Lactose Intolerance in Babies

Lactose intolerance is when your baby just can’t stand drinking milk. Sometimes rashes appear and they throw a fit. Milk is an important source of calcium, Vitamin D and other important nutrients which are vital for growth and wellbeing. In this article, you’ll learn what lactose intolerance is and how to help your baby.

What Is Lactose Intolerance? 

Lactose intolerance is the inability to digest the lactose (sugars) found in milk. When a baby is lactose intolerant, his digestive system is unable to produce the enzyme called lactase which is responsible for digesting milk. Lactose intolerance in infants is rare and usually doesn’t appear before the age of two, until after weaning. Some babies have lactose intolerance from birth which means they cannot even be fed mother’s breastmilk and instead, require specially-formulated lactose-free milk.

How Common Is Lactose Intolerance? 

In the UK, only 1 out of 50 kids exhibit this condition while people who live in parts of Asia and the African-Caribbean region are more prone to it. Those who have underlying medical conditions like Crohn’s disease and Celiac’s disease usually are lactose intolerant and their diet restricts dairy along with other things.

Types of Lactose Intolerance 

Here are the three main types of lactose intolerance problems in babies:

1. Hereditary Lactose Intolerance

Hereditary lactose intolerance is tied to genetics and runs in the family. If this is the case, your baby may lack the lactase enzyme and be unable to tolerate milk and dairy products right from birth.

2. Primary Lactose Intolerance

Primary lactose intolerance happens when lactase production in the gut decreases due to a lowered intake of dairy products like milk and cheese. It usually happens around or after adulthood and cases where babies experience this is extremely rare. This is also known as temporary lactose intolerance.

3. Secondary Lactose Intolerance

If the stomach or gut faces any underlying medical conditions like Crohn’s disease, undiagnosed Celiac disease, or any infections which inhibit the production of the lactase enzyme, it leads to secondary lactose intolerance.

How Do You Know If Your Child Is Lactose Intolerant? 

Take your child to the doctor to get a lactose intolerance diagnosis. The doctor might look into your medical history, diet, and family history to assess and examine your baby during the diagnosis. If she rules it is lactose intolerance, you may be asked to feed your child lactose-free milk for a few weeks to see if the symptoms subside. If the symptoms do subside, you will be asked to continue feeding your child a lactose-free diet or opt for lactose substitutes where feeding is concerned.

Lactose Intolerance and Breastfed Babies  

Contrary to popular belief about lactose intolerance in breastfed babies, they do not stop exhibiting symptoms once the mother stops consuming dairy products. This is because lactase (the sugar in milk) is present in all mammalian milk and not just in humans or other animals. A breastfed baby with primary lactose intolerance will have to be put on a special diet due to severe dehydration or complications arising from intolerance symptoms. For other types of lactose intolerance, the child must continue to be fed breastmilk and taken to the paediatrician for routine checkups to monitor and heal any underlying conditions.

What Causes Lactose Intolerance In Babies? 

Some of the causes of lactose intolerance in babies are:

• When damage to the gut or intestine is due to diarrhoea stemming from a rotavirus infection
• When the lactase levels are too low due to insufficient production of the enzyme (this increases with age and becomes normal later)
• Any underlying conditions like Crohn’s disease or Celiac disease which interfere with the production of lactase enzyme in the baby
• Genetics or heredity, where the baby is unable to produce lactase enzyme and doesn’t have its presence at all since birth

Signs and Symptoms of Lactose Intolerance in Infants 

Some of the signs and symptoms of lactose intolerance in infants are:

• Diarrhoea
• Bloating
• Passing gas
• Pain in the stomach
• Difficulty in breathing
• Rashes
• Vomiting
• Watery stools which are yellow or green
• Reddish spots under the anus from 30 minutes after consuming dairy products

Some symptoms like rashes and excessive vomiting could indicate an allergy to milk and not merely lactose intolerance. If that’s the case, then your baby’s immune system is reacting against the protein in milk and not the sugars. Show your child to a doctor for a thorough clinical examination just to be safe. Some types of cheese like cheddar, feta, and mozzarella have lower amounts of lactose compared to other sources of dairy products.

How is Lactose Intolerance Diagnosed?

Your paediatrician will first take a look at your child’s medical report, family history, and nutrition charts to better understand and evaluate lactose intolerance in the infant. After the initial review, the following tests will be requested by the doctor

Hydrogen Breath Test

This measures the level of hydrogen in a child’s breath before and after he drinks a beverage. A tiny amount of hydrogen is usually present when he drinks dairy products but if this level is abnormal, then the test results will be positive which indicates lactose intolerance.

Acidity Test

A sample of your child’s stool will be collected to analyze the acidity levels. Children with lactose intolerance are known to have acidic stools. Another test is available which measures glucose quantity in the stool and tells if the lactose remains undigested.

Endoscopy

An endoscopy is a type of biopsy in which an instrument can peer into your child’s intestine and be used to measure lactase levels directly. You will have to show your child to a gastroenterologist if your paediatrician or GP recommends this.

Treatment of Lactose Intolerance In Babies 

Treatment of lactose intolerance in babies involves removing lactose from their diet for 2 weeks and slowly reintroducing dairy once the symptoms subside.

Prevention of Lactose Intolerance In Babies 

There’s little parents can do to prevent lactose intolerance in their baby. However, here are a couple of things you can do to help out your child-

1. Breastfeed Your Baby

Don’t stop breastfeeding if your child has temporary lactose intolerance. Since it’s temporary, you can rest assured that the condition will improve with time. If your baby has permanent lactose intolerance, feed him soy-based or other plant-based sources of milk.

2. Track With a Food Log

Keep track of the dairy products that aggravate your baby’s lactose intolerance, when the symptoms show up and what foods are included regularly in his diet. Keeping a food log will help your paediatrician identify which foods, in particular, cause your child’s symptoms to flare up and which don’t. For example, yoghurt (curd) is harder to digest than milk since it’s not fermented into lactic acid for easier digestion.

3. Make Sure Nutritional Requirements Are Met

If your baby has permanent lactose intolerance and the paediatrician recommends eliminating dairy products altogether from his diet, you’ll have to look into other sources of calcium. Calcium is required for strong and healthy bones and a lack or deficiency of it could lead to rickets and bone deformities. Some of the best plant-based sources of calcium include greens like kale (karam saag), and spinach, beans, fruits like oranges and figs, nuts like almonds and brazil nuts, soymilk, sesame and fish like salmon.

Some other nutrients you need to watch out for besides calcium are Vitamin D, riboflavin, phosphorus, and Vitamin A. You can get Vitamin D from ragi or supplement it using liquid drops or giving your baby fortified foods like canned tuna and cereals.

You can give your child butter and margarine if your paediatrician recommends a low-lactose diet. If she asks to eliminate lactose, then stick to lactose-free milk such as soymilk to help improve the symptoms and prevent your kid’s condition from deteriorating.

There is no one-size-fits-all approach when it comes to tackling lactose intolerance and it is important to remember that. Sometimes it just takes time until the digestive system is able to pump up the production of lactase enzyme and other times, you end up not so lucky. But there is still hope for kids who have permanent lactose intolerance since there are various plant-based sources of calcium and Vitamin D to look at. Your child will still be able to meet his nutritional requirements despite having this condition but yes, it will definitely take a bit of legwork to get there and that’s why you have it’s important to have a talk with your paediatrician.