Lexi covers the difference between an allergy and an intolerance, whether dairy needs to be removed completely, the nutrients our kids might be missing if we remove dairy, and some of the great dairy alternatives on the market today. As with all expert content on The Family Thrive, this is not medical advice. Talk to your doctor if your child appears to have a dairy allergy or intolerance.

1. The difference between dairy allergies and intolerance.  

A dairy allergy occurs when the body’s immune system mistakenly thinks a dairy protein is a foreign object that doesn’t belong. Reactions to this type of allergy can be severe (including anaphylaxis) and they usually happen right away.  Blood samples or skin prick tests can help determine this type of immune reaction to a dairy protein.  

An intolerance is a little harder to diagnose because there aren’t lab tests to detect it. The best method to determine an intolerance is to withhold dairy from the diet and carefully reintroduce different types to see when and if symptoms reappear.

Intolerances can be due to the protein (there are 30 different proteins in dairy (!) though the main ones are “Casein” and “Whey”) or the milk sugar (“lactose”). Symptoms of intolerance vary but they usually happen hours to days after ingestion of dairy. Symptoms can range from mild to severe and affect people in different ways. Usually, a lactose intolerance creates uncomfortable bowel symptoms but can also affect the skin (worsening acne or eczema) and the brain (causing inability to focus or brain fog).  

2. Dairy doesn’t always have to be completely eliminated

If your child is intolerant or allergic can they have any dairy? It depends. A person with a true dairy allergy (especially with anaphylaxis), must avoid all forms, including dairy products produced from other animals including sheep, goats and camels. However, a person with a mild intolerance to dairy protein may find that they can tolerate baked or fermented forms (as in yogurt), because proteins are changed by heating in baking or enzymes in fermentation.  

Also, different animals produce slightly different types of proteins. For example, sheep, goats and some cows (like Guernsey’s) produce a Casein protein called “A2” type, while most cows produced in the US (specifically Holstein cows) produce the “A1” type. Some find improved tolerance with the A2 type.  

Some people are intolerant to the natural sugar in dairy milk called lactose. They may be able to tolerate dairy in fermented foods, like ghee and yogurt, where most of the lactose has been removed by refining (in ghee) or the fermentation process (in yogurt). A lactose intolerance is usually caused by inadequate production of the “lactase” enzyme and some people may also find relief by taking “lactase” pills before eating dairy.  

3. Dairy is an important source of many nutrients  

When kids need to avoid or dramatically reduce dairy, it’s important to understand what nutrients they may be missing out on so they can be replaced from other food sources. Milk from cows is a significant source of protein and calories, especially important for younger children. Milk from cows has an average of 10 grams of protein per cup, while most milk alternatives don’t come close to that amount.  

Full fat milk can also be a good source of energy as it provides about 240 calories per cup, while some of the lesser fortified alternatives provide as low as 60 calories per cup. Milk is also an important source of Vitamin D, Calcium, Riboflavin, Zinc, and Vitamin B12, giving about one-third of the daily requirement per 8-ounce cup.    

As a side note, children over the age of 2 should not have more than 16 ounces of fortified milk per day as the calcium contained in it can prevent the absorption of iron and displace other nutrient-dense foods in the diet.

4. Choosing dairy alternatives depends on your goals

If your goal is to get more protein and calories into your kid’s diet, a high-protein alternative made with soy, pea, or flax proteins is a good choice. Regular nut milks surprisingly wouldn’t help meet these goals because, while whole nuts are a good source of protein, most nut milks actually have very little protein. Many have less than three grams per cup.

Rice milk is usually not recommended due to a high chance of contamination with mercury.  If concerned about inflammation or your child rarely eats fish, hemp, or flax milks are good choices for adding omega-3 fatty acids.

Hemp milk is a great choice to bake with, replacing milk in a 1:1 format.  We recommend using unsweetened Hemp milk as the sweetened varieties make for a heavier and denser product.

Oat milk is new on the scene and many children prefer the taste of oat milk over many others, though the nutrition varies widely over different brands. Many oat milk brands are quite high in sugar and simple carbohydrates and low in protein.  

When choosing any brand, look to the nutrition label to verify how much calcium and vitamin D is added.  A better dairy alternative will have 25-30% of the daily recommended intake for those two (which you can find on the nutrition facts label). It would be great to have Vitamin B12, Riboflavin and Zinc fortified as well, though it is easier to get those from a well-balanced diet.

5. A few of our favorite dairy alternatives

Many brands establish a reputation around a particular approach to dairy-free alternatives, like Oatly or Milkadamia. Then they make drinkable milk, butter, cheese, sour cream, and yogurt all from the same alternative food source.  

• High-protein dairy milk alternatives: I’m a fan of Ripple, made with pea protein (8 grams of protein per serving). Orgain makes a protein-enhanced almond milk (10 g of protein) and Calafia Farms makes a protein-enhanced oat milk (8 g of protein). But topping them all in protein content is Silk Ultra, which has 20 grams of protein per serving.  
• Butter: A favorite for butter is Miyoko Creamery vegan butter made from coconut oil and cashews. We find the taste is closest to butter. It also browns and melts and can be used in a 1:1 ratio in any baked good.  
• Cheese: Miyoko also makes a faux mozzarella that is a great sub for pizzas. VioLife brand is also known for its cheeses. They make a delicious block parmesan that is easy to shred as well as a melt-friendly shredded cheddar/jack made from coconut oil (no nuts) and delicious on pasta, sandwiches, tacos, and risottos.  Chef Andrew loves using a Follow Your Heart brand of gouda flavored cheese on his sandwiches.
• Sour Cream: Forager brand makes a sour cream from cashews that has just the right tang for tacos.  
• Cream cheese:  Kite Hill has created a spreadable cream cheese made from almonds and it goes great on bagels.  
• Yogurt: Siggi’s brand coconut yogurt has a high protein option with about 10 grams per ½ cup. Forager also makes a drinkable yogurt that gets rave reviews for taste.  
• Ice Cream: Oatly brand has made a set of ice creams from oat milk that are hard to beat in terms of flavor and creaminess. Nada Moo also makes several different delicious ice creams from coconut oil.

TFT recipes will also include a dairy-free option in all our chef-tested recipes, so keep an eye out for new, tasty ways to remix our recipes with these dairy alternatives!