
The basics
People who are allergic to the proteins in dairy products and some people who are highly intolerant to lactose (the sugar in dairy products) have to eat a dairy-free diet. A dairy-free diet contains no milk, cheese, butter, cream cheese, cottage cheese, sour cream, ice cream, whey, casein, or foods that contain any of these ingredients.
Best bets: Milk substitutes like soy milk, rice milk, nut milks, and milk-free products like soy cheese and rice ice cream
Most people who follow a dairy-free diet are allergic to dairy products. However, a few people who are exquisitely sensitive to lactose—milk sugar—also need to avoid all dairy products.
People who react to lactose are called “lactose-intolerant.” They lack adequate amounts of an enzyme (called lactase) needed to digest milk sugar. Unlike people who are allergic to dairy products, most lactose-intolerant people can consume dairy products that naturally contain only traces of lactose (such as hard cheese) or those that have been treated to break down lactose (e.g., Lactaid™ milk). Many lactose-intolerant people can also eat yogurt without suffering, despite the high amount of lactose found in yogurt. The ability of many lactose-intolerant people to consume yogurt without getting sick used to baffle scientists. Now we know that the bacteria in most yogurt products (except frozen yogurt) consume most of the lactose as soon as the yogurt moves from the stomach to the intestines. These bacteria are so efficient that they often break down the lactose before the lactose-intolerant person has a chance to react to it.
Milk allergy is an immune system response to the presence of milk protein in the body. The body perceives the protein as “foreign” and proceeds to mount an attack against it, which results in the symptoms of an allergic reaction. Cow’s milk is the most common cause of food allergy in infants and young children. Cow’s milk proteins are potent allergens and around 2.5% of infants experience cow’s milk allergy in the first years of life. However, food allergies usually diminish with advancing age. Up to 85% of children will outgrow their allergy by the age of three; the majority will outgrow it by the time they reach school.
The symptoms of lactose intolerance occur within a few hours of ingestion of milk or milk products and include bloating, abdominal pain, gas, and diarrhea. The severity of lactose intolerance varies greatly among individuals. Lactose-intolerant people who experience these symptoms even when they eat only dairy products that contain very little lactose may require a diet free of all dairy products to avoid these symptoms.
Milk allergy symptoms may include any of the common symptoms of food allergies, including skin rashes or hives, gastrointestinal distress, breathing problems, or many other possible symptoms. Anaphylaxis, a life-threatening allergic reaction, is only rarely triggered by consumption of dairy products, even in people who are allergic to dairy.
To avoid milk and milk products ask about ingredients at restaurants and others’ homes, read food labels, and become familiar with the technical or scientific terms for milk. The following list is not complete. Consult with a healthcare professional if you are planning to omit milk from your diet or your child’s diet. Many Americans receive the majority of their calcium intake from dairy products. Therefore, when switching to a dairy-free diet, taking calcium supplements is often advisable.
Milk substitutes:
Nondairy products:
The No Milk Page
www.nomilk.com
Food Allergy Network
www.foodallergy.org
Nondairy Milk Recipes—Leave the Cow’s Milk for the
Calves
www.veganmania.com/pages/non_dairy_milk_recipes.htm
Go Dairy Free
www.godairyfree.com
Ahmed T, Fuchs GJ. Gastrointestinal allergy to food: a review. J Diarrhoeal Dis Res 1997;15:211–23.
Businco L, Bruno G, Giampietro PG. Prevention and management of food allergy. Acta Paediatr Suppl 1999;88:104–9.
Muñoz-Furlong A. Is It Milk Intolerance or Milk Allergy? www.aaaai.org/public/publicedmat/advocate/1999/spring/milk.stm. 10/13/00