Your baby is fussy, full of gas. Symptoms seem to appear shortly after feeding, so you wonder if baby’s formula may be to blame. What to do? The American Academy of Pediatrics (AAP) and Le Bonheur dietitian Katelyn Wolfe offer helpful advice regarding how to identify lactose intolerance.
What is lactose intolerance? Dairy products such as milk, yogurt, and ice cream contain a milk sugar called lactose. In order to be digested properly, our intestinal tract releases an enzyme called lactase. Some people’s bodies do not create enough lactase to properly break down lactose, which causes the lactose to remain in the intestinal tract. Bacteria living in the digestive tract ferments the lactose, leading to gassiness, bloating, abdominal pain, and diarrhea. The body’s inability to digest lactose is what is referred to as lactose intolerance.
Can infants be lactose intolerant? While babies may exhibit gassiness, Wolfe says lactose intolerance in infants is very rare since babies are born with the ability to produce the lactase. “Congenital lactose intolerance is the exception to the rule, in which the body cannot synthesize lactase at all,” says Wolfe.
In fact, the typical onset of lactose intolerance tends to be closer to age 4 or 5, and some children don’t develop symptoms until the teen years or even into adulthood.
Temporary lactose intolerance. The AAP states some babies may develop a temporary inability to digest lactose following antibiotic use or bouts of severe diarrhea due to short-term damage of the digestive enzymes in the intestinal lining.
“When Riley was 9-months-old, he had double ear infections and was on antibiotics for several weeks,” recalls mom Sara Mimsey. “He ended up with severe diarrhea, so we switched to a soy-based formula that helped.” Within a few weeks, Riley was able to drink his cow-milk based formula with no return of symptoms.
Most temporary bouts of intolerance do not require a change in diet. However, do monitor a baby with persistent diarrhea for dehydration. If your infant has diarrhea and decreased wet diapers or diapers with darker colored urine, call your pediatrician’s office to discuss your concerns.
Vitamin D and calcium. Should your baby require a lactose-free diet, even temporarily, getting enough vitamin D and calcium isn’t difficult. Alternative formulas are fortified with vitamin D, calcium, and even iron. For babies transitioning to solids, use baby foods and non-dairy soft solids. “Though not good sources of calcium or vitamin D, they are important for appropriate development,” says Wolfe. Speak with your pediatrician, who may also recommend supplemental sources.
Keep a journal. It’s a good idea to pay close attention to baby’s symptoms if you suspect something’s not right. Wolfe suggests keeping a journal to record your infant’s abnormal behavior or fussiness. Include types of fluids and solids given, symptoms, time of symptom onset, and duration of symptoms.
Also speak with your pediatrician before making any dietary changes, as other conditions such as milk allergies exhibit some of the same symptoms and require different treatment options.
While fussy, gassy babies may be troubling, Wolfe reminds parents that these symptoms are often just a part of babyhood and no cause for concern. However, she also advises parents to bring any persistent or unusual behaviors to the attention of the child’s pediatrician to rule out causes such as lactose intolerance, milk allergies, or other problems. Should dietary changes be required, a dietitian can help ensure your child receives the necessary nutrition for optimal growth.