Nutritional support for lactose intolerant babies and toddlers

Some babies can’t tolerate dairy, whether through the mother’s diet in breastmilk, or once they’ve started solids. But how do you know if it’s lactose intolerance or a dairy allergy? These terms have different meanings, although are often used interchangeably.

What to Know

Lactose itself is the sugar found in dairy products. Lactose intolerance is a digestive problem that can cause discomfort such as bloating, cramping, diarrhea, and gas. Because of a deficiency of an enzyme in the body called lactase, people who are lactose intolerant are unable to digest this milk sugar. The best treatment is avoiding dairy products and choosing lactose-free products. Lactose intolerance is not very common in babies and typically shows up in children after the age of 3.

While lactose intolerance is rare in babies and tots, some little ones with dairy sensitivities may actually have an intolerance or allergy to the milk proteins whey and casein (versus the milk sugar with lactose intolerance.)

A milk allergy or intolerance could potentially cause a wide range of symptoms from a rash, hives, itching, and swelling to a more life-threatening reaction such as anaphylaxis. Babies who have a milk allergy may also experience frequent loose stools that may possibly contain blood or mucus, frequent spitting up, vomiting, and discomfort.  A cow’s milk allergy is the most common food allergy in infants and young children with approximately 2.5 percent of children younger than 3 years being allergic to milk. Fortunately, most children will eventually outgrow this as they get older and their digestive systems mature.

Your pediatrician may ask for a stool sample to check for blood, as sometimes the blood is not visible to the eye. Breastfeeding moms must eliminate dairy in their diet since the milk proteins pass through breastmilk, while formula feeding moms will likely need to switch to a specialized formula.

When eliminating dairy in your own diet or trying to figure out what foods to offer your tot, reading labels is critical. The following words will indicate the presence of milk in the product:

  • Milk
  • Lactose
  • Whey
  • Casein
  • Curds
  • Milk by-products (like butter)
  • Dry milk solids
  • Nonfat dry milk powder

You may wonder how you or your child’s nutritional status may be impacted when foregoing dairy products. Fortunately, there are many foods that can supply the important nutrients that dairy provides, such as protein, calcium, magnesium, and vitamin D. All whole fruits, vegetables, legumes, nuts, seeds, meat, poultry, fish, grains, and eggs are dairy free. There are also many non-dairy substitutes on the market, such as soy yogurt or coconut milk so you can still cook and bake dairy-free with ease. When it comes to meeting your and your baby’s nutritional needs, choose a variety of these non-dairy containing foods.

What to Do

  • Observe the symptoms: Does your baby have gas and bloating? Loose stool with blood in it? Eczema or skin rash? This will help determine the problem.
  • Consult with your pediatrician if you suspect your baby may have a milk allergy or lactose intolerance.
  • Read food labels’ ingredient lists for sources of lactose or milk protein that need to be avoided.
  • Seek out non-dairy alternatives to use in cooking and baking as needed, such as non-dairy margarine and soy milk in baked goods, or canned coconut milk in creamy soups.
  • Eliminate dairy in your own diet if your breastfed baby develops a milk allergy.
  • Seek out non-dairy sources of protein such as meat, eggs, fish, tofu, and beans.
  • Seek out non-dairy sources of calcium, such as dark leafy greens, tofu, legumes, and calcium fortified non-dairy beverages.
  • Seek out non-dairy sources of vitamin D, such as salmon, egg yolks, and some fortified cereals and non-dairy beverages.
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