Can you grow out of milk intolerance? Understanding the different types

October 27, 2025 •

5 min read

An estimated 68% of the world's population has lactose malabsorption, but whether they grow out of a milk intolerance depends on the underlying type. Understanding the difference between a milk allergy and the various kinds of milk intolerance is crucial for effective management and determining if recovery is possible.

Quick Summary

Growing out of a milk intolerance varies based on its cause; some forms are temporary, like those affecting infants or caused by illness, while primary lactose intolerance is typically lifelong. A proper diagnosis from a healthcare provider is key to managing symptoms.

Key Points

Differentiate Milk Intolerance vs. Allergy: A milk allergy is an immune response to milk proteins, while lactose intolerance is a digestive issue due to insufficient lactase enzyme.
Primary Lactose Intolerance is Permanent: The most common type of lactose intolerance, which develops as lactase production naturally declines, is a lifelong condition.
Secondary and Developmental Intolerance Can Be Temporary: Conditions caused by intestinal damage (secondary) or premature birth (developmental) may be temporary and resolve over time.
Many Children Outgrow Milk Protein Allergy: The majority of infants with cow's milk protein allergy will outgrow it, often by the time they are five years old.
Management Strategies Vary: Treatment depends on the diagnosis, from dietary limitations and supplements for intolerance to strict elimination and supervised reintroduction for allergy.
Focus on Alternatives for Proper Nutrition: If avoiding dairy, ensure adequate intake of calcium and vitamin D from fortified foods or supplements to prevent nutritional deficiencies.

Differentiating Between Milk Intolerance and Milk Allergy

Before asking, "can you grow out of milk intolerance?", it's essential to clarify what kind of reaction is occurring. Many people use the terms milk intolerance and milk allergy interchangeably, but they are fundamentally different, involving separate bodily systems.

A milk allergy is an immune system reaction to the proteins in milk, typically casein and whey. Symptoms can be immediate and severe, including hives, swelling, wheezing, and in extreme cases, anaphylaxis. This is especially common in babies and young children, though most will outgrow it.

Milk intolerance, most commonly known as lactose intolerance, is a digestive problem, not an immune response. It happens when the body doesn't produce enough of the enzyme lactase, which is needed to break down lactose, the sugar found in milk. This results in gastrointestinal symptoms such as bloating, gas, abdominal pain, and diarrhea.

Can You Grow Out of Lactose Intolerance?

For the most common forms of lactose intolerance, the answer is generally no. However, there are nuances based on how and why the condition developed.

Primary Lactose Intolerance

This is the most widespread type and is caused by a natural, genetically programmed decrease in lactase production over time. Lactase levels typically decline after early childhood, and for many people, this is a permanent change. It's a normal part of human aging, and it is not possible to naturally regain the ability to produce more lactase.

Secondary Lactose Intolerance

This temporary form of lactose intolerance can be caused by an underlying issue that damages the small intestine, where lactase is produced. Conditions such as severe gastroenteritis, celiac disease, or inflammatory bowel disease can lead to secondary lactose intolerance. Once the root cause is treated and the intestinal lining heals, which can take weeks or months, the body may resume normal lactase production, and the intolerance can resolve.

Developmental Lactose Intolerance

This type affects premature babies whose digestive systems are not fully developed. Their ability to produce lactase is temporarily impaired, but it typically improves as they mature.

The Likelihood of Outgrowing a Cow's Milk Protein Allergy (CMPA)

Unlike primary lactose intolerance, a large percentage of children with CMPA will outgrow it. The prognosis depends on several factors, including the type of allergic reaction.

Non-IgE-mediated CMPA (delayed reaction): These babies have a very high chance of outgrowing their allergy, often by age 1 or 2.
IgE-mediated CMPA (immediate reaction): While more persistent, many children still outgrow this type of allergy, though it may take longer, with many resolving by school age (around 5 years old) or even into their teenage years.
Factors affecting prognosis: Children with more severe reactions, higher IgE antibody levels, or multiple allergies are less likely to outgrow it quickly.

How to Manage Milk Intolerance

If you or your child cannot tolerate milk, a proper diagnosis is the first step. Management strategies will differ based on whether the issue is an allergy or intolerance.

Dietary changes for managing lactose intolerance

Limit your intake: Most people with lactose intolerance can handle some amount of lactose, with many tolerating up to 12 grams (about 1 cup of milk) at a time. Experiment to find your personal threshold.
Pair dairy with other foods: Consuming dairy alongside a full meal slows digestion and can lessen symptoms.
Choose fermented or hard dairy: Products like aged cheddar, Swiss cheese, and yogurt with live active cultures are lower in lactose and often better tolerated.
Explore lactose-free products: Supermarkets offer a wide range of lactose-free milk, ice cream, and other products.
Consider lactase supplements: Over-the-counter lactase enzyme pills or drops can help your body digest lactose when you consume dairy.

Managing milk protein intolerance (CMPA)

Strict elimination: Avoiding all products containing cow's milk protein is the primary treatment for CMPA, and for some, this may also include soy. A dietitian can provide crucial guidance on maintaining nutritional balance.
Hydrolyzed or amino-acid based formulas: For formula-fed infants with CMPA, extensively hydrolyzed or amino-acid-based formulas are recommended as they contain broken-down or individual protein building blocks that are easier to digest.
The milk ladder: Under medical supervision, a systematic reintroduction of baked milk products (a "milk ladder") can be a first step toward building tolerance in children with non-IgE mediated CMPA.

Table: Lactose Intolerance vs. Milk Allergy


Feature	Lactose Intolerance	Milk Allergy (Immune-Mediated)
Bodily System	Digestive System	Immune System
Cause	Lack of lactase enzyme to digest lactose sugar	Immune response to milk proteins (casein, whey)
Symptoms	Gastrointestinal: bloating, gas, diarrhea, cramping	Allergic reaction: hives, wheezing, swelling, vomiting
Severity	Unpleasant but not dangerous; varies based on intake	Can range from mild to severe, including life-threatening anaphylaxis
Onset of Symptoms	Typically 30 minutes to 2 hours after consuming lactose	Can occur within minutes, but some forms are delayed
Permanence	Primary is typically lifelong; secondary can be temporary	Most common in childhood and often outgrown; can persist
Management	Dietary changes, lactase supplements, lactose-free products	Strict elimination of milk protein, supervised reintroduction

Conclusion

While the prospect of growing out of a milk intolerance varies, the good news is that management is possible for all types. If you have permanent primary lactose intolerance, dietary adjustments and lactase supplements can provide relief. For infants and children with milk protein allergies or temporary secondary lactose intolerance, there is a strong possibility of recovery, though medical guidance is essential for the reintroduction of dairy. Always consult with a healthcare provider for an accurate diagnosis and a personalized nutrition plan to ensure you or your child receive the right nutrients while avoiding discomfort.

What to Eat Instead of Dairy

If you have to reduce or eliminate dairy, there are many alternatives to ensure you get adequate nutrition, especially calcium and vitamin D. Here are some examples:

Calcium-rich foods: Leafy greens (kale, broccoli), fortified juices, tofu, almonds, and canned salmon with bones.
Dairy-free alternatives: Milks made from soy, almonds, rice, oats, or coconut; yogurts and cheeses made from similar bases.
Lactose-free dairy products: Many brands offer lactose-free versions of milk, ice cream, and other dairy items.
Foods lower in lactose: Hard cheeses (cheddar, parmesan) and some yogurts with active cultures can be tolerated in small amounts by some individuals with lactose intolerance.

Key considerations for your nutrition plan

Get a diagnosis: Differentiate between milk allergy and lactose intolerance with a healthcare professional to guide management.
Seek medical supervision: If your child has a CMPA, any reintroduction of milk should be done under the guidance of an allergist and/or dietitian.
Evaluate permanence: Understand that primary lactose intolerance is typically lifelong, while secondary can be temporary, and infant CMPA is often outgrown.
Maintain nutrient intake: Ensure sufficient calcium and vitamin D from alternative foods or supplements if dairy is eliminated.
Read labels carefully: Be aware of hidden lactose and milk proteins in packaged and processed foods.

Frequently Asked Questions

A milk intolerance (usually lactose intolerance) is a digestive problem caused by the inability to break down milk sugar, leading to symptoms like gas and bloating. A milk allergy is an immune system reaction to milk protein, with symptoms ranging from hives to anaphylaxis.

Primary lactose intolerance, the most common type that develops over time, is permanent. However, secondary lactose intolerance, caused by intestinal damage from illness, can resolve if the underlying condition is treated and the small intestine heals.

Yes, it is very likely. If a baby has a cow's milk protein intolerance, they have a high chance of outgrowing it, with many becoming tolerant by age 1 or 2. Premature babies with developmental lactose intolerance also typically recover as their digestive systems mature.

A milk ladder is a gradual, step-by-step process of reintroducing dairy products, starting with small amounts of baked milk, to a child who has been diagnosed with a delayed-onset cow's milk protein allergy. This should only be done under medical supervision.

Many people with lactose intolerance can tolerate small amounts of lactose. By having small servings, consuming dairy with meals, or choosing low-lactose products like aged cheese and yogurt, you can often manage symptoms.

A severe, immediate reaction may indicate a life-threatening IgE-mediated milk allergy. You should seek immediate medical attention and consult an allergist for diagnosis and management.

Lactase supplements, available in pill or drop form, can help your body break down lactose and reduce symptoms. They are effective for many people with lactose intolerance but should be used in consultation with a healthcare provider.

Yes. If you significantly reduce or eliminate dairy, you need to ensure you get enough calcium and vitamin D from other sources to maintain bone health. Options include leafy greens, fortified foods, and supplements.

If you are breastfeeding and your infant has symptoms like blood or mucus in the stool, irritability, or poor growth, your pediatrician may recommend you eliminate dairy and soy from your diet to see if symptoms improve.

Yes. The genetic predisposition for lactose intolerance varies widely. It is less common in people of Northern European descent and more prevalent in individuals of Asian, African, and Native American heritage.