I will be posting more on this topic later as I get the information but I just had an interesting conversations with a mother, the school cook, and one of the state inspectors this week.  This is the situation.  This girl, now 5, will be starting kindergarten in the fall.  When she was an infant the mother breastfed , but we noticed that when ever the mother consumed cows milk, the child was more fussy, gassy, colicky and also had more ear infections.  As she aged she still did not tolerate cows milk.  The mother told me this week that she needed a note from the doctor for her daughter to have orange drink instead of cows milk at lunch and at the milk snack break.  I told her this was not a problem, I would give her the note, but I wanted to know why the school will not honor a note from the parent.

Well my request for documentation of the requirement that a physician write the note went way over the head of the school cook, who is only concerned that she have a note on file and seems to have no concern as to why this is needed.  She only expresses that she was told by the previous cook that she had to have a note, and that is all the "proof" she needs.  I eventually talked with a helpful inspector of the school lunch programs for our state who said she would send me some of the copies of the regulations.  One of the things that she said to me was that the federal regulations only allow for substitutions in the case of "life threatening reactions".  Apparently bad belly aches from cows milk, or mild rashes from strawberries don't qualify as "life threatening".

Also neither the school cook or the state inspector could give me firm answers about documentation would be required if the child was to be granted an exception based on religious grounds.  It seems in that case of eating pork for a Muslim or a Jew, only the parents statement is sufficient.  Apparently no note from the Rabbi or Iman (spelling?) is required, of course we have neither religious present in our small rural Iowa school.  I didn't think to ask them what would be required if the child was suppose to be a vegetarian that did not consume milk products, or eggs for that matter.

I know that this may be slightly long and a bit on the fringe or BF related, but I think it has implications about showing how pervasive the influence of the diary lobby is in the minds of many and in the regulations of the government, that have undoubtedly been influence by the dairy lobby.  I wonder what percent of the annual dairy production in the US is used in the production of infant feeding products? Neither the cook or the school inspector seems to be aware of the fact that many people of Asian or African ancestry do not tolerate cows milk as well as those from Northern European extraction.

My point is of posting this to Lactnet is to ask for those that have had similar problems or encounters in the past to email me so that I can pass on to you the regulations as they come to me.

Sincerely, 

Jon Ahrendsen MD FAAFP
Clarion, Iowa 50525