Lactose is a sugar, occurring naturally in both breastmilk and cows’ milk. It is important in your baby’s diet as it provides energy and it also helps your baby absorb calcium – important for their bone development. About 52% of the nutritional composition of breastmilk (dry matter of breast milk) is actually made up of lactose. When your baby ingests lactose, the enzyme lactase in your baby’s gut works to break lactose down, allowing it to be used by the body. Lactose intolerance results from an inability to breakdown lactose due to an absence or an insufficient amount of lactase in a baby’s gut. The symptoms of lactose intolerance include bloating, abdominal pain, ‘frothy’ diarrhoea and excess wind.

Lactose intolerance can be divided into 2 types: Primary and Secondary.

Primary Lactose intolerance is very rare in northern Europe (including Ireland) affecting only 2-5% of babies. It tends to be over-diagnosed however. It results from an inability to make any of the enzyme lactase that breaks down the lactose in your baby’s digestive system. This form of lactose intolerance also tends to develop only after the age of 5 years1. It is extremely rare for it to develop in young infants with less than 100 cases reported worldwide2.

Sometimes if your baby has been quite sick (e.g. if they’ve had gastroenteritis) or they’ve had surgery of the bowel, damage can be done to their little gut resulting in a reduced production of the enzyme lactase. This results in secondary lactose intolerance but this is only temporary. Once your baby’s digestive system has had time to recover (usually takes 3-4 weeks) this temporary lactose intolerance usually subsides. This type of lactose intolerance is more common than primary lactose intolerance.1

Should my baby be on a lactose free formula?                

The expert European guidelines state that even if your baby has lactose intolerance, that a lactose free formula is not necessary3. Therefore your breastmilk or a standard infant formula is sufficient. However, in some cases, should your healthcare professional see it necessary to eliminate lactose from the diet, they may indeed recommend a lactose free formula if your baby is being bottlefed but this should only be for a few weeks and not a long term dietary solution for your baby. If you are breastfeeding, you should without doubt continue to breastfeed.

Remember to always seek advice from your healthcare professional:

If you think that your baby may have lactose intolerance, always seek advice from your healthcare professional before making any dietary changes. As mentioned above, lactose intolerance is very rare and usually only occurs as a result of an illness or an underlying a cows’ milk allergy, so it is always best to get an expert opinion from your healthcare professional.

If you need some advice on this topic, why not give one of our nutritionists.

 

References:

  1. NHS UK. Lactose intolerance. NHS Choices [Online] 2007. www.nhs.uk/conditions/Lactoseintolerance/ Pages/Introduction.aspx. [Accessed 19 May 2009].
  2. Agostoni et al., Scientific opinion on lactose thresholds in lactose intolerance and galactosaemia. EFSA Journal; 2010; 8(9):1777
  3. Heyman MB, Lactose intolerance in infants children and adults. Pediatrics, 2006 118, 1279-1286