An all too common picture in my practice is meeting a young child who is growing weakly or even presenting with failure to thrive (unable to grow above 5th percentiles), developing at a questionably slow pace, and behaving fiercely at the drop of a hat (tantrums). There may be reflux and constipation, possibly medication dependent. Worst case scenario, the child has required tube feeding, or perhaps even lost a section of intestine to tissue damage or inflammation. Parents are weary and have been around the block: Specialists in GI disorders, developmental pediatrics, feeding therapy, and perhaps a neurologist or speech and language pathologist have all had their go’s at the child, but – improvements – if any – are meek, and dependent on pharmaceuticals or weekly therapies.
Maybe your child isn’t this bad. Perhaps they just like a lot of dairy food. Even in that case, you might be surprised at how differently your child behaves, grows, sleeps, or interacts, once that dairy protein (casein) is no longer a major feature in their day. There’s absolutely nothing magical about dairy. Many other foods can deliver protein, better healthy fats and oils, and more minerals, including calcium.
What’s going on here? This mechanism is not an allergy (though allergy or sensitivity may be present at the same time – that’s a different reaction altogether). In this case, a chemistry has evolved in which your kid is literally addicted to milk. You can measure this with a urine test. This is not a standard-of-care test, and your pediatrician will likely never have heard of it. Called urine polypeptide test, it screens for the protein fragments (“peptides”) leftover when dairy protein (casein) is poorly digested. It also screens for same from wheat protein (gluten). These over-sized peptides exist to a tiny, insignificant degree, after a healthy gut with good digestive function takes apart a wheat or dairy meal. But with weak digestion, an overly permissive gut wall (that is, a gut that lets these too-big peptides pass through to circulation), and the wrong gut bacteria (that worsen rather than lessen the impact of these peptides), these peptides will show up in urine in larger than expected amounts.
If they’re in urine, they are circulating widely, and can also be in your child’s brain. Why is this bad? Because these peptides mimic opiates – so much, that they are named after morphine: Casomorphin and gluteomorphin (also called gliadorphin) act like opiates in the brain. They bind the same receptors as drugs like morphine.. and yes, heroin. They are indeed potently addictive. Children who adamantly refuse foods other than just wheat, just dairy, or both may have this addiction active in their brains.
Not only does this deny a child other more nutritious foods needed for their brains and bodies to grow and thrive, it can cause constipation (ever needed a morphine drip or opiate-based painkiller?), and disrupt behavior, learning, social skills, and language development. In my experience, the more diet-sourced opiate measured in urine, the less verbal and more developmentally delayed the child will be. In fact, clinical trials with naltrexone, a drug used to treat opiate addiction, have shown better behavior in children with autism and increased verbal ability.The more functional the child is, the less likely that casomorphin will fall out of range – but if symptoms are active for constipation, hyperactivity, difficulty socializing, rageful reactivity, slow language progress, or dilated pupils, then I will look at eliminating the dairy anyway.
Most every child in my practice, whether they have an autism or sensory processing disorder diagnosis or no diagnosis at all, presents with nutrition challenges that can be addressed for better learning, growing, and being. Your child doesn’t have to be “special needs” to have a problem with dairy – see if the info below applies in your house.
What’s A Milk Addicted Kid?
These are kids who still rely on fluid milk as a major protein and calorie source, well past the age of twelve months, when weaning off breast or formula – as the bulk of daily calories and protein – is typically under way. They are drinking forty to sixty ounces of milk a day (about five to eight cups), and displacing solid calories because of milk intake. This lowers intake of other foods that kids need by age two or three. Milk addicts refuse other foods. They are often oral tactile defensive – that is, they hate varied textures in foods, hate to eat or chew, perhaps have delayed chewing skills (which is why some stick to the bottle in the first place), or still rely on suckling a bottle, thumb, or pacifier to calm themselves. Oral tactile issues or oral motor delays may keep this child drinking from a bottle beyond age three or four. When they accept foods, it’s often dairy items only – sweet yogurt, cheese, ice cream. A few random solids might be in the diet, but on balance, their diets lack vegetables, meats, fruits, or foods rich in essential minerals, vitamins, and healthy brain fats. There is often pallor, allergic shiners, white dots on fingernails, and a blank countenance. Growth failure or a weak growth pattern is common in this scenario too. Parents in this predicament are often told by their doctors and feeding therapists to turn to high-calorie milk-based drinks like Pediasure, Peptamen Junior, Carnation Instant Breakfast, or Boost, in hopes of providing a few micronutrients and extra calories. This won’t work, because it leaves the child addicted to opiates formed from casein, the protein source in these drinks. For non-dairy nutrition boosting options, click here.
These children often have neurological and sensory challenges that make a cold-turkey switch off of milk a sure fail. If bottle feeding is still in the picture, the cold turkey approach can really backfire, entrenching your child’s dependence on the bottle or milk, and fear of losing these, even more deeply. In this scenario, you need a nutritious milk replacement, minerals replenishment, correction for imbalanced gut microbes, and a sensory integration plan to replace the neurological organization that sucking on the bottle gives the child.
Developmentally, milk addicts (especially those with an autism diagnosis) who eat a lot of dairy seem to show the more profound language delays. When they are on the younger end, say age three or four years, they may speak more like a one to two year old, or be non-verbal. If they are school age, say six or so, they may have expressive language praxis issues, meaning that they can talk but not in a typical way. They may use echolalic language (repeating what they hear), misuse pronouns or refer to themselves in the third person, or misunderstand social context. This is often the first area of functioning that shifts when dietary opiates begin to disengage: Your child may begin to use language in a new, more typical way; make eye contact; or comply more typically with your requests.. within 2-3 weeks of being dairy free.
What To Do About Milk Addiction
1 – Talk to your child’s occupational therapist, if you have one, about what can replace the bottle in terms of its sensory benefit. Children with sensory integration disorder using a bottle at a late age may legitimately need this oral activity for self-calming, which they might not have mastered in other ways. Suddenly removing it with no alternative may trigger more setback than progress. A few inches of surgical tubing can be knotted for a child to suck, chew, and pull. Teething rings as for infants may work too. If your child craves and actually eats non food items, this is another problem called pica. It needs assessment and treatment, as it too can impair IQ, learning, or development. Read about pica here.
2 – Replace any gluten foods first. Since gluten is not the opiate of choice for a milk-addicted child, it’s easier to remove it first. In my experience, kids don’t usually notice that the cookies, pasta, bagels, microwave macaroni and cheese, frozen pizza and so on are being replaced with gluten-free versions, as long as they still have their dairy fix. But gluten still has to go, because gluten can trigger the same opiate effect on the brain that milk protein does. Same goes for soy – so, don’t turn to soy milk, soy tofu, soy frozen treats, soy cheese substitutes, edamame, soy yogurt, and so on. Swap in the widely available gluten free versions first, with zero fanfare – and zero explanation, unless your child is functional enough to ask a few questions. Do not expect your child’s approval or even recruit their opinion at this point.
3 – After you’ve successfully launched the transition off any gluten foods that your milk addict eats (and some eat very few, so this can be easy), approach the bigger battle: Withdraw all dairy protein (casein and whey). Begin with casein-free ingredients where they won’t be noticed. When baking, making smoothies, mixing mashed potatoes, or using a pancake mix (gluten free), sub in milks from almond, cashew, hemp, coconut (full fat canned or from carton) but not oat (contains gluten) or soy. Do not use soy milk or soy yogurt – it will trigger the same opiate chemistry. Eventually, your child will completely avoid fluid milk from any mammals (including you mom!) and products made from those milks: Butter, margarines with milk ingredients, cheeses, yogurt that is frozen, creamy, Greek, low fat, any fat, or fat free; Lactaid and lactose free milk (still has casein in it); cream soups and dressings (Ranch dressing, chowders, soups thickened with cream or milk), ice cream, sherbet, pizza or anything else with cheese, Goldfish or Cheezits or cheese puffs, and so on. Avoid foods whose labels say casein, whey, calcium caseinate, powdered dry milk, butter milk, cream, sour cream, cottage cheese, cheese, Parmesan, milk solids, or butter. “Dairy free” does not mean casein free, so read labels carefully.
4 – Balance gut microflora as aggressively and completely as possible. This may necessitate a functional medicine stool microbiology to assess the good and bad gut bugs, plus targeted use of probiotics, antibiotics, herbal anti-microbials, or fermented foods. Long short, if none of this is working, a troublesome gut biome would be high on my suspect list – so get this part sorted out. Need help? Contact me!
5- Begin nightly Epsom salts baths to replenish magnesium and sulfur. Both minerals help liver, gut, and kidney tissue release toxins that may pile up as your child’s gut biome shifts with the new foods he’s eating. Magnesium is calming as well, while sulfur is key for many digestive and liver enzymes. Use about a cup per tub, or a half cup for a toddler weighing less than 30 lbs. Soak your kiddo for 10-20 minutes.
6 – Put in some healthy fats! Oils from nuts, olive oil, coconut oil, ghee (clarified butter), avocado, grape seed oil are all excellent and healthful choices that you can sub in for cooking, baking, and dressings. Nut butters and nuts themselves also provide healthy varied fats. Fish oil supplements are a useful boost too, since milk addicts don’t get much (if any) omega 3 fatty acids. There are some excellent kid friendly products out there.
7 – Minerals! Supplement these until interest in mineral rich foods kicks in. Minerals are abundant in leafy greens, vegetables, bone broths, meats, eggs, and herbs. But before your kid is eating that stuff daily, bridge the gap with a mineral rich supplement. It should contain at least 15 mg zinc and cover selenium, chromium, manganese, molybdenum, and boron also. What about iron? Hard to say without you being my patient and completing an assessment with me. Iron is potentially toxic and deadly if dosed incorrectly. If marginal, it creates multiple functional problems (insomnia, hyperactivity, immune compromise, depleted serotonin and more). But don’t supplement it without guidance from your doctor. Or me.
You’re Good To Go!
The first few weeks of this may feel hardest, but stick with it – for a good four months at least. Some children respond quickly, some slowly. It all depends on the child’s nutrition picture at the start, and everyone is different. But one thing that usually happens in the first one to three weeks of total casein (and gluten and soy) removal is… Fireworks! When the opiates begin to vacate endorphin receptors in his brain, your child may start to be very unhappy with this new plan. They are experiencing withdrawal symptoms and it doesn’t feel great. The may stop eating, have more tantrums, not sleep well. Brace yourself – but don’t crack now. If you’ve done all of the steps here faithfully, you will minimize or possibly even totally divert the discomfort that this new food intake may briefly create. It’s temporary, and it is prelude to much healthier eating that feeds your child so he can learn, grow, and thrive to potential.