Lactose Intolerance
Children with lactose intolerance don’t have enough of the enzyme needed to digest lactose, the main sugar found in milk and milk products. This enzyme is called lactase, and infants are born with it being made by the lining of their small intestine. For children with lactose intolerance, the amount of lactase in made in intestine decreases over time.
Lactose intolerance is very common. It’s more common among people of Asian, African, Hispanic or Native American descent.
Babies who are born prematurely can have a temporary type of lactose intolerance called developmental lactase deficiency, which lasts only a short time. Another type of temporary lactose intolerance can happen after a child has a gastrointestinal infection. In very rare cases, children are born with a complete lack of lactase because of a genetic defect.
Symptoms
People with lactose intolerance usually start to have a decrease in lactase production by the intestine by 3 to 6 years of age. But, the majority of people with lactose intolerance do not begin to get symptoms until the teen years or adulthood. Symptoms start between 30 minutes and two hours after the child eats or drinks a milk product and include:
Crampy abdominal pain
Bloating
Diarrhea
Gas
Each child with lactose intolerance is different, and some experience more severe symptoms than others.
Diagnosis
If your child has symptoms of lactose intolerance, your specialist at Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition will want to rule out conditions with similar symptoms such as irritable bowel syndrome and celiac disease. They will do a physical exam and perform one or more of the following tests:
Hydrogen breath test. During this test, your child gives a breath sample by blowing into a tube. The sample is analyzed for the presence of hydrogen gas, which is given off by undigested lactose. A higher-than-average level shows lactose intolerance.
Test for acidity in the stool. For infants and children who are too young to do the hydrogen breath test properly, this test can show undigested lactose.
Blood tests that can evaluate for other diseases that can present with similar symptoms.
Upper endoscopy. During this test, your child is sedated, and their doctor passes a thin, flexible tube with a camera through their mouth and stomach to the small intestine. The doctor takes a small sample of tissue called a biopsy to be analyzed for the lactase enzyme.
Treatments
While there are no treatments that can help your child’s body produce more lactase, there are many ways to manage their symptoms. At first, the process involves some trial and error as you learn how much lactose your child can tolerate.
The following strategies can help:
Try small amounts of milk products. Children who consume lactose in small amounts throughout the day may tolerate it better.
Use a digestive aid. Products such as Lactaid and Dairy Ease can help your child digest lactose. They are available as tablets to take before a meal or as drops to add to milk.
Buy lactose-free dairy products. These give your child calcium from milk without the symptoms of lactose intolerance.
Look for hidden sources of lactose. Check product labels for terms such a whey, curds, milk by-products or dry milk solids — all of which conntain lactose.
Milk products are a major source of calcium, which is an important nutrient for growing children. If possible, have your child eat some dairy products each day for the calcium. Yogurt, buttermilk and aged cheeses have less lactose than other dairy products and may cause fewer symptoms. Your child also can get calcium from leafy green vegetables, broccoli, salmon, sardines and fortified orange juice. Soy and almond milks also supply calcium.
Next Steps
Lactose intolerance is usually a lifelong condition. At Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition, your team includes registered pediatric dietitians who will answer all your questions and help you establish a diet that is right for your child. Each of our doctors, nurses and dietitians are dedicated to your child’s health and overall well-being every step of the way.
Quick Scheduling with a Pediatric Gastroenterologist
Enjoy comprehensive service and award-winning healthcare. Submit an appointment request today, and our staff will follow up with you shortly to confirm a time that works for you and your family.
Contact Us
If you suspect that your child may have Meconium Ileus, make an appointment with an Orlando Health pediatrician today so your child can start on the road to improved health.