Changing your diet
In most cases, cutting down on or avoiding food and drink containing lactose and replacing them with lactose-free alternatives is enough to control the symptoms of lactose intolerance.
The exact changes you need to make to your diet depend on how sensitive you are to lactose.
Some people are able to tolerate some lactose in their diet without any problems, whereas others experience symptoms after consuming food containing only a tiny amount of lactose.
If you decide to experiment with what you can and cannot eat, make sure to introduce new foods gradually, rather than all at once.
This will help you get used to any foods you might be sensitive to, as well as identify any that cause problems.
Eating fewer products containing lactose, or avoiding them completely, can mean you miss out on certain vitamins and minerals in your diet and increase your risk of complications.
This means you'll need to make sure you're getting enough nutrition from either lacto-free foods or dietary supplements.
If you or your child are extremely sensitive to lactose, talk to your GP about your diet.
You may be referred to a dietitian, an expert in diet and nutrition, who can advise you about what foods should be included in your or your child's diet.
Sources of lactose
A major source of lactose in our diet is milk, including cows' milk, goats' 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.
- 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
Products made with milk, such as cream, cheese, yoghurt, ice cream and butter, also contain lactose and may need to be avoided if you're lactose intolerant.
But the level of lactose in these products varies and is sometimes quite low, so you may still be able to have some of them without experiencing any problems.
It's worth experimenting with different foods to find out if there are any dairy products you can eat, as they're a good source of essential nutrients like calcium.
Other foods and drinks
As well as milk and dairy products, there are other foods and drinks that can sometimes contain lactose.
- salad cream, salad dressing and mayonnaise
- boiled sweets
- some types of 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, as milk or lactose are often hidden ingredients.
The word "lactose" will not necessarily be listed separately on the food label, so you need to check the ingredients list for milk, whey, curds and milk products such as cheese, butter and cream.
Some ingredients may sound like they contain lactose when they do not, such as lactic acid, sodium lactate and cocoa butter.
These ingredients do not need to be avoided if you're lactose intolerant.
Some prescription medicines, over-the-counter medicines and complementary medicines may contain a small amount of lactose.
While this is not usually enough to trigger the symptoms of lactose intolerance in most people, it may cause problems if your intolerance is severe or you're taking several different medicines.
If you need to start taking a new medication, check with your GP or pharmacist in case it contains lactose.
Lactose-free foods and drinks
There are a number of alternative foods and drinks available in supermarkets to replace the milk and dairy products you need to avoid.
Food and drinks that do not usually contain lactose include:
- soya yoghurts and cheeses
- coconut-based yoghurts and cheeses
- almond milk, yoghurts and cheeses
- rice milk
- oat milk
- hazelnut milk
- foods with the "dairy-free" or "suitable for vegans" signs
- carob bars
Lactose-free dairy products
There are a number of lactose-free dairy products available to buy that are suitable for people with lactose intolerance.
These contain the same vitamins and minerals as standard dairy products, but they also have an added enzyme called lactase, which helps digest any lactose so the products do not trigger any symptoms.
Lactose-free versions of milk, yoghurt and cheese are normally available in larger supermarkets.
Getting enough calcium
If you're unable to eat most dairy products, you may not be getting enough calcium in your daily diet.
Calcium has several important functions, including:
- helping build strong bones and teeth
- regulating muscle contractions (including heartbeat)
- ensuring blood clots normally
It's a good idea to choose lactose-free products with added calcium and ensure your diet contains alternative sources of calcium, such as:
- leafy green vegetables, such as kale, broccoli, cabbage and okra
- soya beans
- bread and anything made with fortified flour
- fish containing edible bones (for example, sardines, salmon and pilchards)
You can also buy combined calcium and vitamin D supplements from most pharmacists to help maintain good bone health.
It's important to check with your GP or dietitian whether you should be taking supplements, however, as taking excessively high levels of calcium can cause side effects.
In addition to dietary changes, you may also find it useful to take liquid drops, tablets or capsules that contain lactase substitutes. These are available from most health foods shops.
Lactase substitutes replace the lactase your small intestine is not producing, which can reduce your symptoms by helping your body break down any lactose in your diet more easily.
Lactase substitutes can either be added to milk or taken just before eating a meal containing lactose.
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 find out how much they can comfortably eat or drink.
If your child is unable to tolerate any lactose, your doctor may refer you to a dietitian for nutritional advice.
This is because it's important for young children to have certain nutrients in their diet to ensure healthy growth and development.
In general, the same rules about foods to try or avoid are similar for children and adults.
For babies with lactose intolerance, lactose-free formula milk is available to buy from pharmacies and supermarkets.
But soya formula is not recommended for children under 6 months because it contains hormones that may interfere with your baby's future physical and sexual development.
Breastfed babies may benefit from lactase substitute drops to help their bodies digest the lactose in breast milk.
For many children, lactose intolerance is only temporary and will improve after a few weeks.
After this point, it's safe to gradually reintroduce milk and dairy products into their diet.
Advice for breastfeeding women
It's perfectly safe to breastfeed your child if you're lactose intolerant.
It does not put them at greater risk of becoming lactose intolerant and has important health benefits for your baby.