What Are The Symptoms Of Lactose Intolerance
The symptoms of lactose intolerance will always involve your babys digestive system and can include your little one experiencing diarrhoea, wind, bloating and sometimes nappy rash. Lactose intolerant babies often cry a lot and are uncomfortable which is why its sometimes linked with colic. Its important to note that if your baby has mucus or blood in their poo too then its not a lactose intolerance and you should see your GP.
Lactose intolerance is diagnosed by a doctor taking a detailed history and testing your babys poo for acid. Hydrogen breath tests that measure the amount of hydrogen your baby breathes out can also be done but it can be quite difficult to get young babies to do this effectively, so this test tends to be reserved for older children and adults.
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Will My Baby Grow Out Of Lactose Intolerance
Depending on the cause, your baby may fully recover from a lactose intolerance, or be able to tolerate more lactose in their diet in the future. For example, symptoms of secondary lactose intolerance normally disappear within two to four weeks11, when the intestinal wall has recovered from the gut damage causing it. However, for some people, lactose intolerance lasts for life.
Your GP or paediatric dietician may want to try to reintroduce lactose to your babys diet at some point to test your babys reaction and see if theres been any change. So keep in touch with your health professional and keep them in the loop about how your baby is getting on.
What Is True Lactose Intolerance
True lactose intolerance, or what is medically known or otherwise known as primary lactose intolerance, or Galactosemia is an extremely rare genetic condition, which requires medical treatment to manage.
From birth a baby with Glactosemia fails to thrive, meaning they wont put on any weight. These children require a very special diet and emergency medical treatment, with a hydrogen breath test and tests for reducing sugar in the stools undertaken for diagnosis.
Glactosemia occurs when a baby does not produce lactase, which breaks down lactose. Only a few people in the world have been diagnosed with this condition. The US National Library of Medicine states that, ‘Classic Galactosemia occurs in 1 in 30,000 to 60,000 newborns. Galactosemia type II and type III are less common type II probably affects fewer than 1 in 100,000 newborns and type III appears to be very rare’.
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What To Do If Your Child Is Lactose Intolerant
If your child is lactose intolerant, there are many solutions that allow your child to have a healthy, well-rounded diet. With the right foods and treatments, you can help stop your childâs symptoms.
For true lactose intolerant babies, it is recommended that parents seek the help of a pediatric gastroenterologist to manage this condition. Because these infants are often âfailure to thriveâ and have diarrhea, they may need a special formula and should be closely monitored for adequate weight gain.
Older children have multiple options, such as choosing dairy-free milk and dairy-free cheese products or using Lactaid tablets, which contain lactase enzymes. Lactaid tablets come in a chewable form for children ages 4 years and up.
âYou can take Lactaid tablets with the first sip or bite of dairy,â says Dr. Ramirez. âIt gives you the enzyme needed to break down the lactose for 45 minutes of eating or drinking. Taking a Lactaid tablet should help prevent symptoms such as bloating, stomach pain and diarrhea.â
If children have temporary secondary lactase deficiency, you can help them avoid dairy for about two weeks, then reintroduce dairy products. Transient lactose intolerance can sometimes occur after a viral or bacterial gastroenteritis.
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Causes Of Lactose Intolerance
Scientists dont yet know why some people are lactose intolerant, and others arent, but its pretty common. In fact, up to 50 million people in America suffer from it. Genetics are certainly implicated. For example, around 75 percent of Native American, African American, Hispanic American, and Jewish Americans are lactose intolerant, as well as about 90 percent of Asian Americans. Just 15 percent of people of northern European descent, on the other hand, suffer from the condition.
The fact is, very few babies are born with lactose intolerance. It requires both parents to have the gene and pass it on to their baby. Babies with true lactose intolerance have severe diarrhea from birth, and wont be able to tolerate either their mothers breast milk or cows milk formula. These babies require lactose-free baby formula.
Some medications cause a decrease in the production of lactase and temporary lactose intolerance.
People with conditions that affect the digestive system on a long-term basis such as Crohns disease or celiac disease sometimes have lactose intolerance too.
If your baby has bad diarrhea, s/he might temporarily produce less lactase which could result in temporary lactose intolerance.
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What Are The Causes Of Lactose Intolerance
Only 1 in 50 people of European descent have an intolerance to lactose2. In the UK, its more common in people of Asian or African-Caribbean origin3.
There are three main causes of lactose intolerance4:
Primary this is when the bodys natural lactase production decreases by around 10-30%. This could be as a result of age, or in response to reducing the amount of dairy products that you eat. A primary lactose intolerance doesnt usually occur before adulthood, and in most cases is associated with cultural groups where dairy products are not a regular part of the adult diet5.
Secondary this type of intolerance is temporary. It occurs as the result of gut damage, caused by a stomach bug or infection, undiagnosed coeliac disease, or a long course of antibiotics, for example.
Congenital an extremely rare, genetic form of the lactose intolerance, where babies are born without, or with very low amounts of lactase.
Lactose intolerance may also occur in babies who are born prematurely. This is because their small intestine is not developed enough at birth, and things usually improve as babies get older.
Is There A Link Between Lactose Intolerance And Lactose Overload
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.
Lactose overload Many healthy, thriving, babies develop gastric symptoms, such as excessive gas and frequent, watery bowel movements* due to lactose overload, which is associated with large, frequent feeds. These symptoms cause tummy pains.
The more lactose your child consumes, the more symptoms he or she will experience. Symptoms of lactose intolerance can occur within minutes to hours after drinking milk or eating dairy products and range from mild to severe based on the amount consumed and the amount tolerated. Here are symptoms you should look out for:
Lactose overload can result in an unsettled baby with adequate to large weight gains. The baby usually passes urine more than 10 times a day and has many bowel motions in 24 hours. They may have green, frothy poos that resemble those of a baby with 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.
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What Foods Are Most Likely To Be A Problem
Some of the most likely suspects are cows milk products, soy, wheat, corn, eggs, and peanuts.
Other suspect foods:
- Any food that a family member is allergic to
- A food that mom recently ate a large amount of
- A new food
- A food that mom doesnt like, but is eating while breastfeeding for the benefit of her baby
- A food that mom craves, or feels she has to have after a bad day
Conscious likes and dislikes of foods are signals that your body may be reacting to them in an abnormal way.
Keeping a food journal with a record of foods eaten and babys behavior/symptoms, with time of day for each, may be helpful when trying to pinpoint a problem food.
What Should I Do If I Think My Baby Is Allergic Or Intolerant To Cows’ Milk
If you think your baby is having a reaction to cows’ milk, see your GP to discuss your concerns.
They will be able to assess if your baby’s symptoms may be caused by a cows’ milk allergy or something else. Make sure you get medical advice before taking cows’ milk out of your child’s diet as it contains important nutrients.
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How Closely Do I Need To Watch What I Eat
Most babies have no problems with anything that mom eats. Its generally recommended that you eat whatever you like, whenever you like, in the amounts that you like and continue to do this unless you notice an obvious reaction in your baby.
There is no list of foods that every nursing mom should avoid because most nursing mothers can eat anything they want, and because the babies who are sensitive to certain foods are each unique what bothers one may not bother another.
What Causes Lactose Intolerance In Babies
Unless theres a genetic condition passed on by the parents, its usually caused when a baby doesnt have the digestive enzyme lactase. Lactase is produced in the gut to break down the lactose and make it more digestible. Lactose intolerance can even sometimes appear temporarily, shortly after a tummy bug or a long course of antibiotics.
Some premature babies may have lactose intolerance where their small intestine hasnt been able to fully develop before coming into the world. This usually improves with time.
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Information On Specific Food Allergies & Elimination Diets
Elimination Diets
- Allergy Elimination Diet: More calcium info and lists of foods/ingredients to avoid while on an elimination diet .
- The Elimination Diet from AskDrSears.com
Various allergies
- The Food Allergy and Anaphylaxis Network FAANs mission is To raise public awareness, to provide advocacy and education, and to advance research on behalf of all those affected by food allergies and anaphylaxis. Tons of information here.
- Veggies Uniteyour online vegetarian resource guide, has lots of vegan recipes very useful if you are avoiding dairy, eggs, etc.
Cows milk products
- The No Milk Page. A list of links for people who must be cautious about consuming milk and milk byproducts.
Corn
- Avoiding Corn by Ephraim Vishniac. Information on determining whether you have a corn allergy and on corn-derived ingredients that should be avoided by those with corn allergy.
Food additives
- Food Intolerance Network by Sue Dengate, BA. Dip. Ed.
- Tartrazine info
Wheat
- Wheat allergy diet from Lucile Packard Childrens Hospital
Complications Of Lactose Intolerance
Milk and other dairy products contain calcium, protein and vitamins, such as A, B12 and D.
Lactose also helps your body absorb a number of other minerals, such as magnesium and zinc.
These vitamins and minerals are important for the development of strong, healthy bones.
If you’re lactose intolerant, getting the right amount of important vitamins and minerals can prove difficult.
This may lead to unhealthy weight loss and put you at increased risk of developing the following conditions:
- osteopenia where you have a very low bone-mineral density left untreated, it can develop into osteoporosis
- osteoporosis where your bones become thin and weak, and your risk of breaking a bone is increased
- malnutrition when the food you eat does not give you the nutrients essential for a healthy functioning body this means wounds can take longer to heal and you may start to feel tired or depressed
If you’re concerned that dietary restrictions are putting you at risk of complications, you may find it helpful to consult a dietitian.
They can advise you on your diet and whether you require food supplements.
Your GP should be able to refer you to an NHS dietitian free of charge. Or you can contact a private dietitian.
The British Dietetic Association has information on how to find a private dietitian.
Page last reviewed: 25 February 2019 Next review due: 25 February 2022
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What Is Secondary Lactose Intolerance
This happens when villi in the small intestine have been damaged either by gastroenteritis, or food sensitivities, such as gluten, thus effecting the production of the lactase enzyme. This means the lactose cannot be broken down appropriately.
Secondary intolerance is temporary since the villi are always creating more cells that produce lactase. So when the childs gastro infection stops, or the possible food sensitivities are reduced or eliminated, lactose can again be absorbed correctly. So, if you know your child is well, doesnt have true lactose intolerance and you are doing everything right to avoid lactose overload , then you can try eliminating gluten.
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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What Is Lactose Overload
This is what the majority of newborns actually have but is so often, wrongly labelled as lactose intolerance. Lactose Overload is caused by having too much lactose in the system for the baby to break down, so the digestive system carries on as it should, but it cant cope with the amount of lactose it is receiving.
The overload of lactose then moves from the small intestine into the large intestine where it draws in more water through the intestinal wall this is called osmosis. The bacteria present then ferments the lactose producing a range of symptoms that are listed below. When this happens the baby, or infant actually looks like they are trying to suck more. This is because sucking is their instinctual tool to enable comfort, and lactose overload obviously creates discomfort. However, this looking to suck is often misread and mistaught as a hunger cue only, leading to parents feeding more, resulting in more overload of lactose to produce more symptoms. And so the cycle goes.
Unfortunately, the widely taught practices of feeding from both breasts in one sitting, in quick succession, or cluster feeding creates lactose overload for our newborns, as does overfeeding. Not only because the amount of lactose the child receives is too much, but also because these feeding practices push the milk through the digestive tract too quickly, which doesnt allow enough time for the lactose to be broken down appropriately.