Part 2: What’s the difference between a dairy allergy and lactose intolerance?

Editor’s Note: May is Allergy Awareness Month, and since dairy and eggs are common allergens, we’re sharing some helpful tips for navigating your child’s food allergy in a way that builds confidence and fosters a positive attitude toward food.

Dairy allergies and lactose intolerance are frequently confused and misrepresented, so in this second installment of our four-part series, Sloane Miller, a specialist in food allergy management and author of Allergic Girl: Living Well With Food Allergies, is here to bust some myths.

I often opt for organic dairy (as well as organic eggs, beef, and poultry) whenever possible—not anything to do with food allergies or food sensitivities, but as personal preference. I like supporting small farmers, I love knowing that animals are well treated and well fed, and that what they are producing is organic.

The Organic Valley products that I have in my fridge at any given time are lactose-free milk, as well as slicing cheese, butter, cheese snack sticks, shredded cheese, yogurt, cottage cheese, and cream cheese. (No joke, I love my organic dairy.)

I’m lactose-intolerant, yet I can eat all of those yummy dairy products with ease because all of them* are naturally free of or have very low quantities of lactose, the sugar found in milk that my body can no longer process. Culturing and fermenting cheese and other dairy products breaks down lactose into other compounds, allowing my stomach to digest it with fewer or no issues. Here’s more from The Spruce Eats about how cheese can be naturally lactose-free.

However, an allergy is an entirely different diagnosis. If I were allergic to dairy, even the tiniest speck of dairy could trigger my body to launch a full-scale immune response like anaphylaxis and require emergency medications and a trip to the hospital.

If you are asking yourself, “Wait, huh? I thought being lactose-intolerant meant you get hives when you eat cheese?” Or, “I thought that when milk gives you gas, you’re definitely allergic so I’ve been avoiding it. I’m so confused!”

Your confusion is totally understandable—it can be confusing.

Let’s break this down in the simplest way:

• A food sensitivity involves your gastrointestinal (GI) system; a food allergy involves your immune system.
• When your body is intolerant or sensitive to a food, your body can’t break down the food and your GI system gets cranky. When you have an allergic reaction to a food, your body thinks the protein in the food is an invader and attacks it.
• Symptoms of a food sensitivity are not life threatening, only involve the digestive system, and can become bothersome when eating a large quantity of a food. Symptoms of a food allergy involve the immune system, can be life threatening, and can be triggered by a miniscule or even a trace amount of a food.

So what does this look like?

I’ll use myself as an example as I had dairy allergies as a child and I’m currently dairy sensitive.

As an infant, when my mother switched me from breast milk to cow’s milk, I immediately developed a rash on my cheeks. My pediatrician recognized this as a dairy allergy, diagnosed me as an “allergic girl,” and we switched to soy formula, which was fine.

Luckily, I outgrew that dairy allergy (fairly typical but not always the case for children with food allergies), and I happily consumed milk and dairy products for years without any allergy issues. (Ice cream for breakfast! No? Only me?)

That is, until my mid-30s, when dairy started to give me gas, bloating, and other GI symptoms that are way too TMI for this blog.

Under the advice of my board-certified health care provider, I did an elimination diet, removing cow’s dairy from my diet, and then slowly adding it back in to see what happened. It was very clear that dairy was giving me GI distress, so I cut way back.

These days, I can have a little full-fat dairy like whipped cream, but it’s three bites before I’m a burpy lady. However, I can have all the naturally lactose-free cheese and full-fat yogurt I want, as well as some other dairy products and lactose-free milk, of course.

Now, if I were still dairy allergic, even the tiniest bit of cow’s dairy (whether raw, liquid, solid, or baked) could cause an immune system reaction, so I would need to avoid it at all costs; no cheating ever.

If you believe you or your child have symptoms of an allergy or a food sensitivity, check with your board-certified health care provider about what’s best for you.

In the meantime, clarity around what you can and cannot eat and understanding why is vital to making the best nutritional choices for your family.

Recommended Resources:

• Food Allergy Research and Education (FARE)
• Asthma and Allergy Foundation of America/Kids With Food Allergies (AAFA/KFA)
• American Academy of Asthma, Allergy, and Immunology (AAAAI)

Organic Valley Lactose-Free Products

The following Organic Valley products are verified to be free of lactose:

• Lactose-free milk: all fat levels
• 1% Chocolate Milk
• Ghee

Organic Valley’s lactose-free fluid dairy products use the lactase enzyme to convert lactose into simple sugars that are more easily digestible for those with lactose intolerance. These products are tested to verify they are lactose-free.

For ghee, the way it’s produced makes it lactose-free. Ghee is a type of clarified butter that is heated to cook the milk solids, which include lactose. The solids are then filtered out, leaving behind pure butterfat that has a delicious nutty flavor, a high smoke point, and can be used just like butter in baking. Learn more about the benefits of ghee.

*Although the other dairy products mentioned in this article are cultured, which has been shown to predigest lactose, they may still contain low or trace amounts of lactose. Organic Valley does not test those products for lactose levels or state on the packages that they are lactose-free. If you are lactose intolerant and are interested in exploring potential dairy options, we urge readers to consult a health care provider or allergist first and listen to their bodies when trying new foods.

Read more in our 4-part series on Navigating Your Child’s Food Allergy:

• Part 1: So you’ve learned your child has food allergies. Now what?
• Part 3: How do I talk to my child about their food allergy?
• Part 4: How to teach a child about their food allergy? Get them in the kitchen!