Tips for living with a dairy allergy



Dairy Allergy vs. Lactose Intolerance

An allergy to cow’s milk is the most common food allergy in the United States.  Approximately 3% of American children are allergic to milk.  Also referred to as a “dairy allergy,” it is different than the condition known as “lactose intolerance.”  It is important to understand the two terms:

Dairy allergy – an allergic reaction to any food product that contains milk.

Lactose intolerance – this is not an allergy; it is a “common sensitivity” to the natural sugar found in milk. The intolerance occurs due to a lower amount of the enzyme lactase in the digestive system.  This enzyme is necessary to digest milk.

Living Without Milk

Milk is found so frequently in processed food that reading food labels to identify which foods include milk is very important.  Milk can crop up in the strangest places.  For example, restaurants often add a pat of butter to grilled steaks before serving.  Milk is also added to some brands of canned tuna.

The most common sources of milk include cheese, butter, cream, and yogurt.  If you are allergic to cow’s milk you should also avoid goat and sheep milk.

Remember that “lactose free” milk is safe for individuals with lactose intolerance, but it still contains milk protein so it is not safe for persons with a milk allergy.

Milk Substitutes to Try

With so many people allergic to milk, grocery stores now offer many healthy alternatives.

Soy Milk, Rice Milk, Coconut Milk and Hemp Milk are all readily-available alternatives.  These milk substitutes come in many varieties, including chocolate, unsweetened, or vanilla flavored. They can be found “non-refrigerated” in most stores.  However, they must be refrigerated after opening, and are best served cold.

Substituting for Yogurt, Sour Cream and Cheese

Substituting for other products with milk can be very easy. For example, you can try soy based yogurts which taste very similar to traditional yogurt.  Try the WholeSoy Yogurt products, they are not only dairy free but have no chemical additives. They come in many delicious flavors from cherry to apricot mango.

On your milk free diet you do not have to give up sour cream. Tofutti’s Sour Supreme is an excellent non-dairy sour cream.  The texture is a bit different, but the taste is very similar and delicious. Toffutti’s sour cream can substitute for traditional sour cream in your favorite recipes.

To substitute for cheese in your diet try the brand Daiya. They offer Cheddar, Mozzarella and Jack Cheese varieties. This dairy free cheese comes shredded, all ready to put on top of your pizza.

On-Line and In-Store Products to Try:

  • Vance’s Dari-Free Milk is delicious and is made from potatoes.
  • Divvies is an on-line bakery for all dairy free products.
  • For a great book to help children understand milk allergies, read “Cody the Allergic Cow” by Nicole Smith.

Snacks for the Kids:

Even without milk kids can still have fun snacks.  They will enjoy the following snacks and remain dairy free:

  • Oatmeal with bananas
  • Dried fruit
  • Corn tortillas with soy cheese
  • Raw carrots dipped in honey or hummus

Bon Appetite!

Lezli Stone is a Registered Dietician and a consulting clinical staff member of the Arizona Asthma & Allergy Institute.  She counsels AAAI patients about food allergies and nutrition.  She is authoring a four-part series of articles about living with food allergies, which will be posted on this website over the next few months.

Primatene Mist discontinued over the counter

The FDA has ordered Primatene Mist, the only over-the-counter asthma inhaler, be taken off drugstore shelves December 31st.  Primatene Mist has CFC’s which is not environmentally safe as this can deplete the earth’s ozone layer.  Several other products with CFC’s have already been removed from the market for the same reasons.

AAAI Physicians do not endorse Primatene Mist for asthma treatment because this is no longer the standard of care for asthma and the epinephrine in this medication has harmful side effects if over used.  There are safer and more appropriate medications for asthma treatment.

We feel this will improve patient care by decreasing adverse effects from this medication.  This will also encourage patients to see their physician to discuss their symptoms and have appropriate evaluation and treatment.

Insect Sting Allergy

Insect stings commonly cause local swelling, pain, itching and redness at the site of the sting.  Many people who have an allergy to insect venom have these same symptoms but causing much larger reactions that can persist for days.  Up to 3-4% of Adults and 1% of Children in the general population have an allergy to insects that cause more serious “systemic reactions”.  Systemic reactions will not only cause large local reactions at the site of the sting but also can cause diffuse hives, trouble breathing and possibly life threatening symptoms such as throat swelling and anaphylactic shock.  The most common insect allergies to cause these types of reactions are from Bee and Fire Ant stings.

Here at the Arizona Asthma and Allergy Institute we have accurate testing to evaluate those at risk for these potentially serious reactions to insect stings.  Patients with a known history of serious reactions to Bees or Fire Ants can qualify for allergy injections which can be 98% effective in preventing a systemic reaction to future stings.  If you have any questions or want further investigation on your risk of insect allergy then our providers can help you!

Eczema and Food Allergy

The onset of eczema frequently coincides with introduction of certain foods into the infant’s diet.  Common food allergies and possible triggers to eczema in children include egg, milk, peanut, soy and wheat.  Overall, about 20-30% of children with eczema have food allergies to one or more of these foods.

If your child has eczema there may be an underlying food allergy contributing.  We can further evaluate this to see if foods are a trigger to your child’s eczema and avoiding the food allergen(s) can have a significant benefit in improving eczema.

Immune Deficiency

Many people have an immune deficiency that goes undiagnosed as they are not regularly following up with their physician or their physician is not doing the appropriate immunology work up to make the diagnosis.

Our Physicians are not only Board Certified in Asthma and Allergy but are also Board Certified in Immunology.  We are experts in evaluating the immune system.  If you or a family member have any of the signs listed below you may have a weak immune system that should be further evaluated and treated.

Important signs that may indicate an immune deficiency include:
• Recurrent, unusual or difficult to treat infections
• Poor growth or loss of weight
• Recurrent pneumonia, ear infections or sinusitis
• Multiple courses of antibiotics or IV antibiotics necessary to clear infections
• Recurrent deep abscesses of the organs or skin
• A family history of immune deficiency
• Swollen lymph glands or an enlarged spleen
• Autoimmune disease


Tips for grocery shopping for people with food allergies



Purchasing food for a member of the family with a food allergy may seem like a daunting task, but with some practice you can make that trip to the grocery store as “easy as pie”.  Try these suggestions:

Become an Expert Label Reader

  • Food labeling laws require that common allergens be listed on food labels.  This means food products will always list the following ingredients: milk, eggs, peanuts, tree nuts, wheat, soy, fish or crustacean shellfish.  These common allergens are listed separately in a “contains” statement located directly below the “ingredients” list.
  • Check for cross-contamination warnings. If there is a possibility for cross-contamination with allergens, there will be a warning that the product is “manufactured in a facility that processes a common allergen” such as wheat or nuts.  When applicable, avoid these products to be 100% safe.

CAUTION – Certain Foods Have a High Risk of Cross-Contamination

The risk of cross-contamination with allergens is higher in certain areas of the grocery store. Be cautious when purchasing the foods listed below, and always read the label carefully for warnings:

  • Imported foods
  • Foods from deli counters
  • Foods from salad bars

Be Cautious when Purchasing Non – Food Items

  • Pet food: Food labeling laws do not apply to pet food. Dog food can contain ingredients such as eggs and peanuts. Family pets love to lick faces, so teach your children about this potential exposure to allergens.
  • Medications: Always check medications for allergy warnings and content, whether they are prescription or “over the counter.”  Ingredients can be found on the package insert which you can obtain from the grocery store pharmacist.
  • Cleaning Products: Personal care products such as soap, make-up and cleaning products may be labeled “hypoallergenic” but can contain food products.  Be sure to check the label.

Try “Allergy Friendly” Stores

  • Shopping at stores that are sensitive to living with food allergies and intolerances can help.  Stores such as “Trader Joes,” “Sprouts,” and “Whole Foods” advertise their commitment to serving people with food allergies.
  • Also try online grocery stores that are allergy friendly.  The website offers great selections.

Be “Label Free”- Try Non-Processed Foods

Grocery stores may carry over 50,000 items, and reading labels with fine print can be stressful.  To alleviate some this worry, start becoming “label free.”

This can be done by limiting consumption of processed foods with labels; this will reduce the stress of wondering if you missed an allergen listed as an ingredient on a food product.

Not will you significantly decrease your potential exposure to allergens, you will get the added benefit of a reduced intake of fat, sugar and sodium, which are often added to processed foods.

To start this process, go slowly and start buying products that have less than 5 ingredients listed on the label.  This will also substantially reduce the time you spent looking for ingredients on a label that could cause an allergic reaction.

Make a conscious effort to expand your diet and try different types of fresh fruits and vegetables or whole grains you’ve never tasted. You might find a new food that your family really enjoys!

Lezli Stone is a Registered Dietician and a consulting clinical staff member of the Arizona Asthma & Allergy Institute.  She counsels AAAI patients about food allergies and nutrition.  She is authoring a four-part series of articles about living with food allergies, which will be posted on this website over the next few months.

Penicillin Allergy

Studies have shown that 90% of people that claim to have a Penicillin allergy were either never allergic or lost their allergy.  If you have been labeled allergic to Penicillin it would be important for your long term medical care to have this evaluated with skin testing.  Please schedule an appointment with us for Penicillin skin testing and we can help you!

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Tips for Living Wheat Free

by Lezli R. Stone

You just finished your food allergy testing at the Arizona Asthma & Allergy Institute and have been informed that you have an allergy or intolerance to WHEAT.
A “wheat allergy” is clinically different from another condition you may be aware of, called “Celiac Disease,” which is a complex autoimmune disorder, not an allergy. With either Celiac Disease or a wheat allergy you may think “I’ll never eat pasta again!”

Do not despair – you can live a wheat-free lifestyle and still have a diet full of flavor.
Sensitivity to wheat is linked to the four different proteins in wheat – Albumin, Gliadin, Globulin and the one you are probably most familiar with, Gluten.

To alleviate your symptoms, the most important step is to totally eliminate wheat from your diet.
Since wheat is found in many processed foods, you must be very diligent about reading food labels. It is a legal requirement that food labels state if wheat is in their products. You may be surprised to find that common processed foods like hot dogs and candy can contain wheat.

Fortunately, you have many foods available that can substitute for wheat including: Rice, Amaranth, Millet, Kasha, Gluten-free Oats, Teff, and Quinoa.

A few of these you may not recognize; let’s discuss two of them.

Amaranth is an 8,000 year-old grain utilized by the Aztecs, who thought it had supernatural powers. Amaranth should be soaked overnight in water before cooking. It can be cooked as hot cereal by adding 2 ½ cups of water and 1 cup Amaranth to a pot, bringing it to a boil, then reducing heat to low. Cover and cook for 20 minutes. Serve with honey and raisins for a hot breakfast.
Amaranth can also be popped (somewhat) like popcorn. Add to a hot pan, no oil needed, and it pops in about 30 seconds. Don’t add it slowly to the hot pan, or it will burn. The popped Amaranth may be added to salads for a nice crunch.

One of the best grains to substitute for wheat is rice, of any variety. Of all the grains, rice is considered the least allergenic. Rice is also very nutritious, low in calories (about 100 calories for a ½ cup), loaded with B vitamins, and high in fiber (if you chose the brown rice).
For something different, try Black Rice, which is a specialty rice that is as high in antioxidants as blueberries. The dark color will fade to purple when it is cooked, which is fun for children to watch. When eating rice, always use low sodium soy sauce and watch the portion sizes.

Gluten-Free Products
Another great alternative for wheat-free foods is gluten-free products. The market for gluten-free products has grown considerably in the past five years, and they have improved in quality and taste. Please remember that “gluten-free” does not mean “sugar-free,” “fat-free” or “low calorie.” Here are some products to try:

  • Dr. Praegers – Frozen foods
  • Rustic Crust – Pizza products
  • JK Gourmet – Grain free products

Many gluten-free products are available at Sprouts or Whole Foods. Wheat free living can be delicious, so try new foods and Bon Appetit!
Lezli Stone is a Registered Dietician and a consulting clinical staff member of the Arizona Asthma & Allergy Institute. She counsels AAAI patients about food allergies and nutrition. She is authoring a four-part series of articles about living with food allergies, which will be posted on this website over the next few months.