Lactose-Free Diet

Lactose is the sugar that is found naturally in milk and milk products, as well as foods with ingredients such as milk or whey. In order for the body to use lactose, it has to break it down using an enzyme called lactase. Lactose intolerance is a condition that occurs when a person does not produce enough lactase to break down the lactose in food.

Symptoms of lactose intolerance include:

• Abdominal cramping
• Bloating
• Gas
• Diarrhea

These symptoms may occur shortly after eating foods that contain lactose, but sometimes will not occur until hours later. This is because people vary in the amount of lactose they can tolerate.

When milk products are eliminated from the diet because of lactose intolerance, an important source of calcium and other vitamins and minerals is eliminated. Because of this, your child will need to get calcium from other sources, or may need to take a calcium supplement. Be sure to consult with your child's doctor or dietitian before giving any supplements. The amount of calcium a child needs will depend on their size and age.

Avoiding Lactose

There are many different words that are used to describe the different forms that lactose may come in. Read food labels, and stay away from foods with any of the following ingredients:

• Milk
• Skim milk powder
• Skim milk solids
• Lactose
• Whey
• Caseinate
• Curd

The following ingredients are okay to use:

• Lactase
• Lactalbumin
• Lactylate
• Calcium compounds

Reading food/nutrition labels is a very important habit to get into when looking for foods that do not contain lactose. Lactose can come in many "hidden" forms, and even products that do not appear to have milk included, may in fact have a milk product as an ingredient.

Lactose-Free Foods

Following are lists of lactose-free foods, and foods to avoid:

Food Group	Enjoy	Avoid
Beverages	Teas, regular iced tea, regular carbonated beverages, soy milk, cocoa powder, Nestle's Quik	Milk (all types), powdered milk, sweetened/condensed milk, instant hot cocoa, instant iced tea, Ovaltine, chocolate drink mixes, cream, half-n-half and diet soda
Breads/Cereals/Crackers	Vienna bread, French bread, Jewish rye bread, Italian bread, graham crackers, soda crackers, Ritz crackers, hot or cold cereals without added milk solids (read the label)	Breads/rolls containing milk, prepared baking mixes (muffins, biscuits, pancakes, etc.), Zwieback, corn nuts, instant cereal with added milk solids
Potatoes and Starches	Items prepared without milk or milk products: macaroni, noodles, rice, spaghetti, white/sweet potatoes	Products with milk added, such as instant potatoes, frozen French fries, Scalloped/au gratin potatoes, macaroni and cheese mixes
Vegetables	Fresh, frozen, and canned vegetables without added milk products	Creamed or breaded vegetables or vegetables with margarine added
Fruit	Fresh, canned or frozen fruit not processed with milk/milk products	Any canned or frozen fruit processed with milk or milk products
Meat and Meat Substitutes	Plain meat, fish, poultry, eggs, Kosher prepared meat products, soybean meat substitutes, dried peas, beans, lentils, and nuts	Breaded or creamed eggs, fish, meat or poultry, luncheon meats, sausage, hot dogs containing cheese or cheese products
Fats and Oils	Bacon, shortening, Miracle Whip, milk-free margarine, diet imitation margarine, salad dressings without milk products, vegetable oils, olives, mayonnaise, Coffee Rich and Rich's Whipped Topping	Sour cream, cream cheese, chip dips, sauces and salad dressings made with milk products and peanut butter with added milk solids
Soups/Combination Foods	Bouillon, broth, vegetable soups, clear, soups, consommes, homemade soups made with allowed ingredients	Chowders, ream soups, canned and dehydrated soups containing milk products
Seasonings	Pure monosodium glutamate (msg), soy sauce, carob powder, olives, gravy made with water, Baker's cocoa, pure seasonings and spices, sugar, honey, corn syrup, jam, jelly, marmalade, and molasses	Condiments with milk solids or lactose added
Desserts	Angel food cake, homemade cookies, cakes or pies made from allowed ingredients, tofu desserts, pure-sugar candies, marshmallows, and gelatin	Desserts prepared with milk/milk products, pudding, sherbet, ice cream, custard, frozen yogurt, toffee, peppermint, butterscotch, chocolate, caramels, reduced-calorie desserts made with sugar substitute, or chewing gum made with lactose.

Additional Resources

For more information or lactose-free products:

• Resources for Products see www.missrobens.com for their catalog.
• The Food Allergy Network and Anaphylaxis Network for information and membership.