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Milk Allergy & Lactose Intolerance
Where can I find a dietitian who works with people who don't tolerate milk so that I get enough calcium?
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?
Also, people can be allergic to milk or lactose intolerant to milk sugar. 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 figures they are allergic to milk 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.
These chocolate chips are not lactose free because milk sugar would be found in the nonfat milk solids same as in skim milk powder. While butter oil is almost all milk 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 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 oz. 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.
If your son is also 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 mg 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. 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 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 mg requirement daily rather than totally relying onTums as a supplement. Tums might have adequate amounts of calcium if you take enough to meet your Recommended Dietary Allowances, but with its effects of lowering 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:
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 Vitamin D), see at night (vitamin A), make blood cells (Vitamin B 12) 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 dense. 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.
I was wondering if you knew anything about such milk substitute products as soymilk and rice drink (Rice Dream produced by Imagine Foods in California). 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 read the food label for milk ingredients. Avoid any foods containing milk, milk solids or whey. 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 soymilk contains 80 calories, 8 grams protein, 5 grams carbohydrate and 4 grams of fat. It contains more than 10% of the Recommended Dietary Allowances for protein (includes all 8 essential amino acids), thiamin, vitamin B6 , folacin, phosphorus, magnesium and iron. Eight ounces of cow's milk contains more than 10% protein, vitamin A, riboflavin, Vitamin B12, calcium, phosphorus and magnesium. I do not have the nutritional analysis of Rice Dream so I used a rice beverage called Horchata. One cup of this rice beverage contained 98 calories with less than 1 gram of protein and fat with 31 grams of carbohydrate. It was lacking in most vitamins and minerals, which would make it a poor substitute for milk. I found this information in nutritional analysis software food database.
I would suggest lactose intolerant people take a calcium supplement (1,000 mg per day) and include foods high in vitamin A, 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 cannot find any nutritional analysis of horse milk nor do I know the lactose content. I would guess that horse milk has lactose similar to humans, cows and goats for which I do have nutritional analysis.
Also, I am unaware if there is a market for horse milk in the US. I would suggest you contact the American Horse Breeders Association.
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.
Next, most foods people eat are packaged and prepared, not basic fresh foods listed in the next question. The average grocery store has over 15,000 brand name food products. A complete list would be unmanageable here and I do not know if one exists. Lactose content is not required on the new food label and food manufacturers are unlikely to analyze for nutrients not required by the FDA. Presently, you and your day care will have to read label ingredient declarations for milk, lactose, milk solids and sodium caseinate.
Some resources you could check are "The milk sugar dilemma: living with lactose intolerance" by S Martens and RA Martens, Medi-ed Press, PO Box 957, East Lansing Michigan 48823, 1987. Also contact the National Digestive Diseases Information Clearinghouse, Box NDDIC, Bethesda Maryland 20892 for their "Lactose Intolerance Information Packet", 1991.
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 are all OK. Italian, French or Vienna bread may be made without milk.
Lactose is the sugar in milk and dairy products which include milk (any kind including breast milk but not lactose reduced 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 allergies are usually caused by lactose, the sugar in milk. Whereas, infant milk allergies are usually to casein, the protein in milk, but also can be to lactose. Do you know if you are lactase deficient or allergic to milk protein? If not, go see your doctor to find out because your food choice options depend on which you have.
If you are allergic to milk protein, then do not eat any milk or milk products or foods containing milk ingredients.
If your are lactose intolerant, you should tolerate Lactaid. It is lactase enzyme that you add to milk in a 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 an lactase deficiency 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, using milk with higher fat content or drinking chocolate milk instead. New research in fact suggests that lactase deficient people can actually improve their tolerance to milk products by consuming small amounts periodically during a 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, 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.
There are several infant formulas, such as Isomil, Prosobee, Pregestimil or Nutramigen that you could substitute for fluid milk. Adult formulas such as Ensure, Sustacal and Resource can be substituted for fluid milk. Non-dairy coffee creamers are available in liquid and dry form and can be substituted for fluid milk.
Many foods are made with milk or milk products. Look for whey or milk solids in the ingredient list on a food label. Italian, French or Vienna bread typically does not have added milk. To be sure, read food labels.
Read Martens Skinner "The milk sugar dilemma: living with lactose intolerance" by Medi-ed Press, 1987 for additional information.
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, ice milk, 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 and 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.
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 8 to 10 drops to a half-gallon 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, 70 percent of the lactose in the milk will be reduced to glucose and galactose (two simpler sugars).
For 100 percent lactose reduction, you will have to leave the milk in the refrigerator 48 hours or add twice as many drops of Lactaid for 24 hours. For one half gallon of milk, add 16 to 20 drops of Lactaid for 100 percent lactose reduction. Lactaid cannot be used in 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 two percent milk which is not a significant difference. What is more important for you is getting an adequate intake of calcium, riboflavin, vitamin A and 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.
To help wean yourself off a higher fat milk, try drinking two percent milk for one week, then drink one percent 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, but has he had cheese or other milk products like ice cream since he became allergic to milk? Aged cheeses like Swiss, American or cheddar, Farmer's cheese or cottage cheese are low in lactose (milk sugar) and may be tolerated, but contain milk protein, which would cause allergy symptoms. Ice cream contains lactose and milk protein so would not be tolerated at all. So does your son tolerate any milk products or do all cause the same symptoms?
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?
In the meantime, though, keep your baby on soy formula or soymilk. 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 D, water and calories.
Symptoms of lactose intolerance are abdominal cramping and watery diarrhea that occur within 30 minutes to a few hours after eating a milk product. Milk protein allergy can cause the same or more severe symptoms.
I breast-fed my daughter until she was six months old. Then I switched her to two- percent 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 similar milk protein allergy.
I like two percent 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 two- percent 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 diet.
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. Besides that is an extra 45 calories per glass. Whole milk has 3.5% butterfat or the equivalent of one and one-half teaspoons of butter and 60 calories more. 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 because of using two- percent 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.
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 diet 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 two- percent milk.
The recommended dietary guidelines suggest two cups of milk per day to fulfill your calcium, phosphorus and vitamin D requirements.
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