If you’ve ever experienced bloating or stomach discomfort after drinking milk, it’s a common reason people reconsider dairy. For many people, milk is often the first thing to disappear from the fridge when digestive discomfort appears.
But the explanation isn’t always that simple.
In clinical practice, I frequently see people who believe they are lactose intolerant, only to discover the situation isn’t quite that simple. Lactose intolerance is often self-diagnosed, meaning many people who eliminate dairy may actually be avoiding it unnecessarily.
That matters even more as we get older.
From our 50s onwards, nutritional needs begin to change, particularly when it comes to nutrients that support bone health. Yet most Australians are already consuming less dairy than recommended, which can make it harder to meet important nutrient needs such as calcium, protein and iodine.
Before cutting dairy entirely, it’s worth understanding what may actually be causing digestive symptoms.
Lactose intolerance isn’t always the explanation
Lactose intolerance occurs when the body produces insufficient amounts of lactase, the enzyme needed to digest lactose – the natural sugar found in milk.
When lactose isn’t fully digested in the small intestine, it passes into the large intestine where gut bacteria ferment it. This process can lead to symptoms such as bloating, abdominal discomfort and diarrhoea.
However, lactose intolerance is often confused with other conditions.
A dairy allergy, for example, involves the immune system reacting to milk proteins and can cause symptoms such as hives, swelling or breathing difficulties. Dairy allergies are far less common in adults and require medical diagnosis.
Some people also experience digestive symptoms after consuming dairy that don’t clearly fit either category. This is sometimes referred to as dairy sensitivity, although it isn’t a formally defined medical condition.
Because the symptoms can overlap, it’s easy to assume lactose is the cause – even when something else may be driving the reaction.
Why dairy affects people differently
Another important point is that lactose tolerance varies between individuals.
Even people with confirmed lactose intolerance can often tolerate small amounts of lactose, particularly when dairy is consumed with other foods.
Portion size, overall gut health, and even eating habits such as rushing meals, inadequate chewing, or irregular eating patterns can all influence digestive symptoms.
In many cases, people assume lactose is the problem when the situation may be more complex. With the right guidance, many people find they can reintroduce some dairy rather than eliminating it entirely.
New research is exploring other explanations
Researchers have also begun examining whether components of milk other than lactose may influence digestive symptoms in some people.
One area being studied is the type of beta-casein protein naturally present in milk.
Milk typically contains two main forms of beta-casein protein, known as A1 and A2, and some research suggests digestive responses may differ depending on which type is consumed.
During digestion, A1 beta-casein can release a compound known as beta-casomorphin-7, which has been proposed as one possible mechanism contributing to gastrointestinal symptoms in some individuals.
For people who continue to experience digestive discomfort with regular milk – even when lactose has been reduced – some choose to trial milk containing only the A2 form of beta-casein (sometimes described as A1 protein free milk).
These products come from cows that naturally produce only the A2 form of beta-casein and are widely available in Australian supermarkets, including lactose-free options.
Responses can vary between individuals and research in this area is ongoing.
Why cutting dairy can matter more after 50
Dairy foods are a major source of nutrients in the Australian diet, particularly calcium, protein, iodine, and vitamin B12.
Australian Dietary Guidelines recommend around four serves of dairy or dairy alternatives per day for adults over 50 to help meet calcium needs and support bone health.
Calcium is especially important as we get older because bone density naturally declines with age. For women, this process often accelerates after menopause.
A serve is equivalent to a glass of milk, a tub of yoghurt, or two slices of cheese.
Removing dairy without suitable alternatives can make it harder to meet calcium needs, which is why dietitians generally encourage people to explore ways to manage digestive symptoms while still including dairy where possible.
The good news is that many people don’t need to eliminate dairy altogether.
If dairy seems to upset your stomach, try this first
Before removing dairy completely, a few simple strategies may help:
Start with smaller portions
Many people who experience symptoms can tolerate smaller amounts of dairy, especially when eaten with meals.
Spread dairy intake across the day
Consuming smaller amounts more frequently can reduce digestive discomfort compared with a single larger serve.
Try fermented dairy foods
Products such as yoghurt and cheese naturally contain less lactose and may be easier to tolerate.
Seek personalised advice
Working with an Accredited Practising Dietitian can help determine what may be driving symptoms – whether it’s lactose, milk proteins such as A1 beta-casein, or something else – and develop a strategy that maintains nutritional balance.
The bottom line
Digestive discomfort after consuming dairy is common, but lactose intolerance isn’t always the full explanation.
Understanding the difference between lactose intolerance, dairy allergy and general digestive sensitivity can help people make more informed decisions before removing dairy entirely.
For many people, the goal isn’t necessarily avoiding dairy, but finding ways to include nutrient-rich foods while still managing digestive comfort.
About the author:
Nicole Dynan is an accredited practising dietitian, specialising in gut health.