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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:
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.
The primary goal is to be your own detective, read labels, and make inquiries at restaurants or other events involving food. Allergens can be hidden in coatings, thickeners, spices, natural flavors, and other ingredients found in fresh, frozen, refrigerated, and shelf-stable foods. Preparing meals and snacks at home can help you maintain control over food sources and help prevent cross-contamination.
This meal plan is created for women who are truly allergic, or who are breastfeeding and need to undergo an elimination diet to determine what foods their infant may have an intolerance or allergy to. Taking these foods out during pregnancy or breastfeeding, if not warranted, may actually promote intolerance in your infant as complete avoidance will prevent the immune system from learning that these foods are not actually harmful. If you are breastfeeding and your infant is showing symptoms of allergy or intolerance, and you have discussed the issue with your and/or your infant’s healthcare provider (HCP), this meal plan may be used to eliminate the major allergens.
This diet can be tricky. Make sure to work closely with your HCP as he or she knows what is best for you and your baby. To determine which foods were not tolerated by your baby, your HCP may have you add these foods back into your diet one at a time after they have been eliminated for 2-4 weeks, or until your infant stops having symptoms.
Choosing meals and snacks from the below listed options will help eliminate major allergens (dairy, soy, eggs, gluten, and peanuts) while helping you maintain adequate nutrient intake.
Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia called megaloblastic anemia that makes people tired and weak.
During pregnancy, vitamin B12 is believed to combine with folic acid to help prevent spina bifida and other spinal and central nervous system birth defects in your baby.
Vitamin B12 that is found in food needs the acidic environment of the stomach to separate it from the protein that it is bound to. The synthetic B12 found in supplements does not need to be separated, so if you have a low acid level (maybe you are taking medication to treat reflux or peptic ulcer disease for an extended time period) then you may have low blood levels of B12 and a supplement taken by mouth should be just fine.
Vitamin B12 is naturally found in animal products, including fish, meat, poultry, eggs, milk, and milk products. Vitamin B12 is generally not present in plant foods however it is commonly fortified and found in breakfast cereals, soy and other plant-based milks, nutrition bars, meat substitutes, and Red Star Vegetarian Support Nutritional Yeast.
The top food sources of Vitamin B12 are clams, liver, certain fortified breakfast cereals, fish, beef and dairy products.
Supplemental vitamin B12 for vegans and lacto-ovo vegetarians is recommended during both pregnancy and lactation to ensure that enough vitamin B12 is transferred to the fetus and infant. Pregnant and lactating women who follow strict vegetarian or vegan diets should consult with their health care practitioner regarding vitamin B12 supplements for themselves, their babies and their children.
Recommended intakes for vitamin B12 vary. They are as follows:
Include foods supplemented with vitamin B12 such as breakfast cereals fortified with 100% of vitamin B12.
Include foods that are naturally high in vitamin B12 such as clams, liver, sockeye salmon and rainbow trout.
If you are a vegan or vegetarian, talk to your health care practitioner about a vitamin B12 supplement.
If your diet is low on animal foods such as meat, fish, poultry, milk, cheese and eggs look for fortified vitamin B12 foods. Check nutrition labels because not all fortified foods have the same amounts.
If you are a long time user of certain medications to treat gastroesophageal reflux, peptic ulcer disease or are on metformin, talk to your health care practitioner about checking your vitamin B12 levels or supplementation.
Tip #1: Try to think of a snack as a mini meal. No need to forego foods that you normally eat at meals in favor of more traditional packaged snacks. Got some left over roasted veggies from dinner? Those can be a great snack! Got leftover meatballs? Have one with some veggies for a snack!
Tip #2: Fruits and Veggies. Most of us could could include more fruits and vegetables in our daily diet, in fact, half of our plates should be filled with them. Your snacks can include healthy fruits and veggies too! Start your snack with a fruit or vegetable, and add to it. Think apples, cherry tomatoes, tangerines and bananas, – all portable “fast food” for mom and perfect if cut up for your toddler. Make sure to cut up small circular fruits (like grapes, tomatoes, etc.) and veggies into small pieces for your toddler, to avoid any choking hazards.
Buy your veggies and slice them in advance so you have them ready to grab and go in your fridge. Sliced green, red and yellow peppers and washed berries, cut up mango and melon are also nice to keep on a shelf in the fridge for an easy-to-grab snack, on the go.
Tip #3: Add protein or healthy fat. Once you have your fruit or vegetable, add a little protein or healthy fat such as nut butters, nuts*, hummus, beans, avocado, yogurt, cheese stick, etc. Combining a protein or healthy fat with a fruit or vegetable makes for a more satisfying snack that will keep you feeling full, longer.
*For your toddler, a thin layer of nut butter is advisable vs a spoonful, to prevent choking.
Tip #4: Make it well-rounded. Combine multiple food groups for a balanced, healthy snack. Eating crackers alone for a snack may not be very satisfying but if you add hummus and sugar snap peas , you’ve got yourself a satisfying, healthy snack that could also be considered a mini meal!
Putting all of the above tips together, here are some healthy, satisfying snack examples:
Note: The following is a list of foods that are not suitable for children under the age of 4, due to choking hazard:
Two forms of vitamin A are available in the diet. Preformed vitamin A is found in foods from animal sources including dairy products, fish, poultry, and meat. Provitamin A is found in plant products. Beta-carotene is the most common type of Provitamin A (think yellow, orange, red and dark green fruits and vegetables). Provitamin A can be made into vitamin A by the body.
Common food sources of Vitamin A include:
Vitamin A listed on food and supplement labels are in international units (IU), however the RDA lists vitamin A in micrograms (mcg) of Retinol Activity Equivalents (RAE) to account for how different forms of vitamin A have different bioactivities (how well your body can use various forms). Converting these is complicated because different forms of vitamin A have different usable amounts for the body. Here are the requirements:
Vitamin A deficiency is rare in the United States. Americans are more likely to get too much vitamin A from their diets, than too little. Excessive Vitamin A is mostly a concern from over supplementation. This can cause adverse effects and is of particular concern for women who are pregnant. It would be difficult to consume excessive vitamin A from food sources alone.
There are many ways to prevent foodborne illness in babies and toddlers including:
Choking– Don’t let those pearly whites fool you. Just because your child has teeth, does not mean he is ready to handle all types of food. Babies and toddlers are at an increased risk of choking, so it’s important to provide age appropriate textures and appropriately sized foods.
Mercury– Certain types of seafood have a high mercury content, including albacore tuna, swordfish, mackerel, and tilefish. Fish is a great source of lean protein and can be included in your baby or toddler’s diet. When choosing fish, opt for low mercury choices like salmon, cod, chunk light tuna (in the can), pollock, tilapia, and catfish.
Too much salt can actually be harmful for babies’ kidneys, which is why it’s important to be aware of sources in your child’s diet. The American Academy of Pediatrics and American Heart Association recommend children age 1-3 get no more than 1500 mg per day of sodium. And for babies between 6 and 12 months, the recommended Adequate Intake (AI) is 370 mg sodium.
When you start serving your baby solids, aim to rely on foods’ natural flavors – such as the sweetness that comes from roasting root vegetables – to please your baby’s palate. As for salt, no need to sprinkle it on! To enhance the flavor of foods, try using fresh or dried herbs and spices that add flavor without sodium.
Most pre-made foods that are marketed for infants (up to 12 months old) are low in sodium. However, this is not always the case for foods aimed at toddlers (12-36 months old), such as pasta with sauce, dips and dressings for veggies, crackers, pretzels, processed meats and cheese.
How can parents reduce the amount of sodium in their child’s diet? When feeding babies, select foods that are designed for infants since they have lower sodium levels, or prepare homemade foods that are made with no added salt. Be cautious of “convenience foods” marketed to toddlers as they may contain a high amount of sodium. Compare Nutrition Fact Panels to find products lower in sodium. And whenever possible, provide fresh, whole foods for meals and snacks, enhancing the flavor of foods using herbs, spices and different cooking techniques.
Unfortunately, many packaged foods aimed at babies and toddlers contain added sugar – that is, sugar that has been added to the product and is not naturally occurring. While babies naturally gravitate towards sweet tasting foods, that does not mean their meals and snacks need to be enhanced with added sources of sugar.
Look at the ingredient list of kid-friendly foods such as cereals, bars, juices or fruit snacks and you’ll likely see sugar has been added. Added sugars to be aware of include: cane sugar, malt or corn syrup, evaporated cane juice, brown rice syrup, honey, and high fructose corn syrup – to name a few. When shopping, look for products with minimal or no added sugars in the ingredient list.
Much like with sodium, the best way to minimize added sugar in your child’s diet is to rely on whole, fresh foods as much as possible such as fruit, vegetables, minimally processed dairy, beans, legumes, meat, fish, and whole grains. Enhancing the natural sweetness of foods can be as easy as mashing a ripe banana in yogurt or oatmeal, or roast sweet potatoes with a dash of cinnamon.
While it’s difficult to cut out convenience foods such as jarred sauces and canned beans, added sugar and salt in your child’s diet can be minimized by using fresh, whole foods as much as possible. This will not only expose your little one to a variety of delicious foods, flavors and textures, but also set taste preferences and help children make healthy food choices for life.
While lactose intolerance is rare in babies and tots, some little ones with dairy sensitivities may actually have an intolerance 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. 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 three being allergic to milk. Fortunately, most children will eventually outgrow this as they get older and their digestive systems mature.
Babies who have a milk allergy may be experiencing frequent loose stools that may possibly contain blood or mucus, frequent spitting up, vomiting, and discomfort. 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 non-dairy formula.
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. 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. All whole fruits, vegetables, legumes, nuts, seeds, meat, poultry, fish, grains and eggs are dairy free. When it comes to meeting your and your baby’s nutritional needs, choose a variety of these non-dairy containing foods.
So what causes this discomfort and how can you help your little one avoid it? Inadequate hydration is the likely constipation culprit, along with eating a diet low in fiber.
It is important for babies and toddlers to drink enough fluids to keep their bodies properly hydrated and bowels moving regularly. And when increasing the amount of fiber in your child’s diet, it is important to keep increasing the amount of water to help process the added fiber.
Healthy babies under 6 months are unlikely to experience constipation because they receive adequate hydration and nutrients from breastmilk or formula or a combination. If your baby is experiencing constipation, here are some reasons it may be occurring:
Contrary to popular belief, recent studies have found that formulas with iron do not necessarily cause more constipation than formulas without iron.
Once your baby begins eating solid foods (likely around 6 months), constipation may occur. The transition from breastmilk or formula to solid foods is one of the most common times for children to become constipated because the digestive system needs time to adapt. Some straining during bowel movements is normal (babies still have weak abdominal muscles). But if your baby exhibits any of these symptoms, he may be constipated:
Once in toddlerhood, constipation can occur if your child holds in his stools. Many children do this as they learn to control their bowels, during potty training or when they transition to preschool or daycare.
Although constipation is more common in toddlers than babies, most cases aren’t serious and generally last a short amount of time. Even though most cases aren’t dangerous, it is important not to ignore symptoms or leave constipation untreated because it can lead to more serious health problems (such as fecal impaction, anal fissures, and rectal prolapse).
Keep your child hydrated
Keeping your child well hydrated will help prevent and alleviate constipation. Choose water as the main source of hydration and limit drinks such as fruit juices (and no juice under the age of 1). And remember that in addition to fluids, fresh fruits and vegetables can also contribute to proper hydration.
Constipation in infants
When preparing formula, add water first and then the powder to ensure baby is getting enough fluids. If constipation is consistent even with correct preparation of formula, speak with the pediatrician about additional signs that your little one may not be tolerating the formula well.
Even though research indicates that iron in formula may not cause constipation, all babies are different. If you feel this is the cause, call the pediatrician before switching to a low -iron formula, as iron is important for growth and development.
If you are breastfeeding and are concerned about your baby having an intolerance or allergy to foods you are eating, contact the pediatrician for more information.
If needed, a small amount of 100% prune, apple, or pear juice may be added to formula or breastmilk as long as baby is older than 4 weeks. The general recommendation is to give 1 oz per day for every month of life up to 4 months. For example, a 3 month old would be allowed to have 3 oz per day. Be sure to discuss with your doctor before providing your baby with juice. Note that juice is not recommended for infants younger than 1 year old at any other time.
If these dietary changes do not work, or if you are at all concerned, call the pediatrician.
Include lots of fiber in your child’s diet, from vegetables, fruits, beans and whole grains in your child’s diet
The recommended amount of fiber for toddlers (children 1-3 years old) is about 19 grams of fiber per day.
Examples of foods with fiber include apples and pears (keep the skin on for added fiber), berries, prunes, sweet potatoes, peas, broccoli, beans, oatmeal and whole grain bread or pasta. You can’t go wrong with vegetables and fruits so offer a variety to your child daily.
For reference, half a cup of cooked beans has about 6-9 grams of fiber, 1 small apple with skin has about 3 grams of fiber and half a cup of broccoli or greens has about 3 grams of fiber.
Check the nutrition facts panel on whole grains to determine the amount of fiber they provide.
Avoid too many low fiber foods
Examples of foods that are either low in or don’t have any fiber include cheese, chips, ice cream, meat and many processed foods. Try swapping out low fiber foods for those high in fiber.
Try probiotics
Probiotics, or healthy gut bacteria, may also be helpful in relieving constipation. Try adding yogurt or other foods with added probiotics
Breastmilk contains both probiotics and prebiotics, which have been shown to be beneficial for gut health in people of all ages. Research on formulas with prebiotics shown that they may lead to better stool consistency and frequency in infants. So if your baby struggles with constipation and all other dietary changes have not helped, choosing a formula with prebiotics may be beneficial.
Massage your baby
The “I love you” massage for babies and toddlers can be helpful in reducing constipation, abdominal pain, bloating, and gas. Read Baby massage: Benefits and techniques for all the details.
Encourage your child to move his bowels
When potty training, ask your child frequently if he needs to use the bathroom and visit the bathroom regularly even if your child does not ask to go. Help your child feel comfortable using the bathroom in places other than your own home.
If constipation persists, contact your healthcare provider
If your child is experiencing persistent constipation for 2 weeks or constipation accompanied by fever, vomiting, blood in stool, swollen abdomen or weight loss you should contact your child’s pediatrician.
Do not use treatments such as mineral oil, stimulant laxatives, or enemas without consulting your child’s pediatrician.
