Milk allergies and lactose intolerance

13 June 2024. By FACTS in Allergen Management, Food Industry News

Cow’s milk allergies and lactose intolerance are often confused with each other. Here’s how to tell the difference between the two most common reactions triggered by milk.

What are the most common adverse reactions to milk?

Cow’s milk allergies and lactose intolerance.

What is the difference between them?

They are distinctly different conditions, involving different aspects of the digestive system.

A cow’s milk allergy is an immune system response to one or more of the proteins found in cow’s milk (e.g. casein or whey proteins), and is particularly prevalent among young children. If you suffer from a cow’s milk allergy, your immune system wrongly recognises the milk proteins as harmful. Symptoms range from mild to severe, and include anaphylaxis and include skin rashes, digestive issues and respiratory problems.

Honourable Mention

Food Protein-Induced Enterocolitis Syndrome (FPIES) affects infants, normally resolving between the ages of 18 and 24 months. Symptoms include profuse and repetitive vomiting that can cause dehydration and shock. FPIES is often triggered by cow’s milk and soya.

Lactose intolerance results from the body’s inability to fully digest lactose (the sugar in milk). If you suffer from lactose intolerance, you do not produce any or enough lactase, the enzyme responsible for breaking down lactose. Lactose intolerance does not involve the immune system; symptoms are typically less severe – for example, bloating, abdominal pain, flatulence and diarrhoea – and can appear hours after consuming milk.

Claims on your label

Understanding the differences between cow’s milk allergies and lactose intolerance is essential to ensure that you make the correct claims on your product labels.

Cow’s milk is a regulated common allergen in South Africa. A cow’s milk-free claim is allowed when the absence of cow’s milk can be proven and confirmed using suitable analytical testing. Lactose-free is a nutrient content claim that requires nutritional testing to prove that the product contains not more than 0.5g lactose per 100g/ml of product.

IMPORTANT

Lactose-free products are not necessarily safe for milk-allergic consumers, while a milk-free product is probably, but not always, safe for both allergic and intolerant consumers.

A dairy-free claim should not be used instead of the wording “cow’s milk free” or “milk free”, as the average consumer does not understand the difference. The only instance where “dairy free” can be used is in the case of certain imitation dairy products for which the term is reserved under the dairy and imitation dairy regulations (R. 1510/2019).

Some consumers assume that vegan products are cow’s milk-free. Thus, to protect them, it is recommended that vegan products are also free from animal-derived allergens such as cow’s milk. You can confirm this via suitable testing, such as cow’s milk allergen testing or a vegan food screen. For more information, read our article on Vegan labelling: Requirements & limitations.

We hope this information clarifies and demystifies the differences between milk allergies and lactose intolerance. Contact us for analytical and consulting support.

Other articles, resources and videos you may be interested in:
Vegan labelling: Testing to validate claims
Milk allergen testing
South Africa: Allergen labelling
South Africa’s regulated common allergens