Lactose-Free Doesn’t Have to Mean DAIRY-FREE
As a nutritionist who relies on research evidence, a constant frustration of mine is the list of food restrictions and, at times, total ban of certain foods, in the name of children’s safety at early education settings (daycare and preschool).
My frustration comes from the knowledge that it is not necessary that a child or worse, the entire group of children attending a service, miss(es) out on accessible, affordable and reliable source of important nutrients simply because the people in charge fear a triggering episode.
Please, don’t get me wrong. I completely understand that fear. No one wants a child to have an allergic reaction nor even a mild discomfort triggered by something they ate while in our care. But restricting children who have no adverse reaction to banned foods from having access to them – and their nutritious content – can come at a high cost.
There are several issues with it:
children will not have enough exposure to those foods which may lead to long-lasting fussy eating because they will have less opportunities to develop taste and to learn how to eat it;
They may be missing out on important nutrients, especially children who spend long days in care;
Some children may be unable to express their dietary culture and to eat foods that are familiar to them;
It may impair a developing body’s ability to build tolerance and prevent allergies to develop and set;
It gives a false sense of safety as people may be off guard for an unexpected event of allergic reaction or allergens being brought into the premisses inadvertently and going under the radar – but that’s a topic for another article. Today, I want to talk only about DAIRY RESTRICTION.
I often come across services that have dairy completely out of the menu, sometimes even in their entire chain of outlets. Not as radical, some services will restrict dairy to children who may have an intolerance.
Since the way to combat fear is by getting knowledge, let me contribute to that by describing what all who are involved in feeding children should be aware of to more confidently manage dairy intolerances and allergies.
Dairy Allergy vs Intolerance
A dairy allergic reaction is an immune response to the intake of casein – a protein present in mammalian milks (breast, cow, goat, sheep etc.). This reaction may or may not be life threatening, and very low casein content may trigger a reaction. So, for a person who’s allergic to casein, staying clear of animal milk is the only option.
On the other hand, dairy intolerance is the inability to digest lactose – a type of sugar naturally present in mammalian milks. Lactose can cause discomfort in the gut of people who are sensitive to it, but it is not life threatening, and the level of (in)tolerance to it varies from person to person.
So, while dairy allergic children must not get in contact with any dairy products, the management of dairy (or lactose) intolerance is a whole different story.
ALLERGY: Immune system reaction to dairy protein (casein)
INTOLERANCE: Gut inability to digest dairy sugar (lactose)
Lactose-free products
Lactose intolerant children usually manage well regular yoghurts and cheeses which have its lactose content depleted or significantly reduced during the fermentation process. They also tolerate well lactose-free dairy milks.
Plant-based products are acceptable alternatives, but none is as nutritionally rich as dairy. Also, they are almost always more expensive, and highly processed – with the addition of many other ingredients to make it more appealing, but not necessarily more nutritious.
Dairy restriction management
It all should start with collecting relevant information about each child who starts attending the service. The enrolment form is a great place to start, and so is handing out to the new family the service’s food & nutrition policy.
My recommendation is to have a policy specifically for food & nutrition management, clearly stating what the management and staff are committed to do to ensure that everyone while at the centre (children and adults) is allergy-safe, but also clearly stating the families’ responsibilities, like disclosing relevant information and providing evidence regarding the child’s dietary restrictions such as a medical statement, and updating it when conditions change.
This is quite important because, once the management knows what is the actual issue that child has with dairy, then it is possible to plan for as minimal dairy restrictions as possible.
For example, if you currently have one child in the entire centre who is lactose intolerant, there is no need to restrict all on site from having dairy. Not even that child should miss out on dairy. You can perhaps offer lactose-free milk to that one child and regular dairy milk to all others – given it’s been agreed with that child’s family.
Another scenario: you have a dairy allergic child who attends only one day of the week. You may choose to abstain the whole centre, or maybe just their room, from having dairy on that day, and continue to offer dairy products on the other days that the allergic child isn’t there.
It, of course, can get more complex if you have multiple dairy allergic and intolerant children in multiple rooms. But it is manageable. I’ve seen this less restrictive system working without problems in several centres that I visited and worked over the past ten years.
Knowledge beats fear
The best way to make sure a less restrictive allergy and intolerance management is successful is to educate all people involved – staff, families and children. The better one understands an issue the less they fear it because they learn how to manage it confidently.
To equip yourself and your workmates, have a look at our new workshop Managing Allergies & Intolerances in the ECEC Setting. In this workshop, you’ll get knowledge that will give you more confidence to manage dairy and other food restrictions that should only apply to the children who must be restricted, and not the entire centre.
references
Australasian Society of Clinical Immunology and Allergy (ASCIA) (2023). Food Allergy.
Australasian Society of Clinical Immunology and Allergy (ASCIA) (2023). Food Intolerance.
Australasian Society of Clinical Immunology and Allergy (ASCIA) (2023). Cow’s Milk Protein (Dairy) Allergy.
Allergy Aware website (2023). Best Practice Guidelines for Anaphylaxis Prevention and Management in Children’s Education and Care.
NSW Food Authority (2023). Allergy and intolerance.
Food Intolerance Institute (2023). Food Sensitivity.
ACECQA Nutrition, Food And Beverages, Dietary Requirements Policy Guidelines (2021).
Food allergy Management in Early Childhood Education and Care Services in Australia. (Study, 2019, Australia)
