How Do You Know If A Newborn Is Lactose Intolerant

How Common Is Lactose Intolerance In Babies

Most people with a lactose intolerance dont develop symptoms until later in life when their bodys natural production of lactase the enzyme that helps the body digest lactose declines.

This decline doesnt usually take place until later in childhood, during the teenage years, or in adulthood. So lactose intolerance in babies under age 1 is pretty rare but its not impossible.

Can Lactose Intolerance Cause Immediate Diarrhea

Lactose intolerance typically produces gastrointestinal symptoms such as gas, bloating, and diarrhea 30 minutes to two hours after consuming milk or other lactose-containing dairy products. Lactose intolerance is also called âlactose malabsorption.â Symptoms of lactose intolerance may be mild or severe depending on how much lactose is consumed. If you are able to consume small amounts of milk without experiencing problems, then your body is likely tolerant of the protein casein as well as the sugar lactose. However, if you have large doses of either protein or sugar, your body will respond by producing acids that cause pain throughout your digestive system.

Diarrhea is the passage of many watery stools in a short period of time. It is usually caused by a specific problem with one of the organs involved in digestion â the intestines, pancreas, or colon. Diarrhea can be categorized as having liquid or solid content. Liquid diarrhea contains many watery bowel movements daily. Solid diarrhea consists of very soft or slightly hard stools.

If you are drinking liquids to stay hydrated but are still passing out diarrhea, you may want to consider additional electrolytes. These can come in the form of supplements or additives found in some foods and beverages.

Treatment And Management: Lactose Intolerance In Older Children And Teenagers

If your older or teenage child is diagnosed with lactose intolerance, you can reduce the amount of lactose in their diet. But you dont need to get rid of products with lactose completely, especially if your child eats only small amounts of them with other foods during the day.

Your child can usually eat:

• cheeses with very low lactose content brie, camembert, cheddar, colby, edam, fetta, gouda, havarti, mozzarella, parmesan, halloumi, Swiss and Tilstat
• yoghurt the bacteria in yoghurt breaks down the lactose so its usually fine for your child to eat
• calcium-fortified soy products soy yoghurt, soy milk, soy ice-cream and soy cheese
• lactose-free cows milk
• butter and cream these contain only small amounts of lactose and are usually fine to eat
• bread, cereals, fruit, vegetables, meat and other protein foods
• full-fat milk the fat in full-fat milk gives your childs body longer to digest lactose.

Your child should be careful about eating:

• milk ice-cream and milk desserts
• cream cheese, processed cheese and cheese spread
• instant mashed potato and vegetables with added milk or white sauces.

You or your child should check the ingredientsin:

• biscuits, cakes and cake mixes

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How Is A Milk Allergy Diagnosed

If you think your infant is allergic to milk, call your baby’s doctor. He or she will ask you questions and talk to you about what’s going on. After the doctor examines your baby, some stool tests and blood tests might be ordered. The doctor may refer you to an allergist .

The allergist might do skin testing. In skin testing, the doctor or nurse will place a tiny bit of milk protein on the skin, then make a small scratch on the skin. If your child reacts to the allergen, the skin will swell a little in that area like an insect bite.

If the allergist finds that your baby is at risk for a serious allergic reaction, epinephrine auto-injectors will be prescribed.

How Do I Know If My Baby Is Sensitive To Lactose

If you think your baby might be sensitive to lactose, make an appointment for an exam with your babys pediatrician. Many suspected cases of lactose intolerance actually turn out to be other simple digestive issues that are easily managed. Its a good idea to come prepared and bring a list of questions with you.

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Damage To The Intestinal Lining

If there is any damage to the intestinal lining it can affect the production of the enzyme lactase which is produced in the delicate brush borders of the babys intestines. Types of damage include inflammation , bacterial or viral infection or antibiotic use. Other possible causes of damage include partially digested formula, parasites, and some mothers notice a connection with live vaccines such as rotavirus . If there is not enough enzyme, large amounts of lactose can pass undigested to the lower bowel. Here it will be fermented by bacteria giving the familiar symptoms of gas, discomfort and lots of green watery stools.

Damage to the brush borders may take some time to heal. Joy Anderson says:

Excerpt from

Lactose Intolerance and the Breastfed Baby, Australian Breastfeeding Association, 2017

Average recovery time for the gut of a baby with severe gastroenteritis is 4 weeks, but may be up to 8 weeks for a baby under 3 months. For older babies, over about 18 months, recovery may be as rapid as 1 week.

Treatment: Lactose Intolerance In Babies

The treatment for lactose intolerance in babies often depends on the cause. And no matter whats causing your babys lactose intolerance, its important to soothe and comfort your baby when theyre showing symptoms.

Congenital lactase deficiency If your baby has congenital lactase deficiency, your GP, paediatrician or dietitian will guide your childs treatment.

Secondary lactose intolerance For a breastfed baby with secondary lactose intolerance caused by gastroenteritis, you should be able to keep breastfeeding.

Weaning off breastmilk isnt usually recommended. This is because breastmilk has so many nutritional benefits and lactose is good for your babys growth. Your child can usually tolerate a small amount of lactose, and gradually increasing it can help your childs body produce more lactase.

If your baby is formula fed or youre considering giving them formula, consult your GP or a dietitian before using or changing to a low-lactose or lactose-free infant formula. If your child is under 6 months, avoid using soy-based infant formula.

Talk to your GP if youre thinking of using Lacteeze drops in expressed breastmilk or Lacteeze tablets. Theres some debate about the effectiveness of these treatments. Also talk to your GP if you want to try replacing breastmilk or alternating breastmilk with formula, or youre generally worried about your babys nutrition.

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Symptoms Of Cows’ Milk Allergy

Your child may have symptoms within minutes of having cows’ milk or formula made from it. In other cases, problems might not happen until hours or even days afterward.

There are lots of possible symptoms:

• Digestion problems, including tummy ache, being sick, diarrhoea, and constipation
• Skin reactions, such as swelling of the lips, face, and eye area, and a red, itchy rash
• Hay-fever-like symptoms, such as a runny nose and watery eyes
• Eczema that doesn’t get better with treatment

Sudden, severe symptoms are rare but can include swelling of the mouth or throat, wheezing, shortness of breath, and difficulty breathing — a severe allergic reaction called anaphylaxis, which can also make your child feel faint or become unconscious. This is a medical emergency that requires calling 999 or going to A& E immediately.

What Is Lactose Intolerance

Your child may have a different type of reaction to cows’ milk, or formula made from it, called lactose intolerance. This is when their body can’t digest lactose, which is a type of natural sugar found in milk.

About 70% of people in the world have lactose intolerance. It’s more common among people from Asian, African, and Hispanic ethnic groups.

Babies and young children can also become temporarily intolerant to lactose after they’ve had a tummy bug or another condition.

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Diagnosis And Dietary Changes

Itsquite easy to test for lactose intolerance. Its done using a lactose breathtest, which measures hydrogen levels in the breath after consuming lactose.

Normally,very little hydrogen is detected in breath. Raised hydrogen breath levelsindicate the improper digestion of lactose, which could indicate lactoseintolerance. In young children and those who cannot perform the breathtest, strict elimination of lactose-containing food for two to four weeks isanother option.

Althoughthere is no cure for this digestive problem, some dietary changes can make ahuge difference for your child. I also recommend children with lactoseintolerance take an over-the-counter lactase enzyme supplement if they aregoing to eat any lactose-containing foods to help alleviate symptoms. However,this may not help if consumed with large amounts of lactose-containing foods.

Overtime, you and your child will learn how much dairy-based food and drink he orshe can handle. For patients with significant symptoms, a dietitian can helpidentify foods containing lactose.

It is also important to make sure your child still gets enough calcium and vitamin D, since dairy is normally a good source for these nutrients.

Will My Baby Get Over A Lactose Intolerance

Lactose intolerance following a viral illness or a premature birth is usually temporary hooray! and your babys body may eventually produce normal levels of the lactase enzyme to digest the sugar in milk.

But a congenital lactase deficiency is a lifelong condition, and youll need to modify your little ones diet to avoid symptoms.

The good news is that lactose-free infant formulas contain nutrients like calcium, vitamin D, and vitamin A that babies receive from drinking lactose-based products.

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Lactose Overload Vs Lactose Intolerance

The GI symptoms associated with lactose overload and lactose intolerance are due to the fermentation of undigested lactose in the large bowel. Hence, the GI symptoms for both problems are the same. A baby troubled by lactose overload will have false positive results when tested for lactose intolerance. These tests check the babys stools for indications of acid, which is present when lactose is fermented in the large bowel .

In the case of lactose overload, its the excess lactose, beyond what is normal, that the baby has trouble digesting. Although irritable due to GI discomfort, the baby is physically well and gaining weight well. .

In the case of lactose intolerance, the baby is unable to digest normal amounts of lactose. This means the baby, whose main or only source of nutrition is milk, will be deprived of the calories that lactose provides . She will quickly become unwell and lose weight. .

Talk To Your Pediatrician

Your first call should be to your babys pediatrician. They will be able to help you determine if your child does indeed have lactose intolerance.

When you go through the signs that have led to you suspect the intolerance, the pediatrician can help you determine if they point to your baby being lactose intolerant or if they may be caused by another issue that needs attention.

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Lactose Intolerance In Babies And Ways To Handle It

What is lactose intolerance?

Lactose is the main sugar that is present in cows milk and common dairy products. The enzyme, lactase, helps the body in digesting lactose. When the body doesnt produce enough lactase for digestion, it is called lactose intolerance. The undigested lactose can cause gastrointestinal problems. Often babies, especially premature ones, may have difficulty in producing lactase for a while and this can cause lactose intolerance. Most often, the production of lactase increases as the baby gets older and they may get over their lactose intolerance.

But since milk is the main nutrition for a baby, being lactose intolerant may pose problems. A new mother may not realize that her baby is lactose intolerant and this may give rise to health issues.

Identifying lactose intolerance Symptoms

Gas after a feedExcessive colic pain

If your baby has loose stools, and cries continuously after feeds, you should consult a doctor and check for lactose intolerance. Your pediatrician may test your child for lactose intolerance with a hydrogen breath test.

How should a new mother handle lactose intolerance in her baby?

Quite often, a baby may be lactose intolerant to their mothers milk. If that is the case, usually the baby would also be intolerant to cows milk and related products. The doctor may advice the mother to start the baby on powdered milk with supplements. Here are some tips to follow if your baby is lactose intolerant.

Test it

Milk

My Baby Has These Symptoms Do They Have Lactose Intolerance

It can be difficult to know because these symptoms may also occur in a baby with other conditions.

• Lactose overload can look the same as lactose intolerance and is frequently mistaken for it. You may like to check the information on lactose overload to see if it matches what you see in your baby. Many mums find relief from their and their babys symptoms by addressing lactose overload first.

• Food allergies and food intolerances can cause a baby to be unsettled. The foods to which a baby is allergic or intolerant can pass through the mother’s breastmilk. It can sometimes help for mum to remove the particular food, for example cows milk protein, from her diet. However, this needs guidance from a dietitian to help identify the problem foods and to make sure your diet is nutritionally adequate for both you and your baby.

• Cows’ milk protein allergy is often confused with lactose intolerance and many people think they are the same thing. They aren’t. People probably get confused because cows’ milk protein and lactose are both in the same food, that is dairy products. Since allergy or intolerance to a food protein can cause secondary lactose intolerance, the baby may have both. This adds to the confusion.

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Is Food Allergy The Cause

The underlying cause of difficulty digesting lactose could be an allergy or intolerance to cows milk protein . Over time an allergy may cause inflammation and irritation to babys gastrointestinal tract causing the symptoms of lactose overload. For further information see Milk Allergy in Babies and Elimination Diet for further reading.

Lactose Intolerance And Breastfeeding

This information can also be viewed as a PDF by clicking here.

The information provided is taken from various reference sources. It is provided as a guideline. No responsibility can be taken by the author or the Breastfeeding Network for the way in which the information is used. Clinical decisions remain the responsibility of medical and breastfeeding practitioners. The data presented here is intended to provide some immediate information but cannot replace input from professionals.

Lactose intolerance occurs when a person does not produce the enzyme lactase, or does not produce enough of it, and is therefore unable to digest lactose. If it is not digested and broken down, lactose cannot be absorbed. The undigested lactose passes rapidly through the gut until it is broken down by bacteria, producing acids and gas. The production of lactase decreases in most humans from the age of two years although symptoms of intolerance are rare before the age of six. Lactose intolerance in adults is very common. Lactose intolerance is not the same as intolerance to cows milk protein .

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How To Know They Are Lactose Intolerant

Various signs you can look out for are the following.

• Persistent crying that does not go away, despite lots of cuddles.

• Being continuously sick, because they cannot digest the lactose in the baby formula properly.
• Diarrhea, if it does not come back up in the form of baby sick, then it is likely to emerge at this end instead, and be quite liquidy.
• Check the colour of their stools. If it is yellow or green and very watery.
• Not putting on weight. If they are continually sick or have lots of watery diarrhea, they are not taking in any nutrients. Thus they will struggle to put on weight like a healthy eating baby.
• Any signs of rashes on the skin.
• Excessive wind or rumbling tummy when they have a poo.
• Demonstrating they are in pain by kicking or lifting their legs up, clenching their fists, arching their backs or crying while passing wind.

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How Lactose Intolerance Works

Lactoseis a sugar found in foods that many children love, including milk, ice creamand soft cheeses. Its also present in some baked goods, salad dressings,sauces, candy and other foods you might not expect. Breast milk and infantformulas contain lactose, too.

Lactoseis made up of two simple sugar molecules glucose and galactose. In order forit to be absorbed by the body, lactose has to be split into its two componentsby an enzyme called lactase, which is found in the lining of thesmall intestine.

But for those who are lactose intolerant, the activity of lactase is ineffective, and its unable to digest and absorb lactose in the small intestine. The lactose then passes into the large intestine, where it is fermented by gut bacteria. This process produces carbon dioxide and hydrogen, as well as certain byproducts that have a laxative effect.

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Is Lactose Intolerance The Same As Cows Milk Allergy

No. Having a reaction to traces of cows milk protein that enter breast milk via the mothers diet is not the same as lactose intolerance or lactose overload. However an ongoing food allergy can damage the lining of the gut where the enzyme needed to digest lactose is produced, causing symptoms of lactose overload. Lactose overload and cows milk allergy can therefore both be present at the same time.

Eliminating lactose from a mothers diet wont help a babys symptoms of lactose overload because lactose is added to breast milk in the breast. However, if the real issue is sensitivity to cows milk protein then avoiding foods with lactose probably will help the symptoms because cows milk proteins and lactose tend to be found in the same foods.