If your child is complaining of an upset stomach, you may wonder if it is something they ate. Dairy products can be a source of digestive discomfort for children who are lactose intolerant. Children may be born lactose intolerant or become intolerant as they grow. Learn more about lactose intolerance in children from this guide.
Milk Digestion
Milk and milk products such as ice cream and cheeses contain lactose, a complex sugar molecule. Lactose must be broken down into two simple sugar molecules before it can be digested. The small intestine secretes an enzyme called lactase that breaks apart lactose molecules. Without lactase, lactose molecules pass through the gut without breaking down.
Symptoms of Lactose Intolerance
When there is too little lactase in the intestine, lactose cannot be broken down and properly digested. Lactose causes symptoms of abdominal distress such as gas, bloating, abdominal cramps, and diarrhea as the undigested molecules pass through the gut.
Lactose Intolerance Versus Milk Allergy
Lactose intolerance should not be confused with a milk allergy. Milk allergies produce an immune response triggered by proteins in milk, not lactose or other carbohydrates. An allergic reaction causes hives, vomiting, blood in stool and anaphylaxis in severe cases. Lactose intolerance does not involve the immune system.
Tests for Lactose Intolerance
Before making any dietary changes, it is important to test your child for lactose intolerance. If the results are negative, further testing may be needed to determine the nature of your child's digestive problems.
Breath Test
For the breathing test, the patient drinks a liquid that contains lactose. After waiting a set period, the patient breathes into a device that detects the amount of hydrogen they exhale. If the patient is lactose intolerant, there will be a higher level of hydrogen than normal.
Stool Test
A stool test can be performed after the patient fasts for 24 hours and then ingests a lactose solution. After collection, the stool sample is tested for lactose. For infants and small children, a normal stool sample can be tested for the presence of lactic acid without fasting or drinking the solution.
Types of Intolerance
Most lactose intolerant adults were able to consume dairy products without any problems when they were children and became lactose intolerant later in life. However, a small percentage of people are unable to digest lactose from birth.
Primary Intolerance
Infants born without the ability to produce lactase have a genetic deficiency is called primary intolerance. Infants with primary lactose intolerance cannot digest lactose in breast milk or milk-based formulas. Premature babies without this genetic disorder may also be born lactase deficient, but they usually start producing the enzyme as they mature.
Natural Decline in Lactase
Most infants are born able to produce lactase and digest lactose, but it is not uncommon for children's bodies to experience a natural decline in lactase as they age. Genetics may play a role in determining lactose intolerance, as children often have a family history or lactose intolerance. It also occurs more frequently within some ethnic groups.
Dietary Needs
Daily Calcium Intake
Milk and dairy foods provide a good source of calcium, an essential nutrient for proper growth and development in children. As children grow, their body's need for calcium increases. Infants up to six months old require 200 mg of calcium per day. Older babies need and additional 60 mg daily.
After a child's first birthday, the recommended amount of daily calcium jumps to 700 mg day. School-aged children up to eight years old need 1000 mg of calcium per day. Children age 9-18 need 1300 mg of calcium per day.
Good Sources of Calcium
If your child is lactose intolerant, you will need to boost their diet with plenty of calcium-rich foods to ensure they are meeting the daily requirement. Many products are fortified with calcium, such as breakfast cereals, non-dairy milk beverages, and orange juice. Dark green vegetables such as broccoli and kale are high in calcium. Eggs, liver, and some calcium-fortified foods provide vitamin D, a nutrient the body needs to absorb calcium.
If you think your child may have problems digesting milk or other dairy-based foods, contact us to schedule an appointment.