Lactose is a sugar found in dairy products like milk and cheese. In order to digest it, our small intestine produces an enzyme called lactase. Lactase changes lactose into glucose, which is used as energy by the body. However, in lactose intolerance in children and adults, this digestive process does not occur properly.
Lactose intolerance occurs when your intestine lacks lactase. If you don’t produce lactase, you won’t be able to break down lactose properly. which can lead to several gastrointestinal problems and symptoms.
Symptoms of lactose intolerance in children
When a child cannot properly digest lactose, it can cause many symptoms. Signs that your child may be lactose intolerant include:
- stomach pain and cramps
Babies with lactose intolerance can be very fussy eaters and not gain weight or grow well. Symptoms of lactose intolerance can range from mild to severe, depending on how much lactose a child consumes and the amount of lactase produced by the child’s body.
Is there a difference between lactose intolerance and milk allergy?
Lactose intolerance is not the same as milk protein allergy, the most common food allergy in babies. Babies who have a milk allergy are allergic to the protein in cow’s milk. Children who are lactose intolerant cannot properly digest lactose, which is a sugar.
While both groups may experience similar symptoms, the two conditions are very different.
Causes of lactose intolerance in children
Lactose intolerance in children can occur for different reasons depending on their age. Reasons may include prematurity, congenital lactase deficiency, primary lactase deficiency, and secondary lactase deficiency.
Prematurity and lactase deficiency
Although lactose intolerance is not common in infants, some babies born before 34 weeks do not have a fully functional gastrointestinal tract.
They may lack lactase and other enzymes they need to digest food, although they may develop later as the child grows. Interestingly, these premature babies can still tolerate milk protein-based formulas.
Congenital lactase deficiency
In rare cases, babies can be born with lactose intolerancewhich is known as congenital lactase deficiency.
Babies with congenital lactase deficiency are born without any lactase enzyme. These babies are diagnosed very early in life because they have severe diarrhea and are not gaining weight. You will be able to know immediately if your child has it.
Primary lactase deficiency
The most common cause of lactose intolerance in children is primary lactase deficiency. These children do not have enough of the enzyme lactase, and the amount of lactase they do have may decrease as they get older. Although lactose intolerance may seem to start suddenly, it gradually worsens over time and symptoms become more obvious.
Approximately 65-70% of the world’s population is affected by primary lactase deficiency, which is a genetic condition. It is extremely common among people of Asian and African descent, as well as Native Americans.
Although primary lactase deficiency can begin as early as 2 years, symptoms may not be noticed until adolescence and young adulthood.
Secondary lactase deficiency
Other children may develop secondary lactase deficiency, which can occur suddenly after an illness.
Any disease that damages the small intestine, such as gastroenteritis, can result in temporary or long-term lactase deficiency. Babies under 3 months are more at risk of being negatively affected by this. They may experience severe diarrhea and poor growth.
Chronic conditions like Crohn’s disease or celiac disease they can also cause lactase deficiency.
How can lactose intolerance be diagnosed in children?
An easy way to determine if your child is lactose intolerant is to stop giving him dairy products (such as milk, cheese, ice cream, pizza) and see if his symptoms go away. To make sure your child continues to have a balanced diet, you can offer dairy substitutes such as vitamin D and calcium supplements.
Your child’s pediatrician can also offer additional recommendations and provide a referral to a specialist for further help.
A pediatric gastroenterologist can diagnose lactose intolerance in children by performing a hydrogen breath test. An increase in the amount of hydrogen during the test after drinking a product containing lactose indicates lactose intolerance.
Your child may also be diagnosed through endoscopy, a minimally invasive procedure to take samples of tissues from the esophagus, stomach, and small intestine. The tissue sample from the small intestine may be tested for lactase and other sugar enzymes.
What to do if your child is lactose intolerant
If your child is lactose intolerant, there are many solutions that will allow him to have a healthy and balanced diet. With the right foods and treatments, you can help stop your child’s symptoms.
For truly lactose intolerant babies, it is recommended that parents seek the help of a pediatric gastroenterologist to manage this condition. Because these babies often “do not thrive” and have diarrhea, they may need a special formula and should be closely monitored for adequate weight gain.
Older children have multiple options, such as consuming dairy-free milk and dairy-free cheese products or taking Lactaid tablets, which contain lactase enzymes. Lactaid tablets come in a chewable form for children ages 4 and up.
If your child has temporary secondary lactase deficiency, you can help them avoid dairy products for about two weeks and then reintroduce them. Transient lactose intolerance can sometimes occur after viral or bacterial gastroenteritis.