Is it a milk allergy or lactose intolerance?

Question

My 10-year-old son seems to be lactose intolerant or allergic to milk, but he’s OK eating some dairy products such as cheese. Should I just have him avoid all dairy products to be safe?

Answer

First, a clarification: lactose intolerance and a milk allergy are not the same thing. Lactose intolerance is due to a shortage of the enzyme, lactase, which is necessary to digest or breakdown the milk sugar, lactose. Lactase is found in the small intestine and can end up being in short supply for a number of reasons. First, there can be a genetic tendency towards low lactase levels. A more common occurrence, though, is following a bout of diarrhea caused by a stomach flu or food-borne illness. Decreased lactase results in gas, bloating and/or diarrhea.

But take heart. In younger people (as opposed to the elderly), the production of the lactase enzyme can return to normal levels in time.

A milk allergy, on the other hand, involves an immune system reaction to the protein in milk. Milk allergies are more common in younger children, and usually occur when dairy products are first introduced. Steering clear of dairy products for a few years can usually allow the allergic child to outgrow the problem. Check with your child’s doctor before restricting any foods and to get a clearer picture.

Those with a lactose intolerance need not avoid dairy products. Instead of regular milk, choose lactose-free milk in which the lactose has already been broken down. This is a great alternative because you can still reap the nutritional perks of milk without the side effects for the lactose intolerant. Other lactose-reduced products and natural cheeses are also good choices. In my experience as a dietitian, it’s advisable to avoid lactose-loaded foods and beverages until the symptoms have disappeared completely. This helps regain lactase activity.

While some people choose to avoid dairy products for one reason or another, keep in mind that they offer an assortment of health benefits for all ages. For example, besides being chock full of various nutrients, yogurt and/or kefir is the perfect delivery system for beneficial bacteria or probiotics. Cheese is a terrific protein-packed option which can help naturally curb appetites. While non-dairy milk substitutes may contain calcium, not all measure up nutritionally, so be sure to read labels.

Rosie Schwartz is a Toronto-based consulting dietitian in private practice and author of The Enlightened Eater’s Whole Foods Guide (Viking Canada). Visit rosieschwartz.com for more.

Originally published in ParentsCanada magazine, November/December 2015.