Lactose Intolerance in Babies

Dr Chandra Sekhar Tippareddy

In conversation with Dr Chandra Sekhar Tippareddy
MD (paed) (Neonatology and Pediatrics)

Lactose Intolerance in Babies- Symptoms, Causes, Treatment

What is lactose intolerance in babies?

Lactase is the enzyme that is required to digest sugars present in milk ( lactose ). Lactose intolerance occurs when a person does not produce this enzyme, or does not produce enough of it, and is therefore unable to digest lactose. If it is not digested and broken down, it cannot be absorbed. In rare cases, a baby can be born with lactose intolerance. If this happens, the undigested sugars in the breast milk stay in the large intestine and cause gastrointestinal problems.

What causes lactose intolerance in babies?

Premature Birth: When a baby is born prematurely, they may not be able to produce enough lactase to digest breast milk. The lactase levels in babies usually increase towards the end of the third trimester of pregnancy
Genetics: If the parents are lactose intolerant, there are chances of the baby being born with intolerance due to the genes passed on to the baby from both parents.
Medication: Some medications can cause the body to produce lower levels of lactase, causing lactose intolerance. If the baby gets sick in the first week after birth, there are chances that medicines administered to them can cause lactose intolerance.

How common is lactose intolerance in babies?

Very rare. Because milk is the natural first food of all humans, babies are typically born ready, willing and able to drink (and digest) milk. The exception is premature infants, since lactase levels usually increase during the third trimester. If baby was born early, he or she may not have enough lactase to adequately break down lactose. Interestingly, lactose intolerance becomes more common in kids after age 2, since lactase levels begin to taper off after that age.

What are the symptoms of lactose intolerance

If the baby has lactose intolerance, they are likely to show symptoms including:
• Diarrhoea
• Abdominal Cramping
• Bloating
• Formation of gas within 30 minutes to 2 hours after having breast milk

How to manage lactose intolerance

It may not be necessary that the baby will show symptoms of lactose intolerance at an early age. Consult a pediatrician regarding the symptoms of discomfort seen in the baby. If it is confirmed that the baby has lactose intolerance, some ways to help manage it are:
Avoid Lactose: Dairy products and food items containing milk products should be avoided. When a baby is lactose intolerant, the doctor will recommend a suitable baby formula that is lactose-free. If your doctor does diagnose ‘lactose intolerance’, continuing to breastfeed will not harm your baby as long as the baby is otherwise well and growing normally. Human milk remains the best food and will assist with gut healing.

Watch Their Reactions Carefully: Some babies can digest limited amounts of lactose. It is important to see how the baby reacts to lactose-containing food. If the baby is highly sensitive, it is advised to avoid all foods with lactose completely.

Meet All Other Nutritional Requirements: Since milk and other dairy products need to be restricted from the baby’s diet, it is vital to provide alternate sources of calcium in order to help in healthy teeth and bone development. Rich sources of calcium include green leafy vegetables, fortified juices and soy milk, tofu, broccoli, salmon, oranges, and fortified bread.

Average recovery time for the gut of a baby with severe gastroenteritis is 4 weeks, but may be up to 8 weeks for a baby under 3 months. For older babies, over about 18 months, recovery may be as rapid as 1 week. If the doctor advises alternative feeds for the baby, it is important that the mother understands that her breast milk is still the normal and proper food for her baby in the long term.
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