Lactose intolerance in babies: symptoms and treatments

If lactose intolerance is relatively common in infants, it can be transient when it occurs, for example, after gastroenteritis or any disease causing damage to the baby’s intestine. In this situation, intolerance will cease upon full recovery of the intestinal mucosa. During this period, the use of lactose-free milk or changes in the diet, if the food diversification is already well underway, are recommended.

Cow’s milk protein allergy or lactose intolerance: what’s the difference?

Any allergy, like that to cow’s milk proteins, leads to a reaction of the immune system with more or less violent manifestations in the minutes, or even in the seconds which follow the ingestion of the food. On the other hand, intolerancelactose is metabolic.

« To digest lactose (a sugar found in milk), the digestive system produces an enzyme called lactase. Its activity naturally decreases over time and quite synchronously with an individual’s milk requirements. You will rarely see an adult drinking 800 ml of pure milk per day! But sometimes this decline in activity occurs earlier, usually around the age of 2-3 years. That’s what we call lactose intolerance »Explains Dr Etienne Bidat, pediatrician. No particular worry for parents who suffer from lactose intolerance, it is not transmitted.

How do I know if my baby has lactose intolerance?

Children with lactose intolerance experience bloating, abdominal pain and may suffer from diarrhea. These digestive disorders are due to the fermentation of lactose in the digestive tract. ” It has absolutely nothing to do with gastroesophageal reflux disease (RGO) », Emphasizes Étienne Bidat. Parents usually notice this because the child complains after drinking a bottle or a cup of milk for breakfast (within about two hours).

It exists varying degrees of lactose intolerance. “ It is extremely rare that newborns are affected by lactose intolerance. But in this case, we speak of primary lactose intolerance. The newborn does not gain enough weight. It is then part of a larger metabolic disease », Specifies the pediatrician. He adds that transient lactose intolerance can occur after an episode of severe diarrhea (after gastroenteritis for example). “ The digestive tract is damaged and it takes some time for the enzyme activity to resume », Explains Dr Bidat.

« It can also be a congenital insufficiency in lactase, an enzyme which makes it possible to digest lactose, fortunately very rare. In the latter case, the baby will need to drink only lactose-free infant milk and follow a strict lactose-free diet for life.», Continues Emilie Fumet, dietician.

« Secondary intolerance appears later, generallyaround 3-4 years, lactase being at its maximum level at birth and gradually decreasing with age in this very common caseShe adds. In this case, it is advisable to seek with the doctor or the nutritionist, the lactose tolerance threshold to properly tailor dietary advice and restrictions.

What milk if a baby is lactose intolerant?

For babies intolerant to lactose, there are infant milks formulated without lactose. ” If they are made from cow, goat or sheep milk, depleted in lactose, all the nutrients (iron,vitaminsD, K, in particular, essential fatty acids …) necessary for the good development of the baby were added as in allinfant milks», Notes Emilie Fumet.

Can we turn to vegetable milks or rice milk?

It is also important to specify that vegetable drinks (called milk but corresponding more to purees or juices from almonds, soybeans or rice) not formulated specifically for infants, in particular those sold in supermarkets or in organic stores, not suitable for babies’ needs. And, in exclusive consumption, they cause serious deficiencies for toddlers. They are therefore strongly discouraged by health professionals.

Lactose-free infant milk: when to give it to an infant?

If your child has poor digestion (diarrhea, cramps, bloating, gas), it is important to go consult your pediatrician who can make a diagnosis and recommend a suitable milk for your baby.

Lactose-free milk is indicated for:

• Diarrhea or loose stools without complications
• Abdominal pain and bloating
• Gastroenteritis episode
• Congenital, transient or secondary lactose intolerance

If lactose intolerance is linked to a decrease in lactase activity – the enzyme responsible for the digestion of lactose – following gastroenteritis, for example, low lactose milk may be sufficient while the inflammation of the intestinal mucosa subsides. ” It is generally recommended to give milk low in lactosefor 8 days, then reintroduce the classic infant milk », Specifies Emilie Fumet.

These types of lactose-free milk are sold in pharmacies, on the advice of your doctor, but they can be obtained without a prescription.

How to treat lactose intolerance in children?

If your child has lactose intolerance, it is a question of adjusting his food for a few weeks so that the activity of the Lactase gradually resume. Paediatricians or nutritionists can prescribe low-fat milk. lactose. If the child is already eating “solid”, they will recommend other calcium intakes through products. dairy easier to digest. ” Two pieces of hard cheese (low in lactose) per day is enough to cover a child’s calcium needs », Cites Dr Bidat as an example.

« Apart from cases of very strong intolerance, parents easily adapt meals to this particular sensitivity of their child (which generally regulates itself, identifying the foods that make him feel good) He continues. In most cases, there is no need to make a more precise diagnosis with laboratory tests or to consider synthetic lactase-based drug treatments. On the other hand, in the event of very strong symptoms despite the adaptation of the diet, it is advisable to consult a gastroenterologist.

How do I know if my baby is allergic to cow’s milk protein?

The allergy causes a reaction of the immune system with more or less violent manifestations in the minutes, even in the seconds which follow the ingestion of the food. This is the case with immediate allergies (IgE mediated). For delayed allergies (non-IgE mediated), such as eczema or digestive disorders, the relationship between food intake and clinical manifestations is less obvious. You should know that before the age of one year, cow’s milk proteins are most often involved in allergies. Some allergies can be transient. Thus, in more than 80% of cases, the allergy to cow’s milk proteins very often heals around the age of 3-4 years.

What are the symptoms of a cow’s milk protein allergy?

If sometimes the symptoms immediately make you think of an allergy as in the case of swelling of the lips just after drinking milk for example, most of the time, it is more complicated to read. Itching, allergic rhinitis, bloating, diarrhea, asthma… may very well be signs of an allergic reaction. Some ideas to help you. Note that in younger people, food allergy is most often manifested by atopic dermatitis, that is to say eczema. In addition, it is important to recognize when these reactions occur. If it’s always after taking the bottle, it’s a good clue.

Cow’s milk protein allergy: the child may be allergic to other foods

In addition, the child may be allergic to other foods. Indeed, the organism can react strongly to allergens of very different origins, but which resemble each other in their biochemical structure. It’s cross allergy. For example, a child may be allergic to cow’s milk protein and soy or almond and pistachio. Likewise, a child can be allergic to raw milk, but tolerate it very well when baked in cakes. Hence the importance of consulting an allergist to make a reliable diagnosis and not unnecessarily remove certain foods from the menus of toddlers.

Lactose intolerance: should we eliminate all dairy products (yogurt, etc.)?

Complete elimination of lactose when the infant does not have severe intolerance is not the best solution. Because the less we stimulate lactase, the more its development is compromised. The risk is then see intolerance worsen over time. A doctor or nutritionist can help you estimate the tolerance threshold with cow’s milk for your baby to provide the best possible diet.

« But be aware that in case of lactose intolerance, it may be quite possible to consume dairy products, such as somecheesewhich are lactose-free, specifies Emilie Fumet. Recommended for example are parmesan, goat cheese, emmental, brie, mozzarella, edam, gouda …

Likewise, the consumption of butter may be authorized, especially in cases of mild lactose intolerance, because this food contains very little lactose. “Note, however, that some children may react to butter, warns the specialist,it is therefore necessary to act on a case-by-case basis. »

« As toyoghurt, they certainly contain lactose but also lactase which will help digest lactose, specifies Emilie Fumet. It may therefore be possible for children to consume it.Here again, the advice of a health professional will allow you to identify the recommended foods and those to avoid.