Study Highlights Facts About Anaphylaxis Induced by Goat's and Sheep's Milk

Two-thirds of individuals with a previous history of cow’s milk allergy recovered from their cow’s milk allergy at the time of the goat's and sheep's milk anaphylaxis event, recent findings suggest, and the number of goat’s and sheep’s milk anaphylaxis cases is expected to rise in the future given increasing use of these ingredients in different products.1

This new research on goat’s and sheep’s milk allergy was authored by a team of investigators, such as Guillaume Pouessel from the Department of Pediatrics at the Children's Hospital in Roubaix, France. Pouessel et al highlighted that isolated allergy to goat’s and sheep’s milk, when it is not linked to cow’s milk allergy, is considered to be rare.2

Nevertheless, the investigators noted that there are several cases that prior research has described regarding isolated anaphylaxis related to goat’s and sheep’s milk.

“We aimed to characterize [goat and sheep’s milk] anaphylaxis cases recorded by the allergy-vigilance network (AVN), a French-speaking network collecting data mainly from France, compare the main characteristics and time trends of anaphylaxis induced by [goat and sheep’s milk] with those of other foods, including [cow’s milk] and peanut,” Pouessel and colleagues wrote.1

The coauthors noted the number of cases of anaphylaxis induced by food recorded by the AVN between 2002 - 2024, totalling 3,285 cases. Among these, 97 cases (3.0%) were shown to have been goat and sheep milk-attributed. Among this subgroup of cases, it was highlighted that 58.8% occurred in males, and there was a median age among these cases of 10.5 years (interquartile range: 5.3–17.0).

75.3% of the goat's and sheep's milk-inducted anaphylaxis events were shown by Pouessel and colleagues to have been under 19 years of age. Over the course of their study period, the team found no statistically significant rise in cases of goat's and sheep's milk anaphylaxis (P = .16). They added that 57.7% of the subjects in their analysis had a known allergy to goat's and sheep's milk before their anaphylactic event.

A history of allergy to cow’s milk was noted by the investigative team in 13.4% of the goat and sheep milk anaphylaxis cases. Among these cases, 3 subjects were shown to still be allergic to cow's milk at the time of the event and a single subject was undergoing oral immunotherapy.

The team highlighted that 34.0% of the subjects reported grade 3 anaphylaxis and 4.1% had grade 4 reactions, including 2 fatal outcomes. Trial participants with goat's and cow's milk-induced reactions were generally older (median age 10.5 years versus 1.5 years; P < 10⁻³) and more frequently had a history of asthma (44.5% versus 17.4%; P < 10⁻³) compared to those with anaphylaxis triggered by cow's milk.

Goat's and sheep's milk anaphylaxis cases also tended to involve older individuals compared to peanut-related anaphylaxis. Conversely, when compared to anaphylaxis resulting from other foods, goat's and sheep's milk-related cases involved younger individuals (median age 10.5 versus 19.0 years; P < 10⁻³).

Such cases were also more often linked to asthma (44.5% versus 26.1%; P < 10⁻³), bronchospasm (25.3% versus 36.1%; P = .002), and higher severity of reactions—grade 3 (29.7% versus 4%) and grade 4 (4.1% versus 1.0%) (P = .007). They were additionally more likely to have a known allergy to the trigger food (57.7% versus 33.1%; P < 10⁻³)

Goat and sheep milk allergy accounted for 3% of all food-induced anaphylaxis cases in the investigators' dataset, showing a stable rate over time. This figure contrasts with the 0.9% rate reported in the European Anaphylaxis Registry, potentially suggesting a difference resulting from regional dietary preferences.

Goat's and sheep's milk, Pouessel and coauthors noted, is increasingly being incorporated into a range of different products, including dietary supplements, formulas for infants, personal care products, and pharmaceuticals. As a result, such a rise may contribute to a future increase in anaphylaxis cases related to its use.

Overall, the findings indicate that anaphylaxis related to goat's and sheep's milk may represent a distinct clinical profile as opposed to other food triggers—characterized by its severity (including the 2 aforementioned fatalities), a tendency to emerge in the later childhood period, and a notable link to comorbid asthma.

“Clinicians should be aware of the particularities of [goat's and sheep's milk] anaphylaxis, the risk of [goat's and sheep's milk] allergy in patients with [cow's milk] allergy even after recovery,” they wrote.1 “Data about [goat's and sheep's milk] allergy from other countries are required to possibly envisage the inclusion of [goat's and sheep's milk] in the list of the 14 mandatory allergens for declaration of food products.”

References

1. Pouessel G, Vaia ES, Chatain C, et al (2025). Anaphylaxis Induced by Goat's and Sheep's Milk: An Allergen That We Should Keep Under Surveillance. Allergy. https://doi.org/10.1111/all.16581.

2. O Benjamin-van Aalst, C Dupont, L van der Zee, et al. “Goat Milk Allergy and a Potential Role for Goat Milk in Cow's Milk Allergy,” Nutrients 16, no. 15 (2024): 2402.