For example,
I like chocolate, vanilla, and lemon and orange ice cream.
Indicating "lemon and orange" is a combined flavor, as an item in the list needing an initial and.
For example,
I like chocolate, vanilla, and lemon and orange ice cream.
Indicating "lemon and orange" is a combined flavor, as an item in the list needing an initial and.
I can use one and and another and, and still another and. I can use many ands in the same sentence, and so can you. And on and on and on.
I might hyphenate lemon-and-orange ice cream, though, in your particular case.
You can repeat and as often as you like if you think it conveys your meaning. There is no rule of English grammar that limits its use. The placing of a comma after vanilla makes all the difference. Without it, the sentence leaves open the possibility that your preference is not for lemon and orange ice cream, but for vanilla and lemon ice cream.
You certainly can use "and" more than once in a sentence, but in this case I would consider rewording it somehow instead. I would definitely not use an ampersand. Actually, I think removing the second "and" would make the meaning much clearer. Try: "I like chocolate, vanilla and lemon-orange ice cream."
The sentence is correct as written and does indicate that lemon and orange is to be treated as unit comparable to chocolate. However it may be unclear to some readers, and resists being read quickly.
You might want to consider using lemon-orange to describe the flavor. It is unabiguous and scans quickly and easily.
The general guidance is that the combinations are the first element and have a noun. The second, separate, element has a repeated noun:
A: "What ice cream do you like?"
B: "I like lemon and orange ice cream,[pause] and chocolate ice cream and vanilla."
I prefer "and" when connecting clauses and an ampersand when connecting something within that clause. For example "I like chocolate, vanilla, and lemon & orange, ice cream."