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Milk Allergy & Lactose Intolerance


  1. Where can I find a dietitian who works with people who don't tolerate milk so that I can get enough calcium? Answer
  2. I heard that it's important to buy milk in opaque cartons because vitamins can leak with exposure to light. Answer
  3. A veterinarian told me that the milk from Fulani cattle in Africa will be more tolerated by people drinking it. Do you know whether this is true? Answer
  4. As a registered dietitian in Canada, I have concern about people questions regarding milk products for those who are lactose intolerant. Answer
  5. I am searching for clarification on butter oil. Answer
  6. I am wondering about stearoyl-1-lactylate sounds like some kind of milk derivative. Answer
  7. I have an 8 year old son who is unable to eat dairy products. He has been taking TUMS daily at his doctor's recommendation for calcium supplement. Answer
  8. We would like to know if there is an effect if a person does not drink milk and just drinks sugar water? Answer
  9. May I know the percent of fat content in whole milk as compared to 2%? Answer


  10. Do you know about milk substitute produts such as soy milk and rice drink? Answer
  11. I need information about horse milk. Is this type of milk suitable for people who have lactose intolerance? Answer
  12. My son does take his Lactaid pills, but I would like to be able to give his daycare a complete list of foods that he can eat without having to take his pills. Answer
  13. I have a 2 year old who cannot tolerate any type of lactose in his diet. If possible, a listing of food that does not contain milk or milk solids would help. Answer
  14. I have been diagnosed as allergic to milk and am trying to eat a milk-free diet. Do you have any suggstions as what to do? Answer
  15. Ever since I was a child, I have not liked milk. Do you think I am allergic to milk? Answer
  16. Skim milk has more salt than whole or 2% milk. My doctor told me to follow a low salt diet. Should I cut out milk completely? Answer
  17. When my baby was six months old, he became allergic to milk. Will he ever grow out of the milk allergy? Answer
  18. I breastfed my daughter until she was six months old. Then I switched her to 2% milk, but she had bad cramps and diarrhea. She can now drink some milk. Should I still be giving her the liquid calcium? Answer
  19. I like 2% milk and my doctor told me to switch to skim milk because I'm on a low cholesterol diet. I don't like slim milk. Answer


Where can I find a dietitian who works with people who don't tolerate milk so that I get enough calcium?

The Medical Nutrition and Nutrition Entrepreneurs dietetic practice groups of the Academy of Nutrition and Dietetics work with people who have a lactose intolerance or an allergy to the protein in milk to make sure they get enough calcium in the foods they eat. Dietitians often have their own private practice nutrition counseling services in addition to services provided in a clinic or hospital. You can find a registered dietitian at the Academy of Nutrition and Dietetics. Include your zip code, the type of expertise needed (diabetes, heart disease, wellness, etc).


I searched your Web site for info on this topic, but couldn't find any. I have heard before that it's important to buy milk in opaque cartons because vitamins can "leak" with exposure to light. But now I would like to buy my milk in the new, recyclable glass bottles my grocery store is offering. Is this packaging story true or just a bunch of nonsense?

The vitamin in milk that is susceptible to light is riboflavin, vitamin B2. Yes, it is better to buy milk in opaque containers than clear glass. Remember to recycle the opaque containers.


I recently traveled to Burkina and Mali researching for a documentary film about Fulani cattle breeders. A Fulani veterinarian told me that depending on the blood group of the cow, its milk will be more or less well tolerated by the people drinking it. 0-type cows would give milk suited to everybody. Do you know whether this is true?

Haven't a clue about cow blood types and whether they follow the same typing in humans (A, B, AB or O). However, in the US milk from a single dairy herd is mixed with other herd's milk in the tanker that goes from farm to farm picking up milk. Some dairies do separate milk produced by cows that are not on rbST, a hormone to boost milk production. I would highly recommend contacting the Agriculture Department at your local university for research about blood groups of cows and whether that influences milk tolerance by humans.

Also, people can be allergic to milk protein or lactose intolerant to milk sugar. That said, I highly doubt that cow blood type would affect either milk allergy or lactose intolerance.


I have just been to your website. As a registered dietitian in Canada I was interested in your Q & A site. I have a concern about people's questions regarding milk products for those who are lactose intolerant or allergic to milk.

Those who are allergic to milk, are usually allergic to the protein, often casein, in milk. These individuals (between 2 - 8% of infants / children) should not have any cow or goat milk products. They must avoid all milk products.

In actual fact, it is the lactose intolerant individuals (unable to digest the lactose or sugar in milk) vary in the ability to digest various milk products. Foods such as aged cheese (cheddar) and yogurt (with live bacteria culture) may be reasonably well tolerated. Some may also tolerate small amounts of milk as long as they are eaten with a meal. Lactaid and lactase milks have the lactose already digested (99%) and are often well tolerated. Allergic patients should not drink lactaid or lactase milk. Interestingly enough there is some good recent research that shows that individuals who have been lactose intolerant can actually improve this condition through continuing to drink small amounts of dairy products every day. Drops and pills can also assist in digesting lactose and hence allowing individuals to continue to enjoy dairy products.

To summarize: Most individuals who are allergic to milk are allergic to the protein and therefore must avoid all milk. The symptoms may be anaphylaxis (note: difficulty breathing or swallowing), rashes and / or diarrhea. This should be diagnosed by a doctor.

Lactose intolerance can be diagnosed with a hydrogen breath test. The symptoms are usually diarrhea, bloating, gas and cramps. Patients can usually continue to drink or eat small amounts of dairy products, or use the lactose-reduced products.

Hope this helps your readers.


Thanks for your comments. I think the confusion may be over people's use of the term milk allergy. Sometimes it's a lactase deficiency and sometimes an allergic reaction to milk protein. The public unfortunately sees no difference, only feels symptoms and assume they are allergic to milk so they don't drink it.

Infants and children are more often allergic to the protein and adults more often develop a lactase deficiency. People with lactose intolerance may tolerate small amounts of milk, but dietitians never recommended milk to persons with an allergy to milk protein. I also recommend using Lactaid reduced milk for the lactase deficient individual, but not for persons with a milk protein allergy.

I have read of the research that lactase deficient persons should continue to use dairy products as their tolerance of lactose may improve. I also encourage individuals who don't drink milk because it causes symptoms to see their doctor for a diagnosis. Thanks for writing.



I am searching for a clarification on "butter oil". It is listed as an ingredient on my bag of chocolate chips and I have not been able to get an answer as to whether butter oil is lactose free. Do you know or can you point me in a direction for clarification. My son is on a lactose-free diet and he would like chocolate chip muffins (I have a good recipe for the muffins). Thanks.

Butter oil is the clarified butter fat portion from cream, milk or butter and contains 99.7% milk fat with not more than 0.05% nonfat milk solids (same as skim milk powder). Butter oil is the same as ghee used in Indian cooking.

These chocolate chips are not lactose free because milk sugar would be found in the nonfat milk solids same as in powdered milk that you can buy in the store. While butter oil is almost all butterfat, it still ncludes a trace amount of nonfat milk solids. It is not free enough of lactose to be allowed on your son's lactose-free diet. I would not suggest using these chocolate chps.

You could use small chopped or grated chunks of dark chocolate without butter oil in place of the chocolate chips in the muffins. Make sure to read the ingredient label of a dark chocolate bar, not milk chocolate, that it only contains chocolate and sugar.



I have thought of another substance that I am wondering about:stearoyl-2-lactylate sounds suspiciously like some kind of milk derivative. Would this be a problem for me?

Calcium stearoyl-2-lactylate is a food additive approved by the Food and Drug Administration (FDA) and is manufactured from two acids not milk. It is a calcium salt and used as a dough conditioner for breads and rolls or whipping agent in egg whites, vegetable oil toppings and dehydrated potatoes. This additive should be acceptable for your milk allergy.


I have an 8 year old son who is unable to eat dairy products, due to GI (gastro-intestinal) problems. He has been taking at his Dr.'s recommendation, TUMS daily for calcium replacement. Recently, we have found a soy-based drink that he enjoys. The box that the drink comes in states that 8 ounces of the drink contain 30% of the daily requirement of calcium. It doesn't specify if that's for adults or children. I presume it's for adults. My question is: if my son drinks 4 glasses of this beverage daily, will he be receiving a sufficient amount of calcium? Will we still need to augment with the TUMS? Thank you for your help.

Is your son allergic to or lactose intolerant of milk products?

If your son is not allergic to soy and or rice beverages, they would be appropriate for him especially if he enjoys the taste. However, it is recommended that he get 800 milligrams of calcium daily at his age. The label of the soymilk should provide you with information regarding the calcium content of the soymilk and yes is based on adult needs which is 1,000 milligrams. From the label you could determine how many glasses it would require to reach his calcium requirement. You might also check the label to make sure that the soymilk is fortified with vitamin A, D, riboflavin and vitamin B-12 that are normally found in fortified cow's milk. Foods other than milk that are high in calcium include calcium-fortified orange juice, broccoli, kale, tofu, calcium-fortified bread, breakfast cereals, breakfast bars and snacks.

I would suggest offering your son food sources of calcium along with the soy milk to meet the 800 milligram requirement daily rather than totally relying on Tums as a supplement. Tums might have adequate amounts of calcium if you take enough to meet your Recommended Dietary Allowances, but with Tums effects of lowering stomach acidity, Tums might affect other nutrients (iron) that depend on an acid stomach environment for absorption. Your son can get adequate amounts of calcium through the foods listed above.

The following is a list of descriptive terms used regarding calcium content of labeled foods:
  • High-calcium: 200 milligrams or more per serving
  • Good source of calcium: 100-190 milligrams per serving
  • More or added calcium: at least 100 milligrams more per serving than unenriched food.


We would like to know if there is an effect if a person does not drink milk and just drinks sugar water? If so, what is the effect?

Milk has lots of protein, carbohydrate, vitamins and minerals to help your bones and teeth get hard and stay strong (calcium, phosphorus and vitamim D), see at night (vitamin A), make blood cells (vitamin B12) and turn the rest of the food you eat into fuel (riboflavin). Sugar water has no protein, vitamins or minerals and only provides empty calories as simple carbohydrates.

One long-term effect would be that your bones would not be as strong. Your bones increase in density until you are about 25 years old and after that age you have to eat calcium rich foods to keep calcium in bone. By the way, it also takes exercise to keep your bones hard and strong.


May I know the % of fat content in whole milk as compared to 2%? Thanks.

Whole milk is 3.5% (approximately as it depends on the cow's feed) and 2% contains just 2% fat. There is approximately 1 1/2 teaspoon of butterfat in whole milk, 1 teaspoon of butterfat in 2% milk, 1/2 teaspoon of butterfat in 1% milk and no butterfat in skim or fat-free milk.


I was wondering if you knew anything about such milk substitute products as soymilk and rice drink (Rice Dream). Do you know of any other products available for lactose intolerant people?

Are they healthy and what other benefits do they provide? Thank you very much for your time.

Any soy and or rice beverage would be appropriate for lactose intolerant people though you should still read the food label for milk ingredients since manufacturers periodically change product formulas. Avoid any food containing milk, lactose, whey, curds, milk by products, dry milk solids or non-fat dry milk powder. There is a lot of new soy and flavored soy beverages, which I think, taste really good and there are lots of health benefits to consuming soy products.

Eight ounces of plain soymilk contains 90 calories, 6 grams protein and close to to 2% milk in fat content. It contains more than 10% of the Recommended Dietary Allowances for protein (includes all 8 essential amino acids), vitamin A, D, B12, riboflavin, folate, calcium, and magnesium. Eight ounces of cow's milk contains 8 grams protein, more than 10% vitamin A, vitamim D, riboflavin, vitamin B12, calcium, phosphorus, potassium and selenium. Plain rice milk is comparable in calories and fat to 1% milk, but is higher in sugar than cow's milk since rice is not as sweet. I compared cow's milk to a brand name rice milk which is enriched with vitamins to mimic cow's milk, but it lacks enough protein. So rice milk would not be an acceptable substitute to cow's milk especially for infants or children since milk is such a big contributor to protein in kids' meals.

I would suggest lactose intolerant people who do not drink soy or rice milk take a calcium supplement (1,000 milligrams per day) that includes around 1,000 International Units vitamin D and include foods high in vitamin A, vitamin D, riboflavin and vitamin B12 to compensate for these nutrients normally found in cow's milk.


I need information about horse milk. Is this type of milk suitable for people who have lactose intolerance? Is there a market for this type of product in USA or anywhere in the world. If you know about any producers in USA marketing horse milk I would appreciate if you could inform me.

I found a partial nutritional analysis of horse milk on the Food and Agriculture Organizatio of the United Nations which states horse milk has 6.14% lactose higher than cow's milk at 4.9%. So it would not be appropriate for people with a lactose intolerance. For another resource, I would suggest you contact your local large animal veterinarian or your state university school of veterinary medicine about the lactose content in horse milk.

Also, I am unaware if there is a market for horse milk in the US.




I have seen the doctor in regards to this, but there was no "real" advice given to help me help my son's daycare! That is my real main concern. Fortunately my son does take his Lactaid pills, but I would like to be able to give his daycare a complete list of foods that he can eat without having to take his pills!

First see the next question and answer.

However most foods people eat are packaged and prepared, not basic fresh foods listed in the next question. The average grocery store has over 38,000 brand name food products as of 2010 according to the Food Marketing Institute . A complete list would be impossible here and I do not know if a lactose database exists. Also food manufacturers change the formulas in their brand name foods and any list would soon become out of date. Lactose content is not required on the food label and food manufacturers are unlikely to analyze for nutrients not required by the Food & Drug Administration (FDA). Presently, you and your day care will have to read food package label ingredient listing for milk, lactose, whey, curds, milk by products, dry milk solids and non-fat milk powder. Foods that contain milk are required to be labeled as containing milk according to the 2004 FDA food allergen labeling regulations. So read food packages for "contains milk" tho do not rely on this food allergen statement alone without reading the ingredient listing.


I was wondering if I could get any type of information on lactose intolerance. I have a 2-year-old who cannot tolerate any type of lactose in his diet. If possible a listing of food that does NOT contain milk or milk solids would help.

Fresh fruit, vegetables, rice, meat, poultry, fish, some soy meat substitutes, broth soups without noodles, gelatin, vegetable oil and angel food cake should be OK, but read labels. Italian, French or Vienna bread are usually made without milk, but read the ingredient listing on the food package.

Lactose is the sugar in milk and dairy products which include milk (any kind including breast milk but not lactase reduced milk like Lactaid milk) cream, cheese, ice cream, ice milk, yogurt and sherbet. Butter and margarine contain trace amounts of lactose.

Milk solids may refer to non-fat dry milk and may contain lactose as well. Milk solids may only refer to the protein portion of milk. Sodium caseinate is probably OK. If in doubt, call the manufacturer whose phone number is on the food label and ask if their product contains lactose and how much.

Has your 2-year-old seen a doctor for this problem? A registered dietitian could help you with planning a diet for your child that will accommodate the lactose intolerance and calorie / nutrient needs for normal growth and development. Call your local medical clinic or hospital and ask to talk to a registered dietitian.




I have been diagnosed as allergic to milk and am trying to eat a milk-free diet. It is extremely difficult to find totally dairy-free products. Do you have any suggestions as to what to do?

Adult milk intolerance is usually caused by lactose the sugar in milk. Whereas, infant milk allergy is triggered by casein, the protein in milk. Do you know if you are lactose intolerant or allergic to milk protein? Have you had a milk allergy since you were an infant? If you are not sure, go see your doctor to find out because your food choice options depend on wether you have lactose intolerance or milk allergy.

If you are allergic to milk protein, then do not eat any milk or milk products or foods containing milk ingredients. Be an avid food label reader and look for milk ingredients like milk, milk solids, whey, curds, casein, cheese, cream, milk by products, dry milk solids and non-fat milk powder. If you don't cook, I would suggest learning how to cook so that you know what is in the foods you eat. When ordering food in a restaurant, ask if any foods you want to order contains milk, cheese (any kind), cream, yogurt, ice cream or sherbet. Many sauces contain milk or cheese so I would suggest avoiding foods with sauce unless tomato sauce not made with milk or cheese. Italian, French or Vienna bread typically are not made with milk. To be sure, read food labels.

If your are lactose intolerant, you should tolerate Lactaid. It is lactase enzyme that you add to a milk carton to digest the lactose before drinking. After 48 hours, most of the lactose (90%) is digested to simpler carbohydrates, galactose and glucose, which should not cause lactose intolerance symptoms. Sweet acidophilus milk contains lactose and is not generally recommended for lactose allergies.

Most persons with lactose intolerance can usually tolerate amounts between no milk up to a maximum of 2 cups per day. Tolerance to milk can be improved by drinking milk with meals, milk with higher fat content or chocolate milk instead. New research suggests that lactase deficient people can improve their tolerance to milk products by consuming small amounts periodically during the day.

Salt-free butter usually contains less milk solids than salted butter. Read the food label of butter and margarine to find milk free spread. Aged cheeses (cheddar and Swiss or dry curd cottage cheese) are usually low enough in lactose to be tolerated in small quantities. Yogurt with active cultures contains lactase enzyme and helps digest lactose. Tofu frozen desserts can be substituted for milk based ice creams.


Ever since I was a child, I have not liked milk. Recently, I have tried to drink milk, but get stomach cramps and diarrhea from it. Do you think I am allergic to milk?

First of all, whenever your health status changes and you don't feel the same, you should see your doctor. He/she is the only one who can accurately diagnose what your symptoms mean. You are not tolerating milk and in the meantime should not drink milk or eat milk products. Other dairy products such as soft cheeses, cottage cheese, ice cream, sherbet, pudding, yogurt, evaporated milk, buttermilk, sour cream, half and half and whipping cream contain lactose and milk protein. They should be eliminated until you see your doctor.

Since you haven't like milk since you were a child, it is possible you are allergic to milk protein and should be taking calcium with vitamin D supplements. Then you shouldn't consume any milk or milk products. If on the other hand, you are lactose intolerant, you may tolerate small amounts of milk. If it is just a taste thing and you don't like the taste of milk, then you should talk to your doctor about calcium and vitamin D supplements. Have you tried enriched soy milk?

If your doctor determines that you are lactose intolerant, he/she may recommend you add lactase to your milk. Ask your pharmacist for Lactaid, which is lactase, the enzyme your body produces in the intestines to break down the lactose (sugar in milk) to a simpler sugar. To use Lactaid, add 15 drops to a quart of milk. Shake or stir a few moments to mix. Label, date and store the milk container in the refrigerator for 24 hours. During this waiting period, 99% of the lactose in the milk will be reduced to glucose and galactose (two simpler sugars). Lactaid cannot be added to buttermilk as it is too acid.

Your individual tolerance for this lactose-reduced milk will vary. Most people with lactose intolerance can drink one-half to two cups of lactose reduced milk daily. You will notice that lactose reduced milk is somewhat sweeter than regular milk because glucose has a greater sweetening power than the lactose naturally found in milk.


Skim milk has more salt than whole or 2% milk. My doctor told me to follow a low salt diet. I like skim milk and need to lose some weight. Should I cut out milk completely?

Skim milk contains 7 milligrams more sodium than whole or 2% milk which is not a significant difference. What is more important for you is getting an adequate intake of calcium, riboflavin, vitamin A and vitamin D.

Since you are overweight, skim milk is better for you to drink. Skim milk is actually whole milk (3.5%) with the butterfat removed. This amounts to approximately one and one-half teaspoons of butter or 90 calories. Otherwise, skim milk has approximately the same composition of other nutrients. Adults should drink two cups of milk per day unless they are allergic to milk or have lactose intolerance.

To help wean yourself off a higher fat milk, try drinking 2% milk for one week, then drink 1% milk for one or two weeks and finally start drinking skim milk the remainder of the time. Over time you will become used to the taste of skim milk and higher fat milk will taste like cream to you.


When my baby was six months old, he became allergic to milk. His doctor switched him to soymilk. He hasn't had any milk since then. Will he ever grow out of the milk allergy?

You did not say how old your baby is now. If he is allergic to milk, he should not eat any milk, cheese, pudding or ice cream. Perhaps you can find soy ice cream and soy cheese in the grocery store.

Usually, infants are allergic to the protein casein in milk. I cannot predict whether your baby will or will not ever tolerate milk products. Have you asked your baby's doctor? Perhaps he can re-test your son in a medical environment where he can treat any sudden breathing or swallowing problems your son may have in reaction to a milk test. You should not test your son at home to even small quantities of milk products as it may cause breathing or swallowing problems.

In the meantime, though, keep your baby on soy formula until 12 months of age or soymilk after 12 months of age. There are several infant formulas, such as Isomil, Prosobee, Pregestimil or Nutramigen that you could substitute for fluid milk. Otherwise, discuss a calcium supplement with your baby's doctor. Milk is the most important food in the diet of an infant or child. It is a major source of complete protein, calcium, phosphorus, riboflavin, vitamin A and vitamin D, water and calories.

Symptoms of milk allergy are abdominal cramping, vomiting or watery diarrhea that occur within a few minutes to a few hours after eating a milk product. Milk protein allergy can cause hives (red bumps on the skin) or itchy skin rash in or around the mouth, coughing, runny nose, watery eyes, wheezing or interferring with breathing or swelling in the throat preventing normal swallowing. It can also cause colic in babies.


I breast-fed my daughter until she was six months old. Then I switched her to 2% milk. She had bad cramps and diarrhea. Her doctor did lots of tests on her after she was taken off milk. He also gave her a calcium supplement. She was four years old last summer and can now drink some milk (about a half cup per day). I quit giving her the calcium supplement when she started to drink milk. Should I still be giving her the liquid calcium?

Since your daughter is drinking some milk, it is safe to say that she probably is lactose intolerant rather than allergic to milk protein.

The Recommended Dietary Allowance (RDA) of calcium for children age one to 10 is 800 milligrams per day. This amount of calcium equals two and one-half cups of fluid milk, milk pudding or custard, four ounces of hard cheese, four and one-third cups of ice cream or five cups of cottage cheese.

Your body also needs vitamin D in order to absorb calcium and deposit calcium in bones and teeth. Fluid fortified milk is the best source of vitamin D and calcium.

Call your daughter's doctor about continuing the calcium supplement. Unless she drinks more milk, she needs to continue the calcium-vitamin D supplement. Her doctor can suggest an appropriate calcium supplement.

By the way, current recommendations are to breast feed or to formula feed infants until they are 12 months of age. The protein in cow's milk, casein, is difficult for infants to digest and forms large curds in their stomachs. Also, babies fed cow's milk before one year of age are more likely to develop a milk protein allergy, especially if either parent has a milk protein allergy.


I like 2% milk and my doctor told me to switch to skim milk because I'm on a low cholesterol diet, I don't like skim milk. It looks blue and watered down. Isn't 2% milk OK to drink? I have only one glass a day.

You should follow your doctor's advice and switch to skim milk for your low cholesterol nutrition therapy.

If you were to compare eight ounces of 2% milk to eight ounces of skim milk, the 2% milk has one teaspoon of butterfat homogenized in it and an extra 45 calories. One- percent milk has one-half teaspoon of butter and 20 calories more than skim. While this might not sound like much, multiply one teaspoon of butterfat times 24 days. That would equal one stick of butter every 24 days. Your blood cholesterol may not come down to recommended levels by continuing to drink 2% milk.

Two- percent milk has 18.3 milligrams of cholesterol per one cup. If you drank two cups of two- percent milk per day for one week (256 milligrams of cholesterol), you should still limit egg yolks to four per week including eggs used in recipes.

Skim milk is not watered down whole milk. Skim milk has 99 percent of the butterfat removed. Nutritionally, the only difference between these milks, is the fat content. The blue color you see is from the riboflavin content in skim milk which is not camouflaged by the yellow cream that has been removed from 2% milk.

If your doctor has advised you to follow a low cholesterol nutrition therapy only skim or cultured buttermilk is allowed. To reduce the cholesterol in your blood, you first have to reduce the amount of cholesterol and saturated fat you eat, including 2% milk.

In order to consume your RDA (Recommended Dietary Allowance) for calcium, phosphorus and vitamin D, drink three cups of milk per day or the equivalent in cheese (three 1" cubes).






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