News flash: Bovines have lost their monopoly on the milk market. From almond to soy, with plenty of exotic options in between, parents and kids are enjoying a wider range of choice in milk substitutes than ever before. That makes life simpler for an increasing number of Americans who have been forced to seek alternatives to nutrient-rich cows' milk because they or their children have problems digesting or tolerating it. An estimated 30 million of us have some form of lactose intolerance, and more than 100,000 babies a year are thought to suffer from milk allergy or related gastrointestinal complications. Why the flurry of lacto woes? There's no medical consensus, and it could just be a matter of better diagnosis. "There isn't a clear-cut reason why dairy allergies are on the rise," says New York City nutritionist Robert Pastore, Ph.D. "In my opinion, they were always prevalent, but now we have better testing methods. Plus, doctors are more aware of the role food allergies play in certain health conditions, such as asthma and eczema, so they're more prone to look for the offending cause."
There's a difference between lactose intolerance and milk allergies (lest one be tempted to lump them into one pesky category): Children with the former problem are deficient in lactase, an enzyme produced by the small intestine that breaks down lactose, the milk sugar in all dairy products. This can result in a host of stomach upsets, from gas to diarrhea. Kids who are allergic to milk react badly to some or all of its proteins—casein, whey, and lactalbumin. This adverse reaction can trigger not only gastric distress but skin problems like rashes and eczema, as well as respiratory discomforts, such as a runny nose or nasal congestion.
And milk "issues" often surface long before a kid can clutch a little cardboard carton at lunchtime. "Even breast-fed infants can show signs of milk allergy if the mother is consuming dairy products," says Pastore. "Once it's determined that a child is allergic to dairy, the breast-feeding mother must stop consuming all cow's-milk products."
The good news: "Most of those kids will outgrow that allergy by the time they're about 4," says Paul Ehrlich, M.D., a pediatrician, allergist, and clinical assistant professor of pediatrics at the New York University School of Medicine. "And the more attentive you are to keeping milk out of your child's diet, the sooner the allergy will go away."
But clearly, if any little ones under your care suffer from either lactose intolerance or milk allergy, you'll need know-how to navigate the world of still-exotic (at least in the U.S.) options like goat's milk—thus our road map to alterna-milks. As long as you pick a brand that is fortified with the calcium, magnesium, and vitamin B12 that have long made traditional cows' milk such a nutritional superstar, feel free to pour it on.
