If you used to enjoy yummy cheese, yoghurt, ice cream, milk on cereal or a milky dessert, and maybe milk drinks as well, it is no fun having to exclude all dairy foods. However for most people this can change. It can be such a relief just not having to be really careful that there is no milk at all in your other foods. Of course if you, or your child, is anaphylactic, or exquisitely sensitive, to milk, or you are breastfeeding a very milk-sensitive baby, complete exclusion is necessary. But in other people careful trials of very small amounts can be tested. You can consider allergy, presence of lactose, amount of milk, and the amount of cooking to help your tolerance.
Because milk is better tolerated if it is cooked, a small amount as an ingredient in some of your favourite bread or biscuits is often managed. You may know that you have a bad reaction to a whole mug of coffee when on an outing with a friend but that does not mean all dairy foods must be excluded forever. Using just a little milk can make having your weak coffee, or weak tea, if tolerated, a much more enjoyable experience, especially if it is spread throughout the day. If that whole cup of milk was making you bloated then try lactose-free milk, as lactose definitely can cause bloating. You may be one of those people who have discomfort even if the milk is lactose-free, even if it has no added flavouring. You may even have had a negative allergy test and still react to milky foods. When any of these occur, just how much milk you have, and how well it is cooked can make a big difference. Some people boil their managed amount in a microwave until hot and fluffy and then make coffee to have a delightful eating experience. Evaporated, condensed milk or caramelised milk, or even a plain caramel lolly, or dessert, or home-made caramel slice, may be tolerated. Yum! Milk is also cooked when you make white cornflour custard, or when you cook milk with tolerated breakfast cereals such as oatmeal or rice meal. Another aspect of milk is the separation of its proteins into the curd casein fraction that is in cheese, and the whey fraction in the body-building protein powder. You may find that cheese can be tolerated where whole milk is not, especially if the cheese is melted. Think yummy melted cheese on plain corn chips, on vegies or in grilled cheese on toast. Many children are said to grow out of milk allergy by age four. This is after months or years of gradual increase in the amount used, so all the ideas here can help. Mothers of infants also report that tolerance is better between 10 am and 4.00 pm. Plain fresh yoghurt is another option in the foods to try, still beginning with just a taste working up to a teaspoon over seven days.
Some people stay away from milk as it smells “stale” or “off” to them. If they mention this they are often teased about being “weird” or “fussy” by family or friends. They are often pleasantly surprised when they taste milk that has been kept well chilled until it is opened and they use it within 12 to 24 hours of opening. Use-by dates are not relevant to them. They are smelling or tasting the change in the protein that indicates that the level of amines is too high for them. If they were to drink that milk it may produce their particular symptoms, even though it is no problem to others. They may note, even with surprise, that they tolerate plain ice-cream, so realize that it is not the milk, but how old it is, as freezing slows the staling process, that is the problem. And they can be lucky. I recently heard of a food sensitive child’s father who could detect even a hint of staling in milk. He was employed by an ice-cream company to assess the milk that went into ice-cream so all the ice-cream from that company would have been very well tolerated as it would have been low in amines! These people need also to attend to the smell of stale or strong cheeses, but may manage white cheeses or fresh mild cheddar.
Tolerance can also vary with seasons. I was pleased when patients reported improved tolerance when I suggested dairy trials at the beginning of summer, only to hear that they had symptoms return when the cool changes occurred in autumn. And for some tolerance did not improve in spring time, due to the high pollen load. But just knowing that tolerance is better in summer is wonderful.
An important reason for including milk is its contribution to nutrition. Milk provides protein, energy, calcium, and vitamin B vitamins. It may provide up to half your daily protein needs, and most of the calcium. So even if you gradually work up to tolerating only the equal of one serve of milk each day, when three are recommended, it is still important. Except for soy milk, all the milk alternatives do not provide all the nutrition that milk does. You may even gradually manage up to one cup of milk and also soy, as these are very different proteins. If you have had to exclude all dairy, do see a dietitian and discuss nutritional ways to replace all the nutrition in your particular lifestyle. To give yourself more detail about testing milk read Tolerating Troublesome Foods including where to consider butter and cream, and goats milk, as well as on understanding the idea of the total body load and the factors in you, in your environment and in the food that affect your tolerance. Always test any new food beginning with a small amount and increase it over seven days. If you have a reaction do try again three months later.