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.
Understand the difference between lactose intolerance and dairy protein allergy. Knowing which problem you have will help you know how strict to be with your dairy-free diet.
Learn the scientific terms for milk or dairy products and read food labels to verify that they are dairy-free before you consume them.
Best bets: Milk substitutes like soya milk, rice milk, nut milks, and milk-free products like soya cheese and rice ice cream
Why do people follow this diet?
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 yoghurt without suffering, despite the high amount of lactose found in yoghurt. The ability of many lactose-intolerant people to consume yoghurt without getting ill used to baffle scientists. Now we know that the bacteria in most yoghurt products (except frozen yoghurt) consume most of the lactose as soon as the yoghurt 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 babies and young children. Cow’s milk proteins are potent allergens and around 2.5% of babies 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.
What are the symptoms?
The symptoms of lactose intolerance occur within a few hours of ingestion of milk or milk products and include bloating, abdominal pain, wind, and diarrhoea. 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, gastro-intestinal 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.
What do I need to avoid?
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.
- Home baking such as pancakes, biscuits, muffins, cakes, biscuits, baking mixes (read labels for dairy product ingredients)
- Au gratin foods
- Butter
- Buttermilk
- Calcium caseinate
- Candy (especially creams and chocolate)
- Casein
- Cheese
- Cheese sauces
- Chocolate milk and drinks
- Coffeemate
- Cold cuts (such as bologna)
- Cottage cheese
- Cream
- Creamed or scalloped foods
- Curds
- Dry cereals containing milk powder, such as some granolas
- Dried milk powder
- Dried milk solids
- Evaporated milk
- Fondues
- Grated cheese
- Gravies (some)
- Ice cream
- Malted milk
- Margarine (most)
- Meat loaf and burgers (some)
- Milk: whole, skim, 1%, and 2%
- Milk shakes
- Milk sherbets
- Non-dairy creamers (most)
- Non-kosher luncheon meats (some)
- Ovaltine
- Puddings (most)
- Sausage (some)
- Sodium caseinate
- Wieners (some)
- Whey
- White sauces
- Yoghurt
Best bets
Milk substitutes:
- Soya milk
- Rice milk
- Almond milk
- Other grain drinks and dairy substitutes
Non-dairy products:
- Margarine
- Non-dairy ice cream
- Non-dairy chocolate
- Non-dairy cheese
- Non-dairy yoghurt
- Other milk-free or non-dairy products
Are there any groups or books?
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
Bibliography
Ahmed T, Fuchs GJ. Gastro-intestinal 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

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The information presented in the Food Guide is for informational purposes only and was created by a team of US–registered dietitians and food experts. Consult your doctor, practitioner, and/or chemist for any health problem and before using any supplements, making dietary changes, or before making any changes in prescribed medications. Information expires September 2008.
2007-09-01