Is my baby lactose intolerant?

Look out for signs that your breast- or formula-fed baby has a digestive problem, plus, help junior manage this condition.

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When her newborn son Kieran cried and fussed after every feed, stay-at-home mum Amanda Lim, 36, suspected something was wrong

“It got worse as Kieran’s milk consumption grew — his tummy would be bloated and feel very hard to touch. His stools were also very watery with a lot of gas being passed. At first, we thought it was colic, but then we realised the fussing only occurred after he was fed my breastmilk.

“My husband and I even suspected there was something wrong with my breastmilk! We decided to substitute with formula milk meant for sensitive tummies, but it was still the same scenario,” Lim recounts.

Distraught, Lim brought her son to the doctor several times for check-ups. She says that the doctor recommended trying a lactose-reduced or lactose-free formula instead of breastfeeding.

Symptoms can occur minutes to hours after drinking milk or dairy products and can range from mild to severe.

“Though I was upset that I could not give Kieran my precious breastmilk, we decided to try the recommended formula. To our relief, he was better, fussed less and his tummy was much less bloated. Before this, I had not even known that babies could be intolerant to breastmilk!”

Signs of lactose intolerance

Improper digestion leads to the fermentation of the sugar in the large intestine by the gut flora. This produces carbon dioxide and hydrogen, as well as certain products that have a laxative effect. Lactose intolerance (LI) sufferers experience these symptoms:

Abdominal cramps/pain.

* Watery diarrhoea (loose stools that may be green/yellow in colour).

* Gas/trapped wind after eating or drinking dairy products.

* Stomach bloating, flatulence.

* Fussy, unsettled, cries frequently.

* Noisy bowel sounds.

* Vomiting.

* Red, raw diaper rash caused by acidic poo is another possible symptom or side effect of this condition.

The more lactose your child consumes, the more symptoms he or she will experience. These people lack the enzyme lactase, which helps break down lactose, the sugar found in milk. While it’s relatively uncommon, babies can suffer from LI.

Symptoms can occur minutes to hours after drinking milk or dairy products and can range from mild to severe. If your infant exhibits the symptoms, check with his doctor. Preemies are at higher risk of LI as they may have reduced levels of lactase, since the small intestine doesn’t develop lactase-producing cells until late in the third trimester.
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To check, observe if the symptoms improve after you remove all milk products from your baby’s diet. Then slowly reintroduce the products in small quantities to see if the symptoms return. The doctor may also use a hydrogen breath test — it measures the amount of hydrogen in your child’s breath before and after consuming lactose — to check if bubba has LI.

Incidentally, while lactose intolerance and a milk allergy may share similar symptoms, these two conditions are not the same. This is because LI is a digestive issue while a milk allergy affects the immune system.

“The first option for a lactose-intolerant child is usually soy milk. Non-dairy sources of calcium include leafy greens, fortified juices, soya milk, tofu, broccoli, etc.”

If junior is unwell, LI can also occur temporarily. “A common cause of lactose intolerance is secondary to an episode of gastrointestinal infection. Sometimes, the virus that causes the infection is gotten rid of first but the diarrhoea persists because of lactose intolerance,” explains Dr Simon Ng Pau Ling of Babies and Children Specialist Clinic.

Feeding a lactose intolerant child

To prevent symptoms, you might have to offer your little one a special lactose-free infant formula as both breastmilk and cow’s milk-based formula milk contain lactose.

Dr Ng notes, “The first option for a lactose-intolerant child is usually soy milk. Some kids may reject it initially due to its taste but may eventually get used to it. Do not opt for the flavoured versions that contain added sugar and preservatives — opt for natural instead. Non-dairy sources of calcium include leafy greens, fortified juices, soya milk, tofu, broccoli, etc.”

If you need to eliminate dairy products, make sure to pay attention to your baby’s intake of calcium as this is essential for their growing bones. Therefore, it is important to ask your doctor for recommendations before adjusting your baby’s diet, Dr Ng cautions.

Your baby may recover or learn to tolerate more lactose in the future, but to some people, it is a lifelong condition. Your baby’s doctor may recommend a lactose-reduced or lactose-free formula for now and then try to reintroduce lactose at a later stage to test your baby’s reaction to it.

Photos: iStock

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