Lactose intolerance in babies
lactose; intolerance; baby; pain; lactase; solid; diet; nutrition; milk; breastmilk; breastfeeding; diarrhoea; free; formula ;
Lactase is an enzyme, or chemical, which the body uses to digest milk sugar (lactose). If there is not enough lactase, undigested milk sugar gets into the large bowel and may cause gut pains and diarrhoea. This is called lactose intolerance.
- It is common for adults and children over 4 or 5 years, from many racial groups, to be somewhat intolerant of milk because of the lactose in it.
- This is normal in races that don't often drink milk after babyhood (eg Asian, Australian Aboriginal) but does not usually affect babies in these groups.
- Gastro (gastroenteritis, tummy upset, bowel infection, infectious diarrhoea) can damage the lining of the small bowel and cause lactose intolerance for a few weeks after the illness in babies (or at any age.)
- A severe food or milk allergy may cause lactose intolerance.
- Very rarely newborn babies do not make any lactase, and become really sick in the first week of life. They do not grow until lactose is removed from their diet.
- Many young breastfed babies who are growing well and have not had 'gastro' show some signs of lactose intolerance, but this is not an illness.
- The problem is an overload of lactose, not a true intolerance.
- This can almost always be helped without stopping breast feeding.
- Some bottle fed babies also do not fully digest all of the lactose that they get in their milk, and show signs of lactose overload.
- If your older child seems to get loose poos and tummy pains after drinking milk, you will need to see a doctor to be sure of the reason and to get information about ways to give him the foods he needs for healthy growth and development. (See the section on 'Lactose Intolerance' in the topic 'Reactions to foods'.
- If your young breastfed or bottle fed baby is unsettled with lots of watery or frothy poos, you need to check with your doctor as there could be many reasons for this.
- Your doctor may want to have some tests done for lactose intolerance. A 'Breath Hydrogen Test' may be carried out. However, they are often positive in healthy young babies so they are not helpful in most cases.
If your doctor does say that your baby probably has 'lactose intolerance' you need to know that this will not harm your baby as long as she or he is otherwise well and growing normally. It makes babies uncomfortable, but they still get all the nutrition they need.
- Lactose intolerance does not cause vomiting or eczema.
- Lactose intolerance is not caused by, or made worse by, the mother drinking cow's milk. The lactose in breastmilk is made in the breast, and is not affected by the mother's diet. Breastmilk always contains lactose.
- A severe cow's milk allergy may cause similar symptoms, though, and if this is the cause, sometimes a baby is more settled if the mother avoids all dairy foods.
Breast fed babies
- It is usually better to keep breastfeeding - feeding the baby with a lactose-free formula is sometimes suggested but it does not always help.
- You may like to try some settling ideas. See the topic 'Crying baby'.
- When breastfeeding, make sure your baby finishes the first breast (to try to get more of the fatty milk) before trying her on the other breast, as this often helps. Fat in milk slows down digestion, so more lactose is broken down by the lactase and absorbed.
- Try to space feeds a little, perhaps aiming for about 3 hours from the start of one feed to the start of the next. If your baby wants a feed during this time, put her back to the 'empty' side.
Bottle fed babies
Anderson J. 'Lactose intolerance and the breastfed baby' Essence Magazine, 2010, Vol 35, No 1. Published by the Australian Breastfeeding Association
Lawler Smith C, Lawler Smith L. 'Lactose intolerance' Breastfeeding Review 1998; 6,1: 29-30
National Digestive Diseases Information Clearinghouse (USA) 'Lactose intolerance'
Noble R, Bovey A 'Resolution of lactose intolerance and 'colic' in breastfed babies' Presented at the Australian Lactation Consultants Association of Victoria conference, Melbourne, 1998
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your child's sex.