Lactose is the natural sugar found in milk and milk products. Some people are unable to digest milk. Lactase is the digestive enzyme that helps the body to digest lactose. A lactase deficiency can lead to the accumulation of lactose in the intestine, which can cause nausea, gas, cramps, bloating and diarrhea. Some lactase deficient children can tolerate small amounts of milk products such as cheese, yogurt, ice cream, or milk used in cooking.

When following a lactose-free diet, it is necessary to read food labels for hidden sources of lactose such as whey, milk solids, and dry milk powder.

Since milk and milk products are a major source of calcium, check with a dietitian or your physician regarding calcium supplements.

Following is a listing of various food groups and within each, foods that are allowed on a lactose-free diet and foods to avoid.

Beverages
Foods to Avoid: Whole, lowfat, nonfat milk; half & half, cream; powdered, condensed, evaporated, goat, acidophilus, and chocolate milk; Ovaltine, instant breakfast

Foods Allowed: Non-dairy milk substitutes; Lactaid milk; soy milk, rice drink; carbonated drinks; fruit juices/drinks; lemonade; Isomil, Prosobee, Lactofree, Pregestimil, Nutramigen

Breads/Starch
Foods to Avoid: Most bread, crackers, and cereal; muffin, biscuit, waffle, pancake, and cake mixes; macaroni and cheese; creamed, scalloped, or au gratin potatoes

Foods Allowed: French bread, graham crackers, saltines, bagels, Zwieback; oatmeal, rice cereals, cream of wheat; plain potatoes, rice, pasta

Protein Foods
Foods to Avoid: Creamed meats, poultry, and fish; cheese, cheese spreads, cottage cheese; omelets, quiche, souffles prepared with milk or cheese; peanut butter with added milk solids

Foods Allowed: Plain meat, poultry, or fish; Kosher hot dogs and luncheon meats; tofu; eggs; natural peanut butter

Vegetables/Fruits
Foods to Avoid: Creamed, breaded, or buttered vegetables

Foods Allowed: Fruit and vegetables prepared without milk

Fats
Foods to Avoid: Butter, margarine, salad dressings and sauces containing milk; cream; sour cream; cream cheese

Foods Allowed: Non-dairy creamers and whipped topping

Desserts
Foods to Avoid: Ice cream, sherbet, ice milk; yogurt; chocolate; cakes, pies, custards and puddings made with milk

Foods Allowed: Non-dairy frozen sorbet; angel food cake; custard and pudding made with water or milk substitute

Sweets
Foods to Avoid: Toffee, butterscotch, caramel; artificial sweeteners

Foods Allowed: Molasses, syrup

Soups
Foods to Avoid: Creamed soups; dehydrated soup mixes containing milk products

Foods Allowed: Broth-based soups or soups prepared with milk substitutes

Baby Foods
Foods to Avoid: Custards; creamed spinach or corn

Foods Allowed: Plain vegetables, fruit; combination dinners that do not contain milk products

Miscellaneous
Foods to Avoid: Seasonings with milk products

Foods Allowed: Sauces prepared with
milk substitutes

Lactose Content of Selected Foods

Low Lactose Foods (0-3 grams)

Sherbet - ½ cup
Aged cheese (swiss, cheddar) - 1-2 ounces
Processed cheese - 1 ounce
Cottage cheese - ½ cup
Sour cream - 2 tbsp
Whipped cream - 1 tbsp
Half & half - 1 tbsp
Butter - 1 tsp

Medium Lactose Foods (4-9 grams)

Ice Cream - ½ cup
Ice milk - ½ cup
Pudding - ½ cup
Goat milk - 1 cup

High Lactose Foods (10-20 grams)

Milk - 1 cup
Acidophilus milk - 1 cup
Buttermilk - 1 cup
Chocolate milk - 1 cup
Yogurt - 1 cup
Eggnog - 1 cup