Lactose intolerance

Treating lactose intolerance

If you decide to experiment with what you can and can't eat, make sure that you introduce new foods gradually rather than all at once. This will help you to get used to any foods that you might be sensitive to.

Missing out on the nutrients provided by products that contain lactose can lead to deficiencies in calcium and other minerals. It is particularly important for young children to have certain nutrients in their diet to ensure healthy growth and development.

If you or your child are extremely sensitive to lactose, talk to your GP about your diet. You may need to have regular bone mineral density checks, or you may be referred to a dietitian (an expert in diet and nutrition). They can advise you about what foods should be included in your (or your child’s) diet.

Milk

A major source of lactose is milk, including cow's milk, goat's milk and sheep's milk.

Depending on how mild or severe your lactose intolerance is, you may need to change the amount of milk in your diet.

For example:

  • You may be able to have milk in your tea or coffee, but not on your cereal.
  • Some products containing milk, such as milk chocolate, may still be acceptable in small quantities.
  • You may find that drinking milk as part of a meal, rather than on its own, improves how the lactose is absorbed.

If even a small amount of milk triggers your symptoms, there are some alternatives that you can try, such as soya milk. You can now also buy milk that is made from rice, oats, potatoes and even peas.

Dairy products

Other dairy products, such as butter, ice cream and cheese, can also contain high levels of lactose, Some dairy products may be easier to digest than others. Cheese, for example, usually contains less lactose than milk. In particular, fermented dairy products, such as yoghurts, are often easier to digest.

Fermented dairy products are products that have been broken down by substances, such as yeast, bacteria or other micro-organisms. This means that the lactose they contain will already be partially broken down, and they may be easier to digest than fresh dairy products.

Possible dairy products you could try include:

  • yoghurts, including probiotic yoghurts (that contain live bacteria)
  • probiotic milk
  • sour cream
  • cottage cheese
  • hard cheeses, such as edam and cheddar

It's important not to eliminate dairy products completely from your diet because they provide essential nutrients.

Food and drink containing lactose

As well as dairy products, there are other food and drinks that contain lactose. Depending on how intolerant you are to lactose, you may need to remove them from your diet.

These include:

  • salad cream, salad dressing and mayonnaise
  • biscuits
  • chocolate
  • boiled sweets
  • cakes
  • peanut butter
  • bread and other baked goods
  • some breakfast cereals
  • packets of mixes to make pancakes and biscuits
  • packets of instant potatoes and instant soup
  • some processed meats, such as sliced ham

Check the ingredients of all food and drink products carefully, because milk or lactose are often hidden ingredients.

The lactose contained within milk or milk ingredients will not be listed separately on the food label, so you need to check the ingredients list for milk or milk ingredients such as cheese, butter, cream or yoghurt as well.

Food labelling

Some foods may be labelled "reduced lactose". However, there are currently no rules to say how much less lactose a product must contain in order to be able to display this label. Make sure you check the list of ingredients to find out exactly how much lactose the product contains.

If a product is labelled "lactose-free", it usually means that the product does not contain natural lactose. It is also a good idea to choose products with added calcium.

Lactose-free food and drinks

Food and drinks that do not contain any lactose include:

  • all soya milks, yoghurts and some cheeses
  • all milks made from rice, oats, quinoa, almonds, hazelnuts, coconut and potato
  • all foods which carry the "dairy-free" or "suitable for vegans" signs
  • carob bars

Lactose in medicines

Some prescription medicines, over-the-counter (OTC) medicines and complementary medicines may contain a small amount of lactose. While this is not usually enough to trigger the symptoms of lactose intolerance, it may be if your intolerance is severe, or if you are taking several different medicines.

If you need to start taking a new medication, check with your GP or pharmacist in case it contains lactose.

Lactase substitute

Lactose intolerance is usually caused by a deficiency of the enzyme called lactase (a protein that causes a chemical reaction to occur). A lactase substitute is available that can be taken to replace the lactase that your body cannot produce.

The lactase substitute comes in liquid form (usually as drops) that can be taken before a meal or added to milk. This can be very effective in helping your digestive system to digest the lactose in the meal. You can also take lactase pills (lactase enzyme capsules) before a meal.

Both lactase enzyme drops and capsules are available from most health foods shops.

Calcium

If you are unable to eat most dairy products, you may not be getting enough calcium in your daily diet. You can stock up on calcium by eating foods such as:

  • broccoli
  • cabbage
  • okra
  • kale (a leafy green vegetable)
  • dried fruit
  • soya drinks with added calcium
  • soya beans
  • tofu 
  • nuts (such as almonds, brazil nuts and sesame seeds)
  • fish containing edible bones (for example, sardines, salmon, and pilchards)

Food supplements

You can also buy combined calcium and vitamin D supplements, available in tablet form, from most pharmacists.

It is important to check with your GP or dietitian whether you should be taking supplements as taking excessively high levels of calcium can cause side effects such as kidney problems, constipation and tissue damage.

Advice for breastfeeding women

It is perfectly safe to breastfeed your child if you're lactose intolerant. It does not put them at greater risk of becoming lactose intolerant and breastfeeding brings important health benefits to your baby.

Read more about the benefits of breastfeeding on Ready Steady Baby.

Lactose intolerance in children

If your child is lactose intolerant, they may be able to consume small amounts of lactose without experiencing symptoms. This is quite safe, but you may need to experiment to establish a comfortable threshold.

In some cases, your child may not be able to tolerate any dairy food at all. If so, your doctor can refer you to a dietitian for nutritional advice. There are also lactose-free formulas available for babies, while soya and nut milks make good substitutes for dairy milk, so older children can drink these instead.

Fish, tofu, nuts and green vegetables are also calcium-rich and lactose-free.

Your doctor or dietitian may recommend the use of lactase drops, as discussed above. These can be added to milk to help digest the lactose in it, making it safe to drink.

Remember that secondary lactose intolerance, brought on by a bout of illness such as flu or gastroenteritis, is only temporary. Avoid feeding your child dairy food during the illness, but a few days after symptoms have passed you can gradually reintroduce dairy into the diet.

Last updated: 11 February 2014

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