The GAPS protocol has two options to introduce dairy.The first and most common option is outlined in the ‘Introduction Diet’ and the Second option is outlined in the ‘Dairy Introduction Structure’ which is for those who have shown an allergic reaction after doing the ‘Sensitivity Test’ or for those who, for whatever reason, have chosen to follow the Full GAPS Diet. Before we discuss these two options, it is important to know why milk is a problem.

The GAPS Program promotes the avoidance of lactose because it cannot be digested by people with GAPS and digestive problems. When milk is fermented for 24 hrs or more to make yoghurt or kefir, it becomes virtually free of lactose because the fermenting bacteria consume the lactose as their food. Although a small percent of lactose exists in fermented dairy, it will be broken up by the probiotic microbes in your gut that are constantly re-establishing themselves on the GAPS program. Fermenting Yoghurt or kefir longer than 36 hours will reduce the lactose even further for very sensitive people but the taste will be much stronger.

Another commonly alerted concern is casomorphins from the misdigestion of milk protein casein which causes further problems because it gets absorbed through the damaged gut lining into the blood stream, and across the blood brain barrier which affects the functions of the brain, presenting with different GAPS conditions. It is not until dairy is removed that we begin to see improvements in the majority of cases, however when milk is fermented at home, the majority of the proteins get pre-digested, allowing GAPS adults and children to better digest it.

Dairy allergies and intolerance's should also get a mention, especially if there is an anaphylactic type reaction to which dairy must be avoided. Dairy products have many proteins that are antigenic, which means they have the ability to execute an immune reaction or response. However, in the process of fermentation, these immunoglobulins get broken down.

Therefore, the process of fermentation will allow the majority of lactose to be consumed, whilst digesting the proteins and breaking down immunoglobulins.In addition to this, the lactic-acid will sooth an inflamed gut whilst providing many beneficial vitamins and active enzymes that are essential to the GAPS program.

The Sensitivity Test

The sensitivity test should be conducted every time dairy is introduced, whether it be yoghurt, kefir, ghee or cheese or whether it be at the beginning of the program, the middle or end.It is highly encouraged to test every dairy item regardless of what stage you are at.

The Sensitivity Test Instructions: Take a drop of your homemade yoghurt, sour cream, kefir, ghee or butter (whichever one you are introducing at the time) and apply it to the inside of the wrist at bed time.Let it dry on the skin and let your patient go to sleep.Check the spot in the morning to see if there is a reaction.

If there is no reaction: go ahead and introduce dairy as outline in the ‘GAPS Introduction Diet’.

If there is an angry red reaction: this will indicate that you have an allergy and you should then implement the GAPS ‘Introduction Diet’ without Dairy.Then, later in the diet when some healing has taken place you can try again by following the steps outlined in the ‘Dairy Introduction Structure’ but this time you will start the sensitivity test with ghee.

If you find that the patient has a reaction to yoghurt or kefir, you may find that the patient can tolerate ghee very well because ghee is pure milk fat (clarified butter) which contains virtually no milk proteins or lactose and is generally well tolerated. Pure milk fat is considered by many to be casein free because the milk protein is removed. If there is no reaction to ghee on the sensitivity test, ghee can be introduced in the second stage of the ‘Introduction Diet’.

Which milk should I choose for fermenting?

Goats milk is easier to digest than cow’s milk and preferred by some GAPS people, however, both goat’s and cow’s milk are appropriate for GAPS. According to an article on making baby formula at the Weston A Price Foundation, an important note has been made regarding goat’s milk for infants and young children, advising ‘although goat milk is rich in fat, it is very important to consider its lack of folic acid and low content in vitamin B12, both of which are essential to the growth and development of the infant or young child’ and notably deficient in majority of GAPS patients. If you choose goat’s milk you may compensate for low levels of vitamin B12, by consuming more organic raw or cooked chicken liver.

It is vital to choose organic milk so that it is free of chemicals, pesticides and antibiotics. Alive raw organic milk is even better if you can get it. Alive Raw milk is full of life and live enzymes that will help digest the milk for you leaving very little work for your digestive system.

Pasturised milk destroys all the nutrients and alters its biochemical and physical structure, making it difficult for us to digest and assimilate. This process in-turn causes allergies and other problems. Hundreds of generations before us gave babies raw milk straight from the cow without any problems. It was when we began to process the milk and pasturise it declaring it dead and void of any enzymes and stripping its nutrients that dairy intolerance, sensitivities and allergies began to emerge.

If you are making yoghurt or kefir with raw organic milk which has not been pasturised or processed in any other way, you do not need to heat it before placing it into the yoghurt maker for fermentation.When yoghurt has been made on raw milk it will produce a different result to yoghurt made on pasturised milk and appear to retain more liquid (whey) and unpredictable lumps. Most people are used to the smooth textured yoghurt and if this is the result you prefer, then you should heat the raw milk close to boiling point first so that the bacteria content is better controlled.Gentle heating at home is not as drastic as commercial pasteurisation practices and the long fermentation process will restore a good deal of its vital nutrients.

How to introduce dairy

The ‘Dairy Introduction Structure’ for the Full GAPS Diet

Dr Natasha has found in her clinical experience that only 10% of GAPS patients are sensitive to dairy from the beginning and that these people should introduce dairy as per the ‘Dairy Introduction Structure’ outlined in the GAPS book. The introduction structure is for the following people:

1.Those who have shown an allergy to dairy on the ‘Sensitivity Test’

2.Those who have chosen to follow the Full GAPS Diet and not the ‘Introduction Diet’

All others should introduce fermented dairy as per the introduction structure.

The following is a summary of the ‘Dairy Introduction Structure’

• 1. Introduce homemade ghee; no other dairy is allowed for an average of 6 weeks.
• 2. After about 6 weeks, if the ‘Sensitivity Test’ is negative, you can try to introduce organic butter because it is virtually pure milk fat, containing minimal amounts of whey.Make sure it is organic and unsalted (preferably raw).Watch for any reactions.Also continue with the use of ghee.
• 3. After about 6 – 12 weeks, if the ‘Sensitivity Test’ is negative, you may introduce yoghurt and sour cream. If there is a negative reaction, wait a month and try again. Continue with Ghee and butter.
• 4. When yoghurt is well tolerated and after you test negative on the sensitivity test, you can try to introduce Kefir and Kefir cream which also contains some good yeasts.
• 5. Cheese is one of the more difficult dairy products to introduce and some people can’t tolerate it at all.At this step, you can try a mouthful of organic cheddar cheese with a meal.Watch for any negative reactions.This can take a few days as it may be delayed.If there is no negative reaction, you can try increasing the amount and trying another natural cheese listed in the GAPS book. This should only be introduced when homemade yoghurt is well tolerated.
• 6. Most people should be ready for this step after about two years on the program. Try some commercially available live natural yoghurt.At the end of the second year, fresh cream can be added to the list.

In about 2.5 years and when all dairy products are introduced, your patient may be able to drink raw unpasteurised organic milk.Introduce it gradually starting from 1-2 teaspoons a day. A GAPS person must never have pasteurised milk!Raw milk contains live enzymes which make it easier for the body to digest.It also contains live vitamins, amino acids, proteins, essential fats and many other important nutrients.

How can I tell if I am not ready to introduce milk protein foods?

When introducing milk protein foods, be sure to monitor closely. If you observe any kind of regression, reduced eye contact, self harming, aggression, stimulation, sleep disturbance, hyperactivity, worsening of allergies, eczema or additional behaviour outbursts, then this would indicate that the person may not be ready to introduce this food yet and that more healing time is required. However it is often difficult to distinguish between a die off and severe sensitivities. The introduction of fermented dairy can often trigger bouts of eczema but if the gut has shown all other positive signs of healing and you have given it plenty of time, then persisting with small progressive amounts are encouraged and you will likely find that the eczema eventually corrects itself. This reaction could last a few days or months at a time because it often takes this long for the lactobacillus acidophilus to colonise as an established guardian in the gut. Do the sensitivity test first if you suspect a true allergy.Other more severe cases of eczema, asthma, long standing cases of schizophrenia and cases complicated with epilepsy may need to avoid dairy proteins forever.

Introducing Dairy on ‘The Introduction Diet’

I find that many people starting GAPS and the introduction diet are very concerned about introducing dairy from the beginning however Dr Natasha emphasizes that majority of GAPS adults and children tolerate homemade yoghurt, kefir and sour cream perfectly well as a part of their ‘Introduction Diet’.

The following is the sequence of steps for introducing dairy if you are implementing the ‘Introduction Diet’. Please refer to the ‘Introduction Diet’ steps to know when to commence introducing each dairy protein food.If you have not followed the ‘Introduction Diet’ and started with the Full GAPS diet, please introduce dairy as per the ‘Dairy Introduction Structure’ outlined above and as described in the GAPS Book.

• First start by introducing some whey from dripping your homemade yoghurt (dripping will remove some of the more difficult to digest proteins): start with 1 teaspoon of whey added to the soup or meat stock per day.
• After 3-5 days on 1 teaspoon of whey per day, increase to 2 teaspoons a day and so on, until your patient is having ½ a cup of whey per day with meals.
• At this stage, try to add 1 teaspoon per day of homemade sour cream and gradually increase the daily amount.
• After sour cream is well tolerated, you can introduce homemade yoghurt.
• After yoghurt is well tolerated, you can stop adding the whey and introduce homemade kefir. The kefir probiotic strains and good yeasts are far more aggressive than yoghurt and usually create a more pronounced “die off reaction”. That is why yoghurt is recommended first before starting on kefir.
• At this stage, all items of fermented dairy can be enjoyed. If you are prone to constipation, it is best to stick to sour cream and you can also make your kefir with cream to produce kefir sour cream.If you are prone to diarrhoea, whey, yoghurt and kefir are good.
• Homemade ghee can be introduced regardless of constipation or diarrhoea and is generally well tolerated by gaps patients. Ghee can be introduced in stage two regardless of whether all the above dairy products have been completely introduced starting with one teaspoon a day.

Whilst the above steps indicate a general time frame for increasing each amount, it is best to gauge the person’s response in order to control the die off reaction and introduce slowly and methodically.

Important acknowledgement

Butter and ghee provide many valuable nutritional benefits that GAPS adults and children should not avoid forever unless there is a true allergy. Butter and ghee provide Arachidonic Acid (AA) which makes up 12% of the brain’s fat and GAPS adults and children are deficient in it. Furthermore butter and ghee provide additional important fatty acids, vitamins A, D, E, beta-carotene and other nutrients that are easy to digest.

Fermented dairy, especially kefir are vital components to GAPS (if you do not have a true allergy) so do not be afraid to re-introduce it and try again before deciding to give up on it all together. Kefir alone has over 30 different beneficial strains of good bacteria, including a variety of yeasts.If like some, you have concerns with introducing dairy too soon, try buying some young green coconuts and make some homemade coconut kefir (this can be introduced in stage 3 when die off symptoms have settled but start with tiny amounts.