How To Find Out If My Child Is Lactose Intolerant

By: Anthony Porto, Doctor, MPH, FAAP

It can exist difficult to know whether your baby or child is having symptoms of lactose intolerance or whether he or she may have a milk allergy.

The post-obit frequently asked questions from parents will help you learn more about the common symptoms of lactose intolerance, diagnosis, and treatment options.

Is lactose intolerance the aforementioned thing every bit a milk allergy?

No. Many parents confuse the terms lactose intolerance and milk allergy . While they may share similar symptoms, they are entirely dissimilar conditions. Lactose intolerance is a digestive problem, while milk allergy involves the allowed system. So, while lactose intolerance tin cause a great bargain of discomfort, it volition non produce a life-threatening reaction such as anaphylaxis.

Milk allergies tend to appear within the first year of life, while an baby'south digestive organisation is still quite immature. Lactose intolerance tin can start in childhood into adolescence and can become more than noticeable into adulthood.

What is lactose?

Lactose is a sugar found in foods that many children love—milk and dairy products, such as frozen yogurt and cheeses. The list of other foods containing lactose is long and includes some breads, cereals, and frozen or canned foods.

Lactose is cleaved down past the lactase enzyme located in the pocket-sized intestine—the organ where most food digestion and food absorption takes place. When nosotros consume lactose, lactase breaks lactose down into two elementary sugars: glucose and galactose. The body then absorbs these simple sugars into our intestines. When there is a decrease or loss of the lactase enzyme, nosotros cannot break downwardly or absorb lactose. The unabsorbed lactose can atomic number 82 to symptoms, which is called an intolerance.

In addition to milk, what other food products incorporate lactose?

Lactose is nowadays in many food products and in some medications. Manufacturers also often add milk and milk products to boxed, canned, frozen, packaged, and prepared foods. People who have digestive symptoms later on consuming a minor quantity of lactose should be aware of the many food products that may incorporate even modest amounts of lactose.

You lot can check the ingredients on food labels and the nutrition facts to notice possible sources of lactose in food products. If a food label includes whatsoever of the post-obit words, the production contains lactose:

Milk
Lactose
Whey
Curds
Milk past-products
Dry milk solids
Nonfat dry out milk pulverisation

What are some key symptoms of lactose intolerance?

The symptoms of lactose intolerance depend on the amount of lactose that's consumed. The more lactose your child consumes, the more symptoms he or she volition experience. Symptoms of lactose intolerance can occur within minutes to hours later on drinking milk or eating dairy products and range from mild to astringent based on the amount consumed and the amount tolerated. Hither are symptoms you lot should wait out for:

Nausea
Abdominal pain, cramping, and bloating
Loose stools and gas
Watery diarrhea with gas

If I think my child might be lactose intolerant. How can I tell?

One mode to cheque if your child has trouble digesting lactose is to take all the milk products out of your child's diet for two weeks and to and so see if his or her symptoms improve. After two weeks, slowly reintroduce the products in small-scale amounts each day to see if symptoms return. Your pediatrician can too exam your kid for lactose intolerance with a hydrogen breath exam.

I've heard lactose intolerance can sometimes exist a temporary side effect when kids are ill. Is that truthful?

Yes. Lactose intolerance can occur temporarily in children after a viral infection (that is why you may be told to avoid milk with lactose in it during a breadbasket bug) or it may be seen with weather that pb to inflammation of the intestines, such as celiac illness.

Tin can infants exist lactose intolerant?

Lactose intolerance is actually not very common in infants and typically merely starts showing up after historic period three in children who were born total-term. All babies are born with lactase in their intestines. Every bit they grow older, the lactase enzyme decreases.

Babies who were built-in premature are more probable to have a type of lactose intolerance called developmental lactase deficiency. This condition usually lasts simply for a curt time after birth. Notwithstanding, the majority of premature infants volition be able to consume lactose-containing formula and breast milk.
Congenital lactase deficiency is a very rare disorder in which babies can't break down the lactose in chest milk or formula. Genes inherited from parents cause this disorder. This type of intolerance results in astringent diarrhea, and if not fed a lactose-free infant formula, those babies could develop severe dehydration and weight loss.

If a mother is lactose intolerant, is it safe for her to breastfeed her baby?

It's perfectly safe to breastfeed your child if you're lactose intolerant. Breastfeeding does non put your baby at greater take chances of becoming lactose intolerant, and it has important health benefits for your infant.

How can my kid become enough calcium in her diet if milk or lactose are reduced?

If your child has lactose intolerance, he or she tin can still swallow lactose-free dairy products including lactose-costless milk, cheese, and yogurts—all are expert sources of calcium. In addition, your kid can get calcium from dark greenish leafy vegetables such equally spinach, broccoli and kale, nuts (almonds), beans (white beans), fish (sardines, salmon) and calcium-fortified orange juice. If you feel your child is not getting enough calcium, talk with your pediatrician most starting a calcium supplement.

Are soy or almond milks adequate substitutes for children who are lactose intolerant?

There are many milk substitutes that a child with lactose intolerance can drink, including soy, almond, rice, hemp, and oat milk. Soy milk is a popular milk alternative, considering it is a good source of calcium and protein. Almond milk has also become a popular culling and is safe for children with lactose intolerance or a cow's milk protein allergy. Although almond is a good source of calcium, it is lower in protein and contains fewer calories than cow's milk. Before starting any culling milks, it is important to talk with your pediatrician nearly which may be all-time for your kid.

How is lactose intolerance diagnosed?

Your pediatrician will accept a medical, family, and nutrition history to assist diagnose lactose intolerance in your infant or child. During this discussion, he or she volition review your child's symptoms with yous.

In some cases, a hydrogen breath test is done to test for lactose intolerance. For the test, your child breathes into a container that measures breath hydrogen level before and afterwards he or she drinks a beverage that contains a known amount of lactose. Commonly, but a small corporeality of hydrogen is detectable in the breath when a person eats or drinks and digests lactose. An increase in hydrogen levels is considered a positive test for lactose intolerance.
Pediatricians bank check acidity in the stools of infants and young children who may be unable to properly practice the hydrogen breath test. Acidic stool (low pH) may indicate lactose malabsorption. Some other stool test (reducing substances) looks for the presence of glucose in the stool, which signifies undigested lactose.
If your child's symptoms persist, he or she may be referred to a pediatric gastroenterologist (GI) for further evaluation. Depending on the severity of your child's symptoms, the GI may perform an endoscopy to measure lactase levels directly from the intestine. This is done with a biopsy.

How much calcium and vitamin D are recommended for my kid to eat each day?

The specific amount is based on your child's age. Here is a breakdown of the Recommended Dietary Allowances (RDA) for calcium and vitamin D. Table of RDA for calcium and vitamin D

How is lactose intolerance treated?

How lactose intolerance is treated depends on the extent of your child's symptoms. Some children with lactose intolerance may exist able to have pocket-size amounts of dairy products without having symptoms.

To assist alleviate symptoms if/when your child consumes lactose-containing food, your pediatrician may recommend an over-the-counter lactase enzyme supplement.
If your child'due south symptoms are astringent and warrant removing all lactose from his or her diet, your pediatrician may refer your child to a registered dietitian. Since dairy is a good source of calcium and vitamin D—which all kids need—a registered dietitian can suggest other foods to provide those nutrients and may suggest vitamin supplements.

Is lactose intolerance a lifelong condition?

In some cases, lactose intolerance is temporary—if lactose intolerance develops later on a viral illness or if it is associated with other atmospheric condition, similar celiac illness. For example, in one case celiac affliction is treated, lactase levels can become in the normal range and lactose may be tolerated in the diet. More likely, all the same, lactose intolerance is long-term and requires many older children and adults to alter their diet to avert symptoms.

Boosted Information & Resources:

Vitamin D: On the Double
Milk Allergy
Baby Allergies and Food Sensitivities
Lactose Intolerance in Infants, Children and Adolescents (AAP Clinical Report)

About Dr. Porto:

Anthony Porto, MD, MPH, FAAP is a board certified pediatrician and lath certified pediatric gastroenterologist. He is an Associate Professor of Pediatrics and Associate Clinical Main of Pediatric Gastroenterology at Yale University and Director, Pediatric Gastroenterology at Greenwich Infirmary in Greenwich, CT. He is likewise the medical director of the Yale Pediatric Celiac Program. Within the American University of Pediatrics, Dr. Porto sits on the PREP Gastroenterology Advisory Board and is a member of the Section on Gastroenterology, Hepatology and Nutrition. He is besides a fellow member of the North American Gild of Pediatric Gastroenterology, Hepatology and Nutrition's Public Education Committee, a pediatric expert on nutrition for The Bump's Real Answers, and is the co-author ofThe Pediatrician'southward Guide to Feeding Babies and Toddlers. Follow him on Instagram @Pediatriciansguide.

The information independent on this Web site should not be used as a substitute for the medical intendance and communication of your pediatrician. In that location may be variations in handling that your pediatrician may recommend based on individual facts and circumstances.