Lactose is a disaccharide, a type of sugar that is composed of both galactose and glucose. By weight, lactose makes up approximately 2 to 8% of the weight of the milk. By itself, the compound is white and water soluble and has a mildly sweet taste. In the body, lactase is an enzyme that functions to digest lactose. Lactose is found in milk and if an individual does not have enough lactase, lactose (the undigested milk sugar) makes its way into the large intestines and can lead to pain in the intestines and diarrhea. This condition is known as lactose intolerance. Just like cow’s milk, breast milk also contains lactose.
are many babies that show signs of lactose intolerance such as unsettledness and has lots of watery or frothy bowel movements. This occurs as they have an overload of lactose. Bottle fed babies occasionally are not able to digest all the lactose in their formula leading to lactose overload.
Lactose intolerance is common in children over the age of four to 5 years old as their body no longer have as much lactase enzyme in their body. This is especially seen in individuals who do not usually drink milk after early childhood (for example, Asians and aboriginal Australians). Lactose intolerance is poorly understood and there are often many myths and misunderstandings about it. Some of the myths include:
• There is less lactose in breastmilk if the mother stops consuming dairy products.
• The lactose intolerance between adults and children are different.
• Babies with lactose intolerance should continue breast feeding and fed soy based or lactose free infant formula.
• Lactose intolerance and allergy to cow’s milk protein are different.
Lactose can be found in all mammalian milks and is produced in the breast. Lactose intolerance that is not digested continues to move to the digestive tract of large intestine where bacteria breaks it down and produces acids and gases. The stools of those affected by lactose intolerance are often soft, liquid, green, and frothy. The baby may also pass wind frequently as well.
Lactose Intolerance in Babies
There are two main types of lactose intolerance in babies:
Also known as true lactose intolerance, this is a rare genetic condition that is incompatible with life unless there is medical intervention. There is failure to thrive in babies with primary lactose intolerance since birth. This means that the baby is unable to gain weight and has symptoms of dehydration and malabsorption. Viewed as a medical emergency, this baby requires special diet as soon after delivery.
In secondary lactose intolerance, the tips of the microscopic folds of the intestines that produce the lactase enzyme are damaged due to a variety of reasons such as food allergy (due to wheat, egg, cow’s milk, and more), gastroenteritis, parasitic infections such as cryptosporidiosis or giardiasis, bowel surgery, or coeliac disease(where there is intolerance to gluten in wheat and other grain products). The average time for the baby to recover after severe gastroenteritis can take up to 4 to 8 weeks depending on the age of the baby. Infants over 18 months old can recover as fast as 1 week. The baby does not have to consume foods that he or she is intolerant to but can be passed on through the mother’s breastmilk. If you have doubts and suspicions that your baby is having a food allergy due to your consumption of certain foods, remember to check with your healthcare team to aid you in the identification of culprit foods to ensure your diet is healthy for both you and the baby.
Cow’s Milk Protein Allergy vs Lactose Intolerance
While many often confuse cow’s milk allergy and lactose intolerance and many thinking that both these conditions are the same thing, this is not the case. Many are confused as both the cow’s milk protein and lactose originate from the same food such as milk and dairy products.it is important to take note that allergy can lead to secondary lactose intolerance which further complicates the condition. Secondary lactose intolerance is not permanent as the damaged gut can heal. As long as your baby is growing normally, there is no need to discontinue breastfeeding.
However, in cases where the baby has symptoms of lactose intolerance, it is suggested that breastfeeding be stopped and continue with feeds using lactose free formula. One of the first considerations is to first establish if the baby is sensitive to foreign protein before taking the baby off the breast as human milk is still the best food that can help with gut healing. You can seek professional advice regarding the use of hypoallergenic formula.
Another option is to give the enzyme lactase to babies who are lactose intolerant. There has been little evidence that this method has much value although experts believe that large doses can help in some cases. Lactase enzymesare added to expressed breast milk, so the enzyme can predigest the lactose in the milk.
Causes of Lactose Intolerance
While experts are still unsure why some people are lactose tolerant or intolerant, lactose intolerant is not as rare as it seems. As many as 30 to 50 million individuals in the United States are intolerant to lactose. Genetics play an important role in lactose intolerance where 90% of Asian Americans are lactose intolerant. In African Americans, Jewish, Native Americans, and Hispanic Americans, as many as 75% are lactose intolerant. 15% of the northern European descent are also intolerant to lactose. For a baby to have lactose intolerance, both parent would have to pass on the gene of lactose intolerance to the baby. After delivery, the baby will experience severe diarrhea regardless of breast feeding of formula feeding. A special and lactose free formula will be required for the specific child.
What to Do if My Baby is Lactose Intolerant
One of the things that you can do to prevent or treat lactose intolerance is to:
a) Read labels
– try to avoid foods and products that may contain lactose. This includes foods such that contain milk products such as cookie mixed and pancakes, instant potatoes, soups, breads, margarine, and more. Avoid ingredients such as curds, whey, milk products, non-fat dry milk powder, curds, and more.
– observe your baby as some individuals who are lactose intolerant can digest some lactose while others are sensitive to the smallest quantities. Through observation, you will be able to gage how much dairy food your child can handle. You can try introducing cheese that have a lower amount of lactose and live-culture yogurt that can be easily digested.in babies that are very sensitive, you should avoid all sources of lactose.
c) Nutritional needs
Ensure that your baby has all the necessary nutritional needs. Find alternative sources of calcium such as leafy greens, soy milk, fortified juices, tofu, broccoli, oranges, fortified breads, and salmon if dairy products are not an option. It may be beneficial to consult a dietician.