Lactose-Restricted Diet: Care Instructions

Overview

Lactose is a sugar that is in milk and milk products. Some people do not make enough of an enzyme called lactase, which digests lactose. When this happens it can cause gas, belly pain, diarrhea, and bloating. This is called lactose intolerance. This is not the same as a food allergy to milk.

With planning, you can avoid lactose and still get enough calcium and vitamin D to maintain healthy bones. A dietitian can help you find foods that work based on your level of lactose intolerance and what you like to eat.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Limit milk and milk products. Try having smaller amounts of milk or milk products throughout the day, instead of larger amounts all at once.
  • If you have bad symptoms when you eat or drink something with lactose, you may need to avoid it completely.
  • If you are not sure whether a milk product causes symptoms, try a small amount and wait to see how you feel before you eat or drink more.
• Try yogurt and cheese. These have less lactose than milk and may not cause problems.
• Eat or drink milk and milk products that have reduced lactose. In most grocery stores, you can buy milk with reduced lactose, such as Lactaid milk.
• Use lactase products. These are dietary supplements that help you digest lactose. Some are pills that you chew (such as Lactaid) before you eat or drink milk products. Others are liquids that you add to milk 24 hours before you drink it. Try a few products and brands to see which ones work best for you.
• Eat or drink other foods, such as soy milk and soy cheese, instead of milk and milk products.
• If you are very sensitive to lactose, read labels carefully to spot the lactose products.
  • Some medicines have lactose.
  • Prepared foods that may have lactose include breads, baked goods, breakfast cereals, instant breakfast drinks, instant potatoes, instant soups, baking mixes (such as pancake, cookie, and biscuit mixes), margarine, salad dressings, candies, milk chocolate, and other snacks.
  • Lactose may also be called whey, curds, or milk products.
• Be sure to get enough calcium, especially if you avoid milk products completely. Calcium is very important because it keeps bones strong and reduces the risk of osteoporosis. Ask your dietitian for advice on how to get enough calcium. Foods that have calcium include:
  • Broccoli, bok choy, kale, and collard, mustard, and turnip greens.
  • Canned sardines and other small fish that have bones you can eat.
  • Calcium-fortified orange juice.
  • Soy products such as fortified soy milk and tofu.
  • Almonds.
  • Dried beans.
• Get enough vitamin D. Foods and drinks that have vitamin D include:
  • Fatty fish like salmon, tuna, and mackerel.
  • Eggs.
  • Foods and drinks that have vitamin D added to them. These include plant-based milks (like soy, almond, and rice milk), fortified orange juice, and fortified breakfast cereal.
• If you are worried about getting enough nutrients, ask your doctor about taking supplements, such as calcium and vitamin D.

When should you call for help?

Contact your doctor now or seek immediate medical care if:

• You have new or worse belly pain.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You do not get better as expected.