Detection of relevant amounts of cow's milk protein in non-pre-packed bakery products sold as cow's milk-free

Allergy. 2015 May;70(5):591-7. doi: 10.1111/all.12588. Epub 2015 Feb 26.


Background: Currently, there is no mandatory labelling of allergens for non-pre-packed foods in the EU. Therefore, consumers with food allergy rely on voluntary information provided by the staff. The aim of this study was to characterize allergic reactions to non-pre-packed foods and to investigate whether staff in bakery shops were able to give advice regarding a safe product choice.

Methods: Questionnaires were sent to 200 parents of children with a food allergy. Staff of 50 bakery shops were interviewed regarding selling non-pre-packed foods to food-allergic customers. Bakery products being recommended as 'cow's milk-free' were bought, and cow's milk protein levels were measured using ELISA.

Results: A total of 104 of 200 questionnaires were returned. 25% of the children experienced an allergic reaction due to a non-pre-packed food from bakery shops and 20% from ice cream parlours. Sixty percent of the bakery staff reported serving food-allergic customers at least once a month, 24% once a week. Eighty four percent of the staff felt able to advise food-allergic consumers regarding a safe product choice. Seventy three 'cow's milk-free' products were sold in 44 bakery shops. Cow's milk could be detected in 43% of the bakery products, 21% contained >3 mg cow's milk protein per serving.

Conclusion: Staff in bakery shops felt confident about advising customers with food allergy. However, cow's milk was detectable in almost half of bakery products being sold as 'cow's milk-free'. Every fifth product contained quantities of cow's milk exceeding an amount where approximately 10% of cow's milk-allergic children will show clinical relevant symptoms.

Keywords: accidental reactions; allergen labelling; cow's milk allergy; food-allergic consumers; non-pre-packed foods.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allergens / analysis*
  • Animals
  • Child
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • European Union
  • Female
  • Food Labeling* / standards
  • Food Safety*
  • Humans
  • Infant
  • Male
  • Milk Hypersensitivity*
  • Milk Proteins / adverse effects*
  • Surveys and Questionnaires


  • Allergens
  • Milk Proteins