Why is it used?
Milk free diets may fall into two groups. Firstly, where there is an 'intolerance'
or an allergy to milk itself, and secondly, to lactose, which is the carbohydrate
or 'milk sugar' found in milk. This is known as lactose intolerance. The treatment
for both these conditions is different.
Who would require the diet?
With milk allergy, the symptoms of an 'intolerance' or allergy occur following
milk consumption, either immediately or after some time, and can be clearly
attributed to milk and its products.
In lactose intolerance, the symptoms are usually abdominal pain, bloating and
diarrhoea, which can be attributed to recent antibiotic usage, food poisoning
or in some groups of people, reduced activity of the enzyme lactase, which normally
digests the lactose sugar. It is only the foods that contain lactose that need
to be removed. A low lactose diet may help irritable bowel syndrome.
What is the diet and how does it work?
For some people, there may be a dose response. This means that small amounts
may not trigger any response, but much larger amounts cause problems. This can
only be determined through personal experience.
If the intolerance or allergy is to milk, then all milk and milk products should
be removed from the diet. Some people, however, seem to manage and be quite
happy with only a small amount of milk in their diet.
If lactose intolerance appears to be the problem, there are two possible answers.
Firstly, if there is a link to food poisoning or antibiotic usage, it is worth
trying one of the yogurts or mild drinks with added bacteria. There is some
research that suggests some people benefit from this. The bacteria re-colonise
the gut allowing the lactase enzyme to recover and become effective again.
Alternatively removing milk may solve the problem. Cheese does not contain
lactose and can be eaten. With yoghurts, lactose is already broken down, avoiding
the need for the enzyme lactase, so they also can be eaten. Some people find
that milk in teas and coffees can be used, as the amount is relatively small.
Will the diet harm me?
Excluding milk and milk products from the diet is difficult, as they are so
universally used for drinks, cooking, and in manufactured foods. It is especially
difficult for children, as they enjoy eating foods just like other children,
although milk intolerance in children tends to be short lived and many appear
to 'grow out' of it by the age of 5 years.
Milk is a major contributor of calcium and other useful nutrients and care
should be taken to ensure that there is adequate calcium in the diet for the
maintenance of bones (there is a continuous state of calcium loss and replacement
in all bones).
What else do I need to know?
It is very difficult to diagnose intolerances and allergies to common foods.
The most reliable method is an elimination diet or exclusion diet. This is where
all potential foods that may cause an allergy are removed from the diet (see
food intolerance and allergy). A basic diet of a few foods only are eaten and
the original foods are gradually reintroduced one at a time with a few days
between each food introduction, and if any symptoms of intolerance or allergy
observed, then it is likely that the offending food is the culprit. To test
the food allergy, remove the food and see if the symptoms disappear.
The milk protein found in other milks such as goats is very similar to that
of cows and there is unlikely to be any real benefit in substitution.
Where else can I get help?
If the diet is prescribed by the doctor for a medical condition then help should
sought from a State Registered Dietitian who can help assess if the diet is