My Doctor Says Tests Confirm My Baby Has Lactose Intolerance
Some doctors might diagnose lactose intolerance if they measure excess acid in a babys poop or hydrogen gas in a babys breath due to temporary lactose intolerance . Noble and Bovey state that the presence of reducing sugars in a babys poop can be quite normal for breastfed babies particularly under six weeks of age11 while the Australian Breastfeeding Association says both a hydrogen breath test and a test for reducing sugars in the stool are often positive in normal breastfed babies under three months of age12. James Akre explains:
James Akre, Infant Feeding the Physiological Basis, WHO, 1992
It is usual to find reducing substances such as sugars in the stools of healthy breast-fed infants they contribute to maintaining the acid environment that retards the growth of pathogens. In contrast, the delayed gut transit time of industrially prepared milks permits almost total metabolism of these sugars.
Prematurity And Lactase Deficiency
Though lactose intolerance is not common in babies, some babies who are born before 34 weeks donât have a fully functional gastrointestinal tract. They may lack lactase and other enzymes they need to digest food, though these can develop later as the child grows. Interestingly, these premature infants may still tolerate intact milk protein based formulas.
Quick Onset Of Symptoms
All of these symptoms are common enough to indicate any number of illnesses but a key differentiator between other illnesses and food intolerances is the quick onset of symptoms. Any of these signs will appear within 30 minutes to 2 hours of consuming milk or dairy-based products if your child is lactose intolerant.
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My Doctor Said I Should Stop Breastfeeding
Some doctors are confused about temporary lactose intolerance, milk allergy and colic. They may recommend lactose-free formula or newer special formulas. However the answer to most cases of temporary lactose intolerance is to get help with breastfeeding rather than switch to industrial formulas. A baby with an irritated intestine needs the anti inflammatory effects of breast milk and a breastfeeding specialist can help suggest changes to feeding management10.
- concentrated sources of the problem proteins
- without the advantage of having been processed by maternal digestion
- utterly devoid of the other benefits bestowed by her milk. p47
Inappropriate Use Of Lactose
A recent survey in Northern Ireland assessed formula prescription patterns in infants with likely non-IgE-mediated CMA. The survey found that thickened anti-regurgitation formula, lactose-reduced partially hydrolyzed formula or lactose-free, cows milk protein-containing formulas were commonly prescribed in infants with symptoms suggestive of non-IgE-mediated CMA . The survey was repeated after the implementation of active education and national feeding guidelines . Following the educational interventions, the use of EHF and AAF increased by 63%, while the use of alternative treatments was reduced by 44.6%. Overall, the recognition of CMA increased from 3.4% to 9.8% of treated infants. This study demonstrates both the need for health care provider education on gastrointestinal CMA, as well as the usefulness of educational campaigns and national treatment guidelines.
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Symptoms Of Lactose Sensitivity In Infants
If you have a fussy baby or your baby suffers from diarrhea or frequent spitting up, you may suspect lactose intolerance. Before you stop breastfeeding or switch formulas, check with your health care provider about other possible explanations for her symptoms. Lactose intolerance is extremely rare in infants and is usually a result of another condition.
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How To Take Care Of You
Looking after a baby with lactose intolerance is bound to affect your own emotional state. Remember that youre not alone and its important to look after yourself. Try to ask friends and family for help and find time to do something for yourself such as having a bath, going for a walk or at the very least enjoying a hot cup of tea. If you or your partner feel out of control, anxious, depressed, or unable to cope, its important to speak to a doctor. Feeling this way isnt unusual and its not something to be afraid to talk about.
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Will My Baby Outgrow Cma And When
Most children eventually outgrow a milk allergy and often can begin a switch to cows milk after they reach 1 year of age. For children who still have CMA after 12 months, its common to supplement with a hypoallergenic formula like Similac Alimentum.
Its important to work closely with your healthcare provider to determine when this transition should begin and to identify an appropriate milk-alternative beverage.
References:1. United States Census Bureau QuickFacts . https://www.census.gov/quickfacts/fact/table/US/RHI225218external icon 2. Gupta RS, et al. Pediatrics. 2018 142:e20181235.
Sources: Food allergies. Centers for Disease Control and Prevention. April 21, 2020.
General: Excess Fussiness Sleeplessness Or Colic
Every baby cries, but crying continuously and inconsolably for extended periods is unusual. You might hear someone say a baby who cries a lot has colic. Some doctors find colic controversial, but excess crying comes from somewhere, often with insomnia. Doctors also often downplay fussiness, which can delay diagnosing CMA. We hear this from parents all too often!
When should you suspect that crying is excessive and something serious is happening? The going adage is to talk to the doctor if it happens in threes. That is: if your baby cries for 3+ hours in a day, for 3+ days in a week, for over 3 weeks. That can signal gastrointestinal pain, which could result from CMA.
Extreme fussiness can also come with reflux, a rash, or other factors. Keep this in mind when asking your childs doctor about the possibility of CMA.
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Why Is Lactose Important
Lactose is important to a babys health. It aids in the absorption of calcium and phosphorus and supports the growth of good bacteria in the intestinal tract. Good bacteria are major players in the prevention of disease. They inhibit the growth of harmful microorganisms bacteria, viruses, and parasites – that live in the intestinal tract and those entering the body in food and fluids. Good bacteria help to keep the walls of the intestines healthy, preventing harmful microorganisms from entering into the blood stream. Good bacteria also aid in the digestion of lactose.
Galactose, a simple sugar that comes from the breakdown of lactose, is vital to a healthy brain and nerve tissues. Galactose can be found is some foods, but milk containing lactose will be a babys only source of galactose during the early months – an important time of rapid brain growth and development.
Glucose, the other simple sugar that bonds with galactose to form lactose in milk. Glucose is essential for energy, growth and cell development. Without glucose in the diet a baby will use body fat as a source of energy, and lose weight. A baby will not survive if deprived of glucose for a long period. Most foods, including lactose-free milk, will be broken down or converted into glucose in the body.
Does Lactose Intolerance In Infants Cause Colic
Think about it: If it did, there would be no “witching hour.” Lactose consumption is pretty steady throughout the day, but colicky fussing tends to peak in the evening. But let me explain how this theory got started, and why it’s a myth.
The lactose your baby eats is digested by the enzyme lactase in the intestine. With age, adults have less and less lactase. This makes some of us lactose intolerant causing bloating, bellyache and diarrhea after eating dairy products. This adult problem led some doctors to speculate that colicky babies might be suffering from stomach pain from lactose intolerance.
Soon, the markets were flooded with lactose-free formulas and special lactase-containing colic dropsall claiming to be a cure for colic and lactose sensitivity in babies. But this multimillion-dollar promotion was based on hype not health. A Canadian study showed no improvement from lactose-free formula in colicky babies. And an Australian study found no reduction in crying when fussy infants were given lactase in their mothers milk.
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Treatment Of Infants With Congenital Lactose Deficiency
In infants with congenital lactase deficiency, breast milk or lactose-containing formula cause persistent watery diarrhea and growth failure. In this situation, breast feeding can generally not be sustained. Infants with congenital lactase deficiency require a change to a lactose-free formula. If recognized and treated early, infants with congenital lactase deficiency achieve normal growth and development . Lactose restriction needs to be continued for life. However, older children and adults may tolerate small amounts of dietary lactose, depending on the disease severity.
Signs Of Lactose Sensitivity In Babies
If your baby has a hard time digesting the sugar in milk, they might have lactose sensitivity. This can be uncomfortable for baby and can make the time after feeding difficult for parents. Here are a few signs of lactose sensitivity in babies to watch for.
What is the difference between lactose intolerance and lactose sensitivity in babies?
Lactose intolerance causes harsh digestive issues that occur after ingesting milk or milk products. However, lactose intolerance in infants is extremely rare. Lactose sensitivity on the other hand, is much more common in babies and is typically temporary.
What are some of the signs of lactose sensitivity in babies?
Lactose sensitivity in babies can cause fussiness, gas and crying. This digestive discomfort can occur anywhere from 30 minutes to two hours after consuming lactose. The degree of lactose sensitivity differs from baby to baby. Some babies may have a mild sensitivity, and it may be just a matter of managing the amount of lactose ingested. If babies have more severe or persistent issues, it could signal an underlying cause like a cows milk protein allergy.
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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Symptoms Blamed For Lactose Intolerance
Lactose intolerance is often blamed as being a contributory factor for colic, resulting in cessation of breastfeeding and substitution of lactose free formula. Infants with gastrointestinal symptoms on exposure to cows milk are more likely to have cows milk allergy than lactose intolerance
Green and frothy bowel motions may be a sign that the baby is receiving too much lactose, which has a rapid gut transit time. This may be due to an excess of the early less fat-rich milk or switching the baby between breasts before emptying one breast first. Babies may be very unsettled and windy. Mothers may have an overactive letdown reflex.
Assessment by an experienced breastfeeding worker may be beneficial to ensure optimal milk removal by the baby is taking place before considering lactose free formulae. Imbalance of milk transfer can produce similar symptoms i.e. loose bowel motions, which may be green and frothy. This is due to the rapid transit time of large volumes of lower fat milk and consequently an excessive consumption of lactose . Breast compression when the baby is not actively sucking may improve milk transfer.
Babies can exhibit excess wind and gastric discomfort, which may be diagnosed as lactose intolerance, but which in fact is transitory lactase deficiency i.e. too much lactose for the available lactase.
Treatment For Cows Milk Allergy
If your baby is found to be allergic to cowsâ milk, your GP or allergy specialist will explain to you how to manage it. This will include removing all cows milk from your childs diet for a period of time. Your GP may also prescribe a special infant formula that doesnât contain cowsâ milk for bottle-fed babies.
If your baby gets a cows milk allergy in reaction to the dairy you eat or drink, your GP may tell you to avoid cows milk products in your diet in case these affect your baby.
this is the case, your GP may tell you to avoid cows milk products in your diet in case these affect your baby.
Your GP or dietitian will help you work out the best diet for your child at whatever stage they are at and closely follow your childâs progress. Your doctor will suggest reintroducing milk after a while to see if your child has grown out of their allergy.
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Testing For Lactose Intolerance
While these signs of lactose intolerance in toddlers will help you spot the condition, you can also test for lactose intolerance at the doctor. Depending on your pediatrician, they may recommend a simple breath test, which measures hydrogen levels in the breath after consuming lactose. When hydrogen levels are present or increased, its an indication that lactose isnt being properly digested.
Based simply on symptoms, or on proven test results, your pediatrician will recommend diet changes to support kids allergies such as eliminating or greatly reducing dairy products form your childs diet.
What Type Of Formula Is Available For Infants With Cma
If your babys pediatrician diagnoses your baby with CMA, they will likely suggest whats called a hypoallergenic formula like Similac Alimentum. Its a formula with protein thats been extensively hydrolyzed, or broken down.
Shop now to find a formula thats right for your baby.
Your pediatrician might refer you to a registered dietitian to help you learn about problem ingredients and healthy alternatives to ensure that your little ones nutrition needs are being met.
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Symptoms Of Lactose Intolerance In Babies
The symptoms of lactose intolerance can be similar to those of other conditions, meaning that its sometimes hard to identify. However, common symptoms include6:
- Tummy pain and rumbling
- Excessive wind
These symptoms usually occur within 13 hours after the food containing lactose has been eaten7.
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 her 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.
The following food and diet tips can help.
These foods are OK:
- 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.
Watch out for these foods:
- milk ice-cream and milk desserts
- cream cheese, processed cheese and cheese spread
- muesli bars
- instant mashed potato and vegetables with added milk or white sauces.
Check the ingredients in these foods:
- biscuits, cakes and cake mixes
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