Q: Anonymous – Can I drink lactose-free milk if I have a dairy allergy? I have been lactose intolerant for quite a while, but I am considering cutting out all dairy because I am not sure if my body handles any dairy products well.

A: Alisa – Without knowing your true condition, this is a difficult question to respond to, so I will answer with some information on who lactose-free milk is appropriate for, what it is, and what to look for when purchasing.

First, it is important to identify if you are allergic (or sensitive) to milk proteins or intolerant to the lactose in milk. Allergies are immune reactions to proteins, such as casein and whey in milk, while intolerance is the inability to properly digest certain sugars, otherwise known as lactose in milk. The words “allergy,” “sensitivity,” and “intolerance” are often used interchangeably, but in reality, they are very different and shouldn’t be lumped together quite so conveniently ...

For those who are simply lactose intolerant, lactose-free milk can be a good option (see below for a further discussion on lactose-free milk). However, if you have an allergy or sensitivity to milk proteins, you will need to seek out dairy-free milk alternatives exclusively. Lactose-free milk in your local grocer’s dairy section is still cow’s milk and will be rich in milk proteins. Lactose-free milk is never a good option for those with milk allergies or a sensitivity to milk protein.

What is lactose-free milk? The only material difference between regular cow’s milk and lactose-free milk is that it has undergone a process where lactase is added (lactase is what digests lactose in our systems) to “pre-digest” and eliminate the lactose from the milk. There really is no difference except in the sugars, no lactose. The rest of the composition remains the same.

If you do opt to seek out lactose-free milk, it is important to keep a few things in mind. Some dairy products, including milk, are simply lactose-reduced. This may work for many with lactose “maldigestion,” but those with full blown intolerance may be sensitive to even small quantities of lactose. If concerned, look for the lactose-free label specifically. Also, always look for organic lactose-free milk. Most brands are still at risk for added hormones, but there are a few brands of organic lactose-free milk popping up on store shelves. Finally, I still get frequent reports from people who are very lactose intolerant, and claim that lactose-free milk still causes problems for them. I am not sure if these individuals may have an underlying sensitivity to milk protein, but wanted to note this since I do see this comment frequently.

Of course, with all of the advances in dairy-free milk alternatives, many people with lactose intolerance are actually choosing them over lactose-free milk. There are more types, flavors and consistencies to select from, which can add depth to baked goods or even heighten that ordinary bowl of breakfast cereal. For dozens of milk alternative brand options to choose from (including vegan, gluten-free, and soy-free choices), see the No Dairy Product Lists.

Again, lactose-free milk is not appropriate for infants, children, or adults who are allergic or sensitive to the proteins in milk. It also isn’t suitable for most people who forsake dairy for general health and disease prevention, religious, and/or political reasons. It is still a heavily dairy-based product.

For more dairy-free Q&A topics, see our Ask Alisa Page.

Alisa Fleming is the founder of GoDairyFree.org and author of Go Dairy Free: The Guide and Cookbook for Milk Allergies, Lactose Intolerance, and Casein-Free Living. In addition to her own dairy-free lifestyle, Alisa has experience in catering to the needs of various special diets, including gluten-free, soy-free, egg-free, vegan, and multiple food allergies.

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