Does your baby suffer from gas or diarrhea or spit up frequently? If your little one seems uncomfortable after every meal, lactose intolerance might be to blame. Thinking your baby may have a problem with digesting food can be worrisome, but, fortunately, lactose intolerance in infants can be treated through diet.
What Is Lactose Intolerance?
“Unlike food allergies, food intolerances do not involve the immune system,” says Deborah Malkoff-Cohen, a registered dietitian at City Kids Nutrition and the pediatric nutrition co-chair for the Greater New York Dietetic Association. In the case of lactose intolerance, the enzyme lactase is low or missing. “Without this enzyme, food gets to the large intestine undigested and gastrointestinal symptoms can occur.”
Lactose intolerance is actually not very common in babies and typically only starts showing up after age 2 in children who were born full-term. “Most people are born with the ability to produce lactase, so we normally know early on whether lactose intolerance is present or not,” says Dr. Matthew Brennecke, a board-certified naturopathic doctor in Fort Collins, Colo.
Babies who were born prematurely (less than 34 weeks’ gestation) are more likely to have lactose intolerance, termed “developmental lactase deficiency.” Congenital lactase deficiency is a rare disorder in which babies can’t break down the lactose in breast milk or formula. This disorder is based on genes passed down from both parents. Such an intolerance results in severe diarrhea, and if not fed a lactose-free infant formula, those babies could develop severe dehydration and weight loss. Not everyone has the same likelihood of having lactose intolerance — it is much less common in people of European descent compared to those with Asian, African and Native American ancestry.
To further complicate the issue, Dr. Brennecke says that sometimes children become temporarily lactose intolerant as a result of malnutrition or infections of the gastrointestinal tract. If this is the case with your child, “As soon as you get the proper nutrients or clear the gastrointestinal infection, you should be able to slowly reintroduce [lactose] back into the diet.”
What Symptoms Will You Notice?
While babies can’t use words to explain abdominal pain, Dr. Brennecke says, “Infants will definitely be able to show you that they are uncomfortable.” Even a new parent should be able to see the signs. “These can include an extremely fussy baby, inconsolable crying, sleep disruption, decreased intake, bloating, vomiting, gas and diarrhea,” says Malkoff-Cohen. “For infants and toddlers, it can mean ‘toxic’ diapers — ones that smell offensively different from normal kid poop smell!”
Confirming the Diagnosis
“For infants and toddlers, if lactose intolerance is suspected, I recommend an elimination diet and removing all dairy for two weeks to see if gastrointestinal symptoms resolve,” says Malkoff-Cohen. If a baby is formula-fed, a non-milk based formula should be tried. “Afterwards, slowly reintroduce milk products in small portions and monitor if symptoms reoccur.” If you’re breastfeeding, you don’t need to change your own diet; while cow milk proteins pass through breast milk, lactose does not and shouldn’t pose problems to your baby. Just make sure your baby avoids dairy products.
While there are breath and blood tests available to confirm lactose intolerance in infants, most commonly, a simple and non-invasive stool acidity test is used for babies. Once your a pediatrician confirms that your child is lactose intolerant, ask about giving your baby lactose-free formula. Although it’s made from cow’s milk, the lactose is replaced with a different type of sugar. A 2011 study found that lactose-free milk-protein-based infant formula didn’t affect normal growth in term infants.
What’s Next?
When it’s time for your little one to transition to milk, you have many low-lactose and lactose-free alternatives to choose from. Look for lactose-free and lactose-reduced milks, lactase-treated milks (such as Lactaid), vitamin-enriched supplements (like Ensure and Boost) and milk substitutes made from things like rice, almonds, soy, coconut and hemp.
Raising a baby with lactose intolerance issues will most likely turn into the experience of raising a child with lactose intolerance, so keep in mind that all your hard work is helping to build healthy nutritional habits for a lifetime!
And check out how to deal with baby allergic reactions.
Nancy J Price is an Arizona-based mother of four, as well as a writer, editor and web developer. One of the original co-founders of SheKnows.com, she now writes for several websites, including Myria and Click Americana.
* This article is for general informational purposes only. It is not intended nor implied to be providing medical advice and is not a substitute for such advice. The reader should always consult a health care provider concerning any medical condition or treatment plan. Neither Care.com nor the author assumes any responsibility or liability with respect to use of any information contained herein.
