On the promise of a plant-based alternative, a customer ordered oat milk coffee at Jakarta’s Tuku coffee shop earlier this month.

But what she did not realize was that the oat milk used still contained cow’s milk, which triggered her milk allergy and sent her to the hospital.

“[If coffee shops] provide an option to use oat milk at an additional charge, please don’t mix it with regular milk [...],” Wulan Mega lamented on Aug. 2 on Instagram stories and X, formerly Twitter.

“There are customers out there who choose to have oat milk not for the aesthetics, but because we actually have a milk allergy,” she said.

Support poured in for Wulan, with many other users commenting that they also suffered from the lack of awareness among local food outlets about lactose intolerance.

While milk allergy is an immune problem and lactose intolerance is a digestive issues, ingesting dairy products can cause similar symptoms that range from intestinal problems to life-threatening allergic reactions.

The Tuku management has since apologized to Wulan for the incident and fixed their milk options on delivery apps, but it has highlighted the dissonance between the commercial use of plant-based products and consumers’ dietary restrictions.

Irritating condition

While she has not gotten a clinical diagnosis, 24-year-old Agnes cannot consume any milk or dairy products, else she will have a stomachache for the whole day.

“I only realized this during university when I started drinking milk coffee. I did not grow up drinking milk at home,” she told The Jakarta Post on Aug. 8.

“I’ve tried plant-based milk, and although it doesn’t affect my digestive system, its nutty flavor tastes weird to me,” she said.

Others, like 44-year-old creative entrepreneur Grace Wiroreno, only realized they were lactose intolerant later in life.

“It was when I hit 40 that I started experiencing digestive problems, and through the process of elimination and watching another lactose intolerant friend, I found out that you could have adult onset of the [condition],” Grace told the Post on Tuesday.

As the body ages, it can suddenly stop producing the enzyme lactase, which is necessary to break down lactose so it can be digested. Lactose intolerance basically describes the body’s inability to digest lactose, a sugar found in milk and dairy products.

Meanwhile, beauty industry veteran Affi Assegaf was diagnosed in 2013 with lactose intolerance and having an autoimmune disease that cannot tolerate dairy products, so she must be very careful about avoiding dairy products and ingredients in the food and drink she consumes.

“Thankfully, more alternatives that are lactose-free are easier to find these days in [local] food outlets,” she said.

Food alternatives and dilemma

Affi and many like her generally do not worry when they want to eat out, as traditional Indonesian foods don’t contain dairy products like milk or cheese. And while santan (coconut milk) is a common ingredient, it is naturally lactose-free.

“I’m not really into pizza or desserts, and when I drink coffee, I’ll just take it black,” said Grace.

If she craves ice cream, Grace takes a lactase supplement like Lactaid to provide the enzyme her body needs and she can have her ice cream without any stomach pain. But Lactaid is still imported and is yet to reach the wider market beyond online sellers.

In recent years, plant-based alternatives to dairy have become a mainstay on menus at Indonesia’s food outlets, especially coffee shops.

Research by Rakuten Insight in 2022 showed that 86 percent of Indonesian respondents had tried plant-based milks, though the study did not indicate if they did so for health reasons or as a lifestyle choice.

“At first, I assumed that the growing trend in plant-based milks was also catering to those who cannot consume milk aside from diet-oriented people like vegans,” Affi said.

But after her incident at Tuku, she said she started wondering if some food outlets weren’t informed about the basic reason for offering plant-based milks and were simply following “the rising demand”.

Adhif, the 24-year-old owner of a coffee shop in South Bandung, West Java, admitted that he started offering plant-based milks due to sudden demand among consumers. Along the way, though, he realized that consumers with lactose intolerance needed them as substitutes for cow’s milk.

“We have completely replaced dairy milk with plant-based ones, though I have to say, it’s hard for people to find completely lactose-free milk coffee in the country because some outlets still use regular dairy creamer instead of nondairy ones in their coffee,” Adhif said.

Need for more awareness

The use of allergens like lactose or gluten in food is actually regulated in the country. In 2016, the Food and Drug Monitoring Agency (BPOM) issued regulation No. 13 as an update to a 2011 rule on the importance of listing major allergens on food labels and packages.

Under that regulation, food products that conventionally contain lactose must be labeled low-lactose or lactose-free.

But the BPOM regulation does not apply to the menus of restaurants, cafés and other retail food outlets.

“People also have an option to buy fermented milk, which is also lactose-free, though not many people know that,” said Epi Taufik, a lecturer and expert on milk biochemistry at IPB University.

Epi also said some local dairy milk brands had been processed so they were lactose-free, but were still rarely found on supermarket shelves. According to him, the only available brand so far was MilkLife.

At the same time, these products’ exposure was still fairly low compared to plant-based milks.

“I think the awareness is already there, it’s just that smaller coffee shops and restaurants might not be aware of how important [lactose-free products] actually are,” said Agnes.

As for Affi, she hopes to see more information about lactose content on menus.

“We’re just hoping for more transparency about how much dairy is in the food and drink we buy, since it directly affects our health,” she said.