Your child has an allergy to cow's milk. After eating or drinking something with milk, your child may get a rash or have nausea, vomiting, wheezing, coughing, or trouble breathing. Milk allergies can be life-threatening for some kids. Follow these instructions to keep your child safe.

Instructions for Food:

• Avoid all the foods on the list the health care provider gave you.
• For infants: 
  • If you breastfeed your infant, ask your health care provider what foods and drinks you should avoid.
  • If you use formula, use the one your health care provider recommends.
• Read food labels carefully every time you give a food or drink to your child: 
  • Avoid all products with "milk" on the label or ingredient list. Even non-dairy foods may contain milk. Your child should avoid every type of animal milk (such as sheep's milk and goat's milk) because they're similar to cow's milk and also cause reactions.
  • Check a product's ingredient list every time. Ingredients can change.
  • Watch out for cross-contamination. Avoid foods and drinks labeled "may contain milk," "processed in a facility that also processes milk," or "manufactured on equipment also used for milk." Not all companies label for cross-contamination, so if in doubt, call or email the company to be sure.
• When preparing food: 
  • Wash countertops, bowls, plates, spoons, and other utensils with dishwashing soap and hot water to remove any traces of milk.
  • Wash your hands with soap and water before touching food. Hand sanitizing gel doesn't get rid of allergens. If soap isn't available, hand cleaning wipes can be used. 
• If you keep foods that contain milk in the house, store and prepare them in a separate part of your kitchen so they don't accidentally contaminate your child's food.
• When eating outside the home, make sure you tell the people preparing or serving your child's food about the milk allergy.

Safety Planning:

• Give copies of your child's allergy action plan to teachers and other care providers. Your child should not share other kids' food because it may not be safe. Make a plan for snacks, lunch, field trips, and other food-related situations.
• Talk to your health care provider about whether your child should sit at an allergen-free table in school.
• Your child should wear a medical alert ID bracelet with their name and allergies. You can buy one in a drugstore or online.
• Check labels on non-food items, such as cosmetics, art supplies, and latex gloves because they may contain milk protein. If there are no ingredient labels, you can contact the company to find out if products are safe for your child.

Epinephrine:

• If the health care provider prescribed epinephrine auto-injectors, keep two with your child at all times, including at school, child care, and activities. This is in case one injector does not work or your child needs another dose of epinephrine before help arrives in an emergency. Make sure the auto-injectors have not expired, and don't leave them in cars or other places where they're exposed to too much heat, cold, or sunlight.
• Immediately use the epinephrine auto-injector if your child shows signs of a severe allergic reaction, which may include: 
  • trouble breathing, swallowing, or speaking
  • tightness in the throat
  • swollen tongue or lips
  • a hoarse voice
  • wheezing
  • coughing
  • vomiting
  • feeling lightheaded or fainting
  • many hives on different parts of the body or widespread redness
  • a combination of two mild symptoms, like a few hives with nausea

• You have questions about what your child can eat or drink.
• Your child no longer consumes any milk products but still has signs of an allergy.
• You're not sure how or when to use your child's epinephrine auto-injector.
• Your child has an accidental exposure to milk and needs treatment. Get emergency care first, then update your allergist and/or primary care provider when your child is feeling better.

• You or your child is injected with epinephrine in the hand or foot by accident.

If your child shows signs of anaphylaxis, such as trouble breathing, throat tightness, a combination of two mild symptoms (such as hives with vomiting), or loss of consciousness, follow these steps, in this order:

• Give your child the epinephrine auto-injector right away. Give the epinephrine even if you're not sure your child needs it. It won't do any harm. After getting the epinephrine, your child must go to the ER to see if any other treatment is needed. This is true even if your child is doing better, because there can be a second wave of symptoms.
• Call 911.
  • If someone is with you, have that person call 911 and tell the person your child is having a life-threatening emergency.
  • If you're alone, give epinephrine first, then call 911 right away and say your child is having a life-threatening emergency.
• Lay your child down with their legs raised while you wait for the ambulance.
• Don't take your child to the ER in a car. Wait for an ambulance with trained specialists to transport your child.
• Take the used epinephrine auto-injector to the hospital with you.

What causes cow's milk allergy? Most people digest the proteins in milk without any problems. But in kids with cow's milk allergies, the immune system treats the proteins like dangerous invaders and goes into overdrive, causing an allergic reaction.

How do health care providers diagnose cow's milk allergy? To confirm a milk allergy, health care providers ask questions and will do an exam. They may order skin tests and/or blood tests.

What is anaphylaxis? Anaphylaxis is a severe allergic reaction. Someone with anaphylaxis may have trouble breathing or swallowing, may vomit repeatedly, or might pass out. If not treated, anaphylaxis can cause death.

Some kids with milk allergy are at risk for anaphylaxis. If your child is at risk, your health care provider told you this and prescribed epinephrine auto-injectors.

What is epinephrine? Epinephrine is a medicine that treats anaphylaxis. It comes in an auto-injector. When needed, it is injected into the thigh.