Pregnancy, Birth and Baby home

Milk allergy and lactose intolerance in babies and children

Call triple zero (000) and ask for an ambulance if your child is having difficulty breathing, they are pale and floppy or unconscious. They may be having a severe allergic reaction and need urgent medical attention.

Key facts

  • Some babies and children have a reaction when they drink cow's milk or formula made from cow's milk.
  • Symptoms after drinking cow's milk may be due to milk allergy or lactose intolerance.
  • If your child has a milk allergy, you will need to completely remove milk and other foods made from milk from their diet.
  • If your child is lactose intolerant, you will need to reduce dairy products that contain lactose in their diet.
  • Speak to your doctor or a dietitian before removing milk and dairy products from your child's diet.

    • What is the difference between a milk allergy and lactose intolerance?

    Milk allergy and lactose intolerance are common reactions to dairy milk. Milk allergy affects more than 1 in 50 young children in Australia and New Zealand.

    Milk allergy is a problem with your immune system (Opens in new tab). This causes your body to react to the protein in milk. An allergy usually causes symptoms in your stomach as well as in other parts of your body.

    Lactose intolerance is a problem with your digestive system (Opens in new tab). It means your child doesn't have the enzyme needed to digest lactose. Lactose is the sugar that is found in milk.

    There are some common symptoms between both milk allergy and lactose intolerance in children. Many young children grow out of their milk allergy or lactose intolerance.

    Don't remove milk or dairy products from your child's diet unless told by your doctor.

    What are the symptoms of milk allergy and lactose intolerance?

    Call triple zero (000) and ask for an ambulance if your child has any of these symptoms:

    They could be having a severe allergic reaction (anaphylaxis) and may need urgent medical attention.

    Milk allergy

    Allergic reactions to milk can take minutes to several hours to happen.

    Rapid reactions may take up to 2 hours to appear and include:

    Delayed reactions include:

    If you start to see an unusually large amount of mucus, and sometimes streaks of blood, in your baby's poo, it could be a sign of a food intolerance or allergy.

    Lactose intolerance

    The symptoms of lactose intolerance in babies and children are:

    These symptoms can be common in babies. They don't necessarily mean your child has lactose intolerance. But if your child has ongoing diarrhoea or is not putting on weight, see your doctor.

    What causes milk allergy or lactose intolerance

    Milk allergy

    Milk allergy occurs when your child's immune system reacts to the protein (Opens in new tab) in milk. It's one of the most common food allergies in young children. Most children outgrow milk allergy by the time they reach school age.

    Lactose intolerance

    Lactose is the sugar found in the milk produced by mammals, including humans. Some people don't produce enough lactase to break down the lactose. Lactase is an enzyme that helps you to digest lactose.

    Very few babies have true lactose intolerance (Opens in new tab). This is a rare genetic condition where you have no lactase enzymes at all. This is called primary lactose intolerance.

    Babies and young children can become temporarily intolerant to milk. This happens when the lining of their gut is damaged. It can happen if they have gastroenteritis (Opens in new tab), or an allergy or intolerance to another food. It will get better once the gut heals. This usually takes a few months. This is called secondary lactose intolerance.

    Lactose intolerance is more common among:

    • Aboriginal and/or Torres Strait Islander people
    • people from Asia and Africa
    • people from the Middle East
    • people from some Mediterranean countries

    When should my child see a doctor?

    It's very important to see a doctor if your child has symptoms of milk allergy.

    FIND A HEALTH SERVICE — The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

    How is milk allergy or lactose intolerance diagnosed?

    Your doctor will ask about your child's symptoms and do medical tests, such as a:

    Tests that aren't supported by evidence do not have a place in testing for milk allergy. Avoid tests like:

    • vega testing
    • kinesiology
    • ALCAT tests

    If your doctor thinks that your child is lactose intolerant, they may suggest cutting out lactose from your child's diet.

    How are milk allergy and lactose intolerance treated?

    Treatment for milk allergy

    If your child is allergic to milk, you need to completely remove dairy products from their diet. You may also need to avoid milk from other animals, such as goats.

    You will also need to remove other foods that contain milk. This may include solid foods such as cakes, biscuits and other packaged foods.

    You will need to follow your doctor's advice and read food labels carefully. Watch out for other words used to describe milk on food labels, such as:

    • butter and ghee
    • buttermilk and cream
    • casein and caseinates
    • cheese and curd
    • dairy
    • milk solids
    • yoghurt and whey

    You should also use coconut products with caution. These may be contaminated with cow's milk.

    If your child is over the age of one, they can be given soy milk, or other calcium-enriched milks made from:

    • nuts
    • oat
    • rice

    It's important to make sure your child is getting enough calcium (Opens in new tab).

    Do not reintroduce milk or dairy products into your child's diet until your doctor says it's safe.

    Medicines for milk allergy

    If your child is allergic to milk, you may be advised to carry an adrenaline autoinjector (Opens in new tab) (EpiPen® and Anapen®).

    Severe allergic reactions can sometimes lead to anaphylaxis. This is an emergency and can even be fatal (cause death). You can use an adrenaline autoinjector to give first aid in the event of anaphylaxis.

    Can I still breastfeed my baby who has a milk allergy?

    Breastmilk is best, including for babies who have a milk allergy. In some cases, your doctor may advise you to remove milk and dairy products from your own diet.

    In other cases, you may be able to eat your regular diet. You can speak to your doctor for guidance.

    Which formula can I use for my baby who has a milk allergy?

    If your baby is formula-fed, and they have a milk allergy then you can use extensively hydrolysed formula (EHF) or amino acid-based formula (AAF).

    Do not use formula made from:

    • cow's milk
    • goat's milk
    • sheep's milk
    • hypoallergenic (HA) or A2 milk
    • lactose-free formulas

    If your baby is over 6 months old, and not allergic to soy, you can also use soy protein formula.

    Treatment for lactose intolerance

    The main treatment for lactose intolerance is to reduce or remove lactose in your child's diet.

    Older children will need to cut down on, but not eliminate, dairy foods from their diet. They can still have some:

    • cheeses
    • yogurt
    • calcium-fortified soy products
    • lactose-free milk, butter and cream

    Your doctor or a dietitian (Opens in new tab) will advise you on the best diet for your child.

    Most of the time, young children will recover from lactose intolerance after a few weeks on a low-lactose diet.

    Speak to your doctor or dietitian about how to slowly reintroduce milk and dairy products into your child's diet.

    Can I still breastfeed my baby if they are lactose intolerant?

    If your baby is lactose intolerant, you should keep breastfeeding.

    Reducing the amount of dairy in your diet will not reduce the amount of lactose in your breastmilk.

    Which formula can I use for my baby who is lactose intolerant?

    If your baby is formula-fed, talk to your doctor or child health nurse before switching to a low-lactose or lactose-free formula.

    Resources and support

    For support to deal with milk allergy and lactose intolerance, you can get help from:

    Read more about avoiding food allergies in babies (Opens in new tab) from the Royal Australian College of General Practitioners.

    Speak to a maternal child health nurse

    Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 (Opens in new tab) or video call. Available 7am to midnight (AET), 7 days a week.

    Last reviewed: September 2024

    Need more information?

    These trusted information partners have more on this topic.

    Milk, yoghurt, cheese and / or their alternatives ( mostly reduced fat ) | Eat For Health

    Low or reduced fat milk, yoghurt and cheese choices are recommended for most people two years and over. Most Australians consume only about half the recommended quantity of milk products or alternatives, but eat too many full fat varieties, which can increase the kilojoules and the saturated fat content of the diet. Reduced fat varieties of milks are not suitable as a milk drink for children under the age of two due to their high energy needs required for growth. For nearly everyone else (over the age of two) this is the best choice.
    NHMRC logo
    Learn more on NHMRC website