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Cow’s Milk, Asthma, & Milk Alternatives


Got Camel Milk?

By Katherine Wight, R.D., L.D.

Have you noticed? There is a new crowd of ‘milks’ alongside the traditional cow’s milk cartons. How does a nice tall glass of cold and refreshing camel milk sound? Too weird? What about donkey milk or buffalo milk? You may wrinkle your nose at the thought, but likely if you haven’t yet tried one, you have at least seen a cow’s milk alternatives. Almond milk, soy milk, rice milk, coconut milk, oat milk and hemp milk are gaining real estate on grocers’ shelves, but more interestingly are replacing cow milk products in many shopping carts.

According to SymphonyIRI Group, a Chicago market research firm, the introduction of almond milk in the refrigerated dairy case in 2010 helped to fuel 13% growth in milk alternatives. Refrigerated non-dairy alternates are the highest growth dairy category in the natural channel with 18.1 percent growth in 2010, according to SPINSscan Natural. What is behind the recent boom in sales? At LMI we have been recommending these products for years, long before their newfound popularity, which has even skeptics pouring themselves a glass.

Why are so many milk alternatives becoming so much more available? The market is responding to increased consumer demand. So why the increased consumer demand? While cow’s milk alternatives appeal to a vegan or vegetarian consumer group and that is certainly responsible for some of the boom, we believe their growth is driven by the increased awareness of food allergies and sensitivities, with allergies to cow’s milk being one of the most common.

Unfortunately, food allergies in general are on the rise and the population that is hit the hardest is children. Food allergies in children have increased by nearly 20% in the last 10 years, and are increasing among children of all ages (boys and girls) and among children of different races/ethnicities[1]. Physicians are diagnosing more food allergies as newer research has linked food allergies to both asthma and skin allergies such as eczema[2]. For example, asthma now affects 1 in 12 Americans, an increase of 12% during the last decade[3]. While more common in children (9.6%) than adults (7.7%), asthma is increasing in all population subgroups. Shockingly, the most significant increase in prevalence is occurring in black children, who saw an almost 50% rise in diagnoses from 2001 to 2009. Now, nearly 1 in 6 black children has asthma. The presence of asthma is a predictor for persistent cow’s milk allergy.[4]

The US Centers for Disease Control and Prevention (CDC) reported the recent rise in asthma, but are unsure of why the rate is increasing because outdoor air quality has improved over the past decade as well as exposure to smoking. Apparently they are not stopping to consider the connection with food allergies. Food allergies don’t always manifest themselves in obvious immediate gastrointestinal effects or anaphylactic reactions.   At LMI we take into consideration the influence food allergies and sensitivities can have on whole body symptoms, and we have for years. It is nice to see studies starting to confirm the other effects food allergies can have. In a study that included 153 children with confirmed IgE-mediated cow’s milk allergy, most of the children had skin reactions including eczema and hives but half had asthma and rhinitis (runny nose) as symptoms[5]. This same study found respiratory symptoms with a cow’s milk allergy such as wheezing or runny nose strongly predicted the likelihood that the allergy will persist longer into childhood, challenging the belief that children outgrow their allergies as they get older. Milk is a top allergy with babies and children. In one infant study more babies showed positive blood levels of immunoglobulin E (IgE) towards cow’s milk (31%) than to peanuts (23%), indicating the high allergenicity of cow’s milk.[6]

In terms of the recent boom in alternative dairy products, we could theorize that since more children are being diagnosed with food allergies, specifically cow’s milk allergy, it is translating into a need for alternative products. But we can’t dismiss the likelihood that many adults are discovering they too have trouble tolerating cow’s milk and other top allergens. Revisiting asthma as a marker for probable food allergies, research has found that children who have eczema, particularly with hay fever, are nine times more likely to develop allergic asthma in their adulthood[7]. And childhood asthma for as many as one in three people may persist as a low-grade, subclinical condition even when patients grow up and are asymptomatic. A study of New Zealanders with a history of childhood asthma found that even if they outgrow their symptoms by late teen years, there was 35% re-occurrence rate by age 26, raising the question of why asthma symptoms return in some patients and not others.[8]

Food allergies and sensitivities can have far-reaching effects on our health, but if you suffer from asthma and or eczema, there is a high likelihood it is related to food allergies. If you suspect you may have food allergies, skin and serum testing is available through integrative practitioners as well as traditional allergists. We recommend looking at both IgE and IgG antibodies. The National Institute for Allergy and Infectious Diseases issued clinical guidelines for diagnosing and treating food allergies, saying that blood and skin testing isn’t sufficient when making a diagnosis and the most definitive test is an oral food challenge. At LMI we recommend eliminating suspected allergens for a set period of time and then mindfully reintroducing the food to test for tolerance.

However, one of the hardest things about food allergies is how to truly recover from them. Avoiding the food is a start, but as many of our patients can confirm if you don’t take steps to improve the health of the intestinal tract, you may only go on to develop allergies to new foods. One of the measures we have long recommended is the use of probiotics (healthy bacteria in the digestive tract). As the frequency of allergic disease is increasing worldwide, it is gratifying then to see that probiotics are being studied for their role in regulating the development of allergic-type immune responses. For example, a study found that allergic children have a delay in their development of protective Bifidobacterium and Lactobacillus microflora suggesting healthy gut flora has a crucial role in the development of a healthy nonallergic immune system[9]. Probiotics help strengthen our gut defense barrier mechanisms and reduce the antigen load that migrates from the gut, which can help protect against the development of allergies. On the other hand, anything that compromises our gut flora, antibiotics for example, increases the risk for allergies. Antibiotic exposure in early childhood, which decreases the concentrations of healthy flora in the gut, has been linked to increased risk for later childhood asthma and allergy at 6 years old.[10]

We hope that one day this research will translate into more probiotics being recommended for children and will help more children avoid a food allergy diagnosis. For the population of children and adults who have discovered allergies or intolerances, it is a relief to at least have alternative products more readily available. The grocery stores are filled with delicious, nutritious and often calcium fortified alternatives. The popularity of alternative milks indicates that consumers are listening to their guts and choosing a milk mustache that makes them feel good.







[1] Branum, A. Pediatrics, December 2009.

[2] J Allergy Clin Immunol 2011.

[3] Morb Mortal Wkly Rep. Published online May 3, 2011

[4] J Allergy Clin Immunol. 2005 Oct;116(4):869-75. Epub 2005 Aug 19

[5] ACAAI 2006 Annual Meeting: Abstract 13. Presented November 12,2006

[6] American Academy of Allergy, Asthma and Immunology Annual Meeting 2010

[7] J Allergy Clin Immunol 2011

[8] ATS 99th International Conference: Abstract 304. Presented May 21, 2003.

[9] J Allergy Clin Immunol 2001; 108:516-520

[10] American Journal of Epidemiology. 2011;173(3):310-318