What is it?
Lactose is the main sugar found in all milks; breast milk, formula milk and animal milks. It provides an important source of carbohydrates for babies and infants. In order for the body to use lactose it has to be broken down by an enzyme in the body called Lactase. If your body does not produce lactase, or enough of it, then your body cannot use the lactose in milk to provide energy. This is called lactose intolerance.
It is different from an allergy, where the body mistakes a protein within a specific food as harmful and mounts an immune response to it. It is not possible to have an allergy to lactose as lactose is not a protein.
Not having enough enzymes to break down lactose means that it stays in the body and can cause water to be drawn into the digestive system. As it travels, bacteria naturally found in the body feed on this, producing gas and causing symptoms.
What are the symptoms?
Can vary among infants but include:
- Being unsettled
- Frequent crying
- Loose, watery stools (may be green/yellow in colour)
- Trapped wind
- Noisy bowel sounds
These can occur anywhere from a few minutes to a few hours of having milk or milk products. The ‘general’ nature of these symptoms can make it quite hard to spot lactose intolerance in a young baby.
There are three different ‘types’ of lactose intolerance:
1. Hereditary lactose intolerance:
Baby is born without any of the enzyme lactase. Symptoms tend to occur after the first milk feeds and can be quite severe.
2. Primary lactose intolerance:
Baby is born with lactase enzyme but amount of it gets less over time and symptoms increase. The baby might be able to have small amounts of milk but over time milk alternatives may need to be used.
3. Secondary lactose intolerance:
A temporary condition where illness affects how well the body can make the enzyme lactase. Symptoms usually go away after 3-4 weeks.
How is it diagnosed?
If you suspect your baby may have lactose intolerance it is important to see your GP as soon as possible, so that anything else can be ruled out. Your GP may take a medical history, look at how well they have been growing and make a note of any symptoms. They might also ask you to try your baby on a lactose-free milk product, and avoiding weaning foods with lactose in, for a trial period to see if this solves the symptoms. If it does then they may ask you to continue with this to stop the symptoms from coming back.
How is it treated?
If your baby is diagnosed with lactose intolerance then the treatment will involve avoiding lactose both in milk and in foods. If they are quite young this will involve feeding with a lactose-free milk formula and weaning diet, and they may need additional calcium, magnesium and zinc to replace what they aren’t getting from milk. As they get older you may need to swap from a milk-free formula to a lactose-free milk (found in most supermarkets), and check ingredients labels carefully to make sure there is no lactose.
With primary lactose intolerance sometimes toddlers can tolerate small amounts of foods with lactose in such as cheese and yoghurts. In this case your GP or dietitian can advise you.
This can sound a bit daunting but removing the lactose usually resolves the symptoms so the change in diet is usually met by a change in health and happiness of your baby. Also, due to a rise in people with lactose intolerance many supermarkets now have quite a good range of lactose-free products. Look for the following words on ingredients lists which indicate that the food may contain lactose: milk, whey, curds, milk by-products, dry milk solids, non-fat dry milk powder.
All HiPP packaging lists cows’ milk as an ingredient and also in a yellow ‘CONTAINS’ box for easy checking.
Have a look at the HiPP Organic products that are all lactose free.