Q: Michelle (via the Go Dairy Free Facebook Page) -  My friend has a boy going into Kindergarten and told the school to not give him milk. Well, before they do that they want a doctor’s note!?! Is that legal? She is the mother and should be able to decide. Does the school have a right to demand this? And on top, just give the child the milk until the meantime which will cause him to totally get sick!!!

A: Alisa – Michelle, you aren’t the first person to contact Go Dairy Free on this issue. A couple of years ago a milk allergy mom out of Iowa sent the same inquiry. After I posted about the concern here on Go Dairy Free, I received a flood of emails from individuals and moms who had the same problem with school lunches.

Not all school districts and schools enforce this issue, but many do require a doctor’s note for a child to turn down the milk provided in the school lunch. Ridiculous and unjust? Yes. An extra burden and often the expense of a doctor’s visit each year? Unfortunately, yes.

Your friend’s basic options include the following:

• Get a doctor’s note excusing their child from taking milk at lunch, preferably before the school year starts. Most schools require a new note every year.
• Teach the child that they must dispose of the milk rather than consume it. Yes, wasteful as it may seem, your child has the right to throw away that milk, but they have to take it.
• If it is an option, send the child with lunch and don’t have them partake in the school lunch program.

Some more progressive lunch programs are beginning to offer options like soymilk and calcium-fortified orange juice as an alternative to milk. However, some of these still require a doctor’s note for the child to make the swap.

Here are two sample emails I received from viewers who responded on this topic:

“It's been about 4 years since I graduated high school, but even then I had trouble with the lunch program in the Florida public school system. When I was about 12 years old I discovered that I was lactose intolerant. I couldn't have the milk at lunch anymore at school. I was able to refuse it, but I wasn't able to get a second orange juice to replace the milk. So, I would often accept the milk and exchange it with a friend who liked the milk in return for their orange juice. I was told that if I wanted to have 2 juices I would have to get a doctor's note. This problem persisted all the way until graduation. I also couldn't get a real vegetarian meal through the school. I was offered a salad with no meat on it, but I couldn't have their only dressing offering (Buttermilk Ranch).  Schools need to realize that students don't want milk or can't have milk and need another option. The states need to realize this when budgeting for the school year and so does the federal government. Food allergies are becoming more prevalent and everyone deserves to eat.” ~ Amanda

“Yes, my son's preschool refused to allow him to drink soy without a letter from the doctor.  It made me very angry not to have authority over such choices for my son at school.  Turns out they were afraid they would lose their funding if they didn't force kids to drink milk at school and an inspector saw them.  I took the easy way out and got a letter from my doctor who, fortunately, believed that I had the right to make that choice for my son. He even signed it by phone/fax, so I didn't have to pay for an office visit.  If your regular pediatrician won't, then find an N.D or O.D. who will.  Don't give up!” ~ Jennifer

To help explain the policy, we received this email from a viewer:

"You might inform your readers about the USDA's requirements.  If that school, or any for that matter, is requiring a Medical Statement with doctors authorization the school is following the Federal Regulations of the USDA which governs the National School Lunch Program.  They also have a specific Milk Substitution guide.  Schools are required to make a substitute and cannot force a child with a life-threatening food allergy to take food on his/her tray that they are allergic to.  It is considered a disability under Section 504 and that is why the Medical Statement with the doctors signature is required.  Specifically for Section 504 for those schools who receive federal funding, including lunch reimbursements from the USDA.  The disability designation under Section 504 also affords children with disabilities other Civil Rights protections in the school, not just in the cafeteria.  Most parents are not even aware of the law."

For more information, see the USDA's document on Accommodating Children with Special Dietary Needs and the Policy on Milk Substitutions.

This is great clarification for those parents dealing with a food allergy (note still required!), but unfortunately does not help those who are dealing with kids who are lactose intolerant or who choose to raise their children without dairy or milk specifically. It seems those parents will still need an understanding physician willing to write a note. 

Thankfully, programs like this one are beginning to surface. The concept of healthier and special diet lunch options is still in its infancy, but the pressure is rising from moms and students who speak up!

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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