All the answers on lactose intolerance in children and infants

Lactose intolerance, as has already been stated in previous articles , is a problem due to the deficiency of the lactase enzyme , responsible for the digestion of the sugar present in milk, lactose.

Can children also suffer from it?

This situation, although rare, being more common in adults, can also occur in infants and young children who, for example, have acute diarrhea.

It could therefore manifest itself, but not before the sixth month of life, therefore close to the weaning period. Infants, on the other hand, especially if born preterm, may have "lactase deficiency" , that is a deficiency due to failure to develop, but this is also very rare.

What are the symptoms to observe in a child?

Only 12 g of lactose is enough to cause symptoms in children, which manifest as chronic abdominal pain.

Unabsorbed lactose is a substrate for intestinal bacteria, especially in the colon. In fact, they metabolize sugar, producing gas (methane, carbon dioxide and hydrogen), thus leading to flatulence.

The symptoms are very similar to those experienced by adults:

• abdominal pain and swelling
• diarrhea
• flatulence
• meteorism
• and sometimes nausea

If your child exhibits one or more of these symptoms, continuously, it is advisable to contact the pediatrician immediately, to understand the cause and evaluate any lactose intolerance.

How is intolerance diagnosed in children?

The pediatrician will evaluate, what is the best way to make a correct diagnosis, through the use of tests for lactose intolerance. The most common is the breath test , also known as the breath test , which detects the amount of hydrogen present in the air exhaled by the baby, after taking a predetermined dose of lactose.

It is also possible to carry out the faecal ph test , a non-specific but sometimes useful indicator, as, in the presence of intolerance, a lowering of the fecal ph will occur. It should be remembered that this fecal pH will normally be lower (5.0-5.5) in infants, compared to older children and adolescents, due to the physiological overload of the lactose present in their diet.

Finally there is the genetic test , not invasive at all, and very quick in the procedure, therefore suitable for children.

What to do after the diagnosis of intolerance?

The first step to take, under medical supervision, is to exclude all those foods that contain lactose . In this way, a regression of symptoms should be observed.

A common question is: is lactose-free milk bad for you? The answer is no. On the market there are numerous companies that produce lactose-free milk for babies, or as an alternative to cow's milk, choose from the numerous drinks called "vegetable milks".

Attention to calcium , which must be included in the diet through food alternatives or with so-called "enriched" drinks.

If you have any doubts that your child, being intolerant, consumes foods containing lactose, you can resort to the use of a lactase supplement , but only if recommended by your pediatrician.

Bibliography

1. Melvin B. et al. (2006). Lactose Intolerance in Infants, Children, and Adolescents. Pediatrics. September 2006, VOLUME 118 / ISSUE 3
2. Gremse DA. et al. (2003). Abdominal pain associated with lactose ingestion in children with lactose intolerance. Clin Pediatr (Phila). 2003 May; 42 (4): 341-5.
3. Harvey Louise et al. (2018). Prevalence, cause and diagnosis of lactose intolerance in children aged 1-5 years: A systematic review of 1995-2015 literature. Asia Pacific Journal of Clinical Nutrition Volume 27 Issue 1