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Lactose Intolerance in Children: A Guide for Parents and Caregivers

Lactose intolerance is a common condition in which the body has difficulty digesting lactose, a sugar found in milk and other dairy products. This happens when the small intestine doesn’t produce enough of an enzyme called lactase, which is needed to break down lactose into simpler sugars for absorption. As a result, undigested lactose moves into the large intestine, where it can cause uncomfortable symptoms like bloating, gas, and diarrhea.

Lactose intolerance isn’t dangerous, but it can be uncomfortable for children and may affect their diet. At Gertrude’s Children’s Hospital, we’re here to help you understand how to manage your child’s lactose intolerance, ensuring they can enjoy a healthy and balanced diet without discomfort.

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Symptoms

  • Bloating: A feeling of fullness or swelling in the belly.
  • Gas: Excessive flatulence after eating dairy.
  • Diarrhea: Loose, watery stools.
  • Stomach cramps or pain: Discomfort in the abdomen.
  • Nausea: A feeling of sickness that may sometimes lead to vomiting.

Causes

  • Congenital lactase deficiency is extremely rare and occurs when babies show symptoms of lactose intolerance right after being exposed to lactose in milk.
  • Primary lactose intolerance happens naturally as people age. After weaning, most mammals, including humans, experience a decline in lactase production, which is needed to digest lactose.
  • Secondary lactose intolerance occurs temporarily after damage to the small intestine, such as from celiac disease or a rotavirus infection.

Diagnosis

  • Genetic testing:
    • Lactose intolerance, especially in adults, can now be detected through genetic testing.
    • This test looks for a specific gene variant (CC genotype) that causes low lactase production.
    • However, just having this gene doesn’t mean a person will have symptoms right away—lactose intolerance can develop later in life.
  • Hydrogen Breath Test:
    • This test checks how well your body breaks down carbohydrates like lactose.
    • When lactose isn’t absorbed, it moves into the large intestine, where bacteria break it down and release hydrogen gas.
    • This gas enters the bloodstream and is exhaled through the lungs.
    • By measuring hydrogen levels in your breath after drinking a lactose-containing beverage, doctors can determine if lactose is being properly absorbed
  • Elimination Diet:
    • If removing lactose or milk from the diet causes symptoms like diarrhea to stop, and the symptoms return when lactose is reintroduced, it’s a strong sign of lactose intolerance.
    • However, not resolving symptoms after removing lactose doesn’t necessarily mean a person can tolerate it.
    • There could be other reasons for symptoms, and sometimes eliminating milk products can improve symptoms caused by a milk protein allergy rather than lactose intolerance.
  • Stool analysis
    • Testing stool can help diagnose lactose intolerance by checking if the body is absorbing carbohydrates properly.
    • If the stool contains certain “reducing substances,” it means the body isn’t absorbing the sugars properly.

Treatment Options

Lactase Deficiency in Newborns:

  • In newborns, the body can increase lactase production when exposed to lactose.
  • For premature babies, feeding with milk that contains lactose has been shown to help stimulate lactase activity.

Dietary Adjustments:

  • Lactose-Free or Reduced-Lactose Diet:
    • Removing or reducing lactose-containing foods like milk, cheese, and ice cream can help prevent symptoms.
    • There are plenty of lactose-free alternatives available, such as lactose-free milk, almond milk, and soy products.
  • Lactase Supplements:
    • These over-the-counter supplements contain the enzyme lactase, which can help your child digest lactose.
    • They are taken just before consuming dairy products.
    • Yogurt with live cultures is generally easier for people with lactose intolerance to digest, and lactose-free or low-lactose dairy products are widely available.
  • Trial and Error: Some children may be able to tolerate small amounts of lactose or certain dairy products without symptoms. Testing which foods your child can safely eat will help develop a balanced diet.

Maintaining Nutritional Balance:

Treating Underlying Causes

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We teach children and families how to care for them and prevent future cases

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Please feel free to contact us with any general or medical enquiry by calling us.

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