be prescribed. Sometimes prednisone will be prescribed to prevent a possible late-phase type I hypersensitivity reaction. Severe allergic reactions (anaphylaxis) may require treatment with an epinephrine pen, i.e., an injection device designed to be used by a non-healthcare professional when emergency treatment is warranted. A second dose is needed in 16–35% of episodes. Avoiding dairy Most people find it necessary to strictly avoid any item containing dairy ingredients. The reason is that the individual threshold dose capable of provoking an allergic reaction can be quite small, especially in infants. An estimated 5% react to less than 30 milligrams of dairy proteins, and 1% react to less than 1 milligram. A more recent review calculated that the eliciting threshold dose for an allergic reaction in 1% of people (ED01) with confirmed cow's<unk>  is 0.1 mg of cow's<unk>  protein. Beyond the obvious (anything with<unk> , cheese, cream, curd, butter, ghee or yogurt in the name), in countries where allergen labeling is mandatory, the ingredient list is supposed to list all ingredients. Anyone with or caring for a person with a dairy protein allergy should always carefully read food package labels, as sometimes even a familiar brand undergoes an ingredient change. In the U.S., for all foods except meat, poultry and egg processed products and most alcoholic beverages, if an ingredient is derived from one of the required-label allergens, then it must either have the food name in parentheses, for example "Casein <unk> ," or as an alternative, there must be a statement separate but adjacent to the ingredients list: "Contains<unk> " (and any other of the allergens with mandatory labeling). Dairy-sourced protein ingredients include casein, caseinates, whey and lactalbumin, among others. The U.S. FDA has a recall process for foods that contain undeclared allergenic ingredients. The University of Wisconsin has a list of foods that may contain dairy proteins, yet are not always obvious from the name or type of food. This list contains the following examples: * Bread, baked goods and desserts * Caramel and nougat candies * Cereals, crackers, food bars * Chewing gum * Chocolate ('milk' and 'dark') * "Cream of..." soups * Creamy pasta sauces * Creamy salad dressings * Eggnog * Flavored potato chips * Hot dogs and lunch meat * Instant mashed potatoes * Margarine * Medical food beverages * Non-dairy creamer * Sherbet * Pudding and custard There is a distinction between “Contains ___” and “May contain ___.” The first is a deliberate addition to the ingredients of a food, and is required. The second addresses unintentional possible inclusion of ingredients, in this instance dairy-sourced, during transportation, storage or at the manufacturing site, and is voluntary, and is referred to as precautionary allergen labeling (PAL).<unk>  from other mammalian species (goat, sheep, etc.) should not be used as a substitute for cow's<unk> , as<unk>  proteins from other mammals are often cross-reactive. Nevertheless, some people with cow's<unk>  can tolerate goat's or sheep's<unk> , and vice versa.<unk>  from camels, pigs, reindeer, horses, and donkeys may also be tolerated in some cases. Probiotic products have been tested, and some found to contain<unk>  proteins which were not always indicated on the labels. Cross-reactivity with soy Infants – either still 100% breastfeeding or on infant formula – and also young children may be prone to a combined cow's<unk>  and soy protein allergy, referred to as "milk soy protein intolerance" (MSPI). A U.S. state government website presents the concept, including a recommendation that nursing mothers discontinue eating any foods that contain dairy or soy ingredients. In opposition to this recommendation, a published scientific review stated that there was not yet sufficient evidence in the human trial literature to conclude that maternal dietary food avoidance during lactation would prevent or treat allergic symptoms in breastfed infants. A review presented information on<unk> , soy allergy and cross-reactivity between the two.<unk>  was described as occurring in 2.2% to 2.8% of infants and declining with age. Soy allergy was described as occurring in zero to 0.7% of young children. According to several studies cited in the review, between 10% and 14% of infants and young children with confirmed cow's<unk>  were determined to also be sensitized to soy and in some instances have a clinical reaction after consuming a soy-containing food. The research did not address whether the cause was two separate allergies or a cross-reaction due to a similarity in protein structure, as which occurs for cow's<unk>  and goat's<unk> . Recommendations are that infants diagnosed as allergic to cow's<unk>  infant formula be switched to an extensively hydrolyzed protein formula rather than a soy whole protein formula.
Milk allergy
Lactose intolerance  Lactose intolerance  1
Egg allergy
Peanut allergy
Corn allergy
Soy allergy
Poultry allergy
Latex allergy