Infants and children who are lactose intolerant are unable to digest the sugar lactose, which is mainly found in milk and dairy products. Lactose intolerance is caused by low or nonexistent production of the enzyme lactase, which is responsible for breaking down lactose in the intestines. Because milk is a commonly recommended source of vitamins and minerals for children, diagnosing and treating lactose intolerance wil ensure proper safety and nutrition for people of any age.
Childhood Lactose Intolerance
Lactose intolerance in infants and children is fairly rare, as this disorder normally develops later in life, unlike milk allergies, which are more common in childhood and are caused by a faulty immune system response instead of a missing enzyme. Most infants are able to digest lactose because it is the primary sugar in human milk. Premature infants who are yet unable to make sufficient lactase enzymes, or babies who inherit the gene for lactose intolerance from both parents, may develop this disorder in infancy. Gas, bloating, diarrhea and stomach cramps are common symptoms of childhood lactose intolerance. The degree of lactose intolerance varies from child to child, with some able to tolerate a moderate amount of lactose and others who react to even very small amounts.
Significance
For most children, the primary source of calcium and vitamin D is through milk or milk products such as cheese and yogurt, which are high in lactose; and formula-fed infants frequently get these nutrients through formulas that are cow's milk--based. Breastfed infants receive these nutrients through their mother's milk and sometimes through additional vitamin supplements. When a baby if weaned off of breast milk or formula, he typically begins consuming cow's milk as a source of vitamin D and calcium. Fortified soy milk may be an alternative for severely lactose-intolerant children.
Testing
Testing for lactose intolerance may be necessary to distinguish it from a milk allergy. A doctor can test your infant or child for lactose intolerance using a machine that measures the amount of hydrogen in the child's breath. When lactose is not broken down by the digestive tract, it ferments and produces excess hydrogen. In some cases, a doctor may take tissue samples from the intestines to look for the presence of lactase.
Solutions
Some lactose intolerant infants may be able to tolerate the lactose in breast milk but have more difficulty with cow's milk or formulas that are cow's milk--based. Lactase drops, a liquid version of the enzyme lactase, can be given to the baby or child before she consumes breast milk, formula or cow's milk in order to help her digest lactose. In some cases, lactase can be added to expressed breast milk and allowed to sit in the refrigerator overnight to give it time to digest the lactose before the baby drinks the milk. Babies with severe lactose intolerance may need to be put on lactose-free formula. For older children, lactose-free dairy products or supplemental lactase may help keep dairy in the diet.
