Poorly digested lactose sits in the intestine, where it ferments and causes the unpleasant symptoms described above. It's normal for the level of lactase in the intestinal tract to begin declining after the age of three. But there is a wide range of reactions to lactose. Some people with lactose intolerance can drink small amounts of milk; others none at all.

It's easy to assume that when a person reacts so violently to a food that it is due to an allergy. But in the case of milk and dairy products, all is not as it seems.

Although both milk allergy and lactose intolerance trigger similar symptoms, they are two very different problems. Of the two, milk allergy is the more serious. It is also much less common. According to the Asthma and Allergy Foundation, about one to two percent of Americans suffer from food allergies in general; milk triggers only a small number of those.

While lactose intolerance is the body's reaction to the sugar in milk, a milk allergy is the body's reaction to the protein in milk. In people who are allergic, the milk protein is absorbed and the immune system kicks in. Its fight against the invader protein is responsible for allergy symptoms.

For most people, living with lactose intolerance doesn't have to mean living with chronic discomfort. Neither is it necessary for most sufferers to completely avoid milk products. That's good news, because dairy foods are superb sources of calcium and vitamin D -- much needed nutrients for building bones and holding bone-destroying osteoporosis at bay.

Here are some tips for anyone who must confront living with lactose intolerance, and especially for child care providers who are aware of lactose intolerance in any of their day care children:

• Read labels carefully. Not all sources of lactose are as obvious as milk and ice cream. There are often-overlooked sources in foods like pizza, casseroles, lasagna, and pancakes. For some people, foods like these that are made with dairy products can be just as troublesome as dairy products themselves.

• Check food labels for lactose-rich ingredients, such as whey, whey protein concentrate, and milk solids. They are commonly used in many types of processed foods, including some you might consider lactose-free, such as chewing gum and frozen dinners.

• Be aware that some over-the-counter and prescription pharmaceutical products contain lactose as well. Among them: Centrum Silver vitamin supplements, Contact cold medication, Maalox caplets, and Premarin prescribed for estrogen replacement therapy.

• Eat small amounts of lactose-rich foods at a time. Smaller amounts may be easier to digest. For example, drinking several small glasses of milk throughout the day may be better tolerated than drinking one or two large glasses at once.

• Eat lactose-rich foods in combination with low-lactose or lactose-free foods. Lactose is better tolerated as part of a meal than when it is taken separately.

• Choose dairy products such as aged cheeses, like cheddar and cultured yogurt. They are easier to digest than others because they contain less lactose.

• Don't turn to lactobacillus milk or sweet acidophilus milk. They do not contain less lactose, nor are they better tolerated than regular milk.

• Try lactose-reduced and lactose-free dairy products. Dairy Ease lactose-reduced milks and Lactaid lactose-free/lactose-reduced milks and lactose-reduced cheeses are available in the dairy case at many supermarkets. Both Dairy Ease and Lactaid milks are available in whole, low-fat, and non-fat varieties. Lactaid also makes chocolate and calcium-enriched versions.

• Check out Lactaid and Dairy Ease caplets. They can be chewed or swallowed before you eat a lactose-rich dish, like ice cream, fettucini Alfredo, lasagna, milk, or pizza. Lactaid offers drops that can be added to regular milk, reducing the lactose. These products actually contain the lactase enzyme, which will help you getter digest the lactose in food so you wonÕt experience discomfort after eating. Each company answers questions and offers coupons, free samples, and product literature via toll-free hot lines:
  • Lactaid: 1-800-522-8243

  • Dairy Ease: 1-800-331-4536

Some material drawn from: Environmental Nutrition, October 1993

From the December, 1993, issue of The Teddy Bear.