After a first baby that was every parent’s dream, I expected our second child, Jack, to be no different. The first few months sailed by without too many issues, but when my delightful little boy reached the age of 6 months, something changed. After a successful start to breastfeeding with both children, we began to introduce some formula at 6 months so that my husband could help out as I slowly returned to part-time work.

Upon introducing the formula, Jack’s stools suddenly became very runny, and he developed some nasty sores on his bottom. He would scream with tummy pains for much of the day and became a very unhappy baby. Eventually, with the help of our doctor, we discovered that he was lactose intolerant. Thus began a long journey of figuring out what he could and couldn’t eat.

Here are a few important things I’ve learned along the way about lactose intolerance in children.

What is lactose intolerance?

Lactose intolerance occurs when a person is unable to fully digest the natural sugar (lactose) in dairy products. When the small intestine stops making enough of the enzyme lactase, the body is unable to effectively break down the lactose. This causes the undigested lactose to move into the large intestine, where it mixes with the natural bacteria present there and produces several unpleasant symptoms.

This condition is also known as lactose malabsorption or lactase deficiency, and it’s usually relatively harmless although the symptoms can be very uncomfortable. Fortunately, most people can manage the condition without having to give up completely all dairy products. With a bit of knowledge and advice, lactose intolerance doesn’t have to be a big problem in a person’s life.

What is the difference between lactose tolerance and cow’s milk protein allergy?

Cow’s milk protein allergy (CMPA) and lactose intolerance are often confused, but they’re not the same thing. An allergy to cow’s milk involves the immune system, and as such, babies allergic to the protein in cows’ milk might show allergy-type symptoms, such as a rash, a runny nose, wheezing, or coughing.

These symptoms are not seen with lactose intolerance because this condition relates to the digestive system having difficulty breaking down the lactose rather than an allergic reaction. While eliminating lactose from a breastfeeding mother’s diet won’t help a baby with lactose overload, it can certainly help an infant with an allergy or sensitivity to cow’s milk protein.

Signs of lactose intolerance in kids

How do you know if your kid is lactose intolerant? There are some very common tell-tale signs. Diarrhea, gas, and bloating after the consumption of dairy products are usually pretty good indicators that the body has some issues with digesting lactose. Symptoms of lactose intolerance in children often manifest within 30 minutes to 2 hours of ingesting the dairy products. Lactose intolerant people will need to limit or avoid eating these products to prevent the unpleasant symptoms.

Can lactose intolerance cause eczema? While it’s important to seek professional advice, eczema is more often a sign of cow’s milk allergy rather than lactose intolerance. Some testing might be necessary to determine what’s going on. The best advice really is to consult a doctor if in doubt.

Does breast milk have lactose?

Contrary to popular belief, the amount of lactose in a mother’s milk is not dependent on her consumption of dairy products. All mammalian milk contains lactose, regardless of the mother’s diet. When an infant has primary lactose intolerance, they would fail to thrive from birth and show symptoms of malabsorption and dehydration. In these cases, the baby would need a special diet soon after birth in order to survive. Thankfully, this kind of lactose intolerance is very rare.

The more common kind in babies is referred to as lactose overload. It occurs when there’s too much lactose in the gut for the enzyme lactase to effectively digest it. This can lead to watery stools and gas. In such cases, parents should seek a doctor’s opinion to determine if the mother can keep breastfeeding.

Very often, the infant builds up enough of the enzyme to process the lactose over time, so continuing to breastfeed is frequently a good option. In our case, Jack seemed to cope ok with my breast milk, but had difficulty with digesting the lactose in the cow’s milk formula we were using. As my breast milk supply began to diminish, we switched to a lactose-free formula. Then Jack’s symptoms quickly improved, so we had a much happier baby.

What should I do if I suspect my child to be lactose intolerant?

The first step is seeking professional medical advice. There are two ways to diagnose lactose intolerance: a hydrogen breath test and an elimination diet. Since some of the symptoms of lactose intolerance and food allergies are similar, it can sometimes be difficult to diagnose.

Fortunately, the treatment for lactose intolerance is very simple. Monitor, limit, or avoid the ingestion of lactose by reducing or eliminating dairy products from the diet. Most people with lactose intolerance can cope with some lactose in their diet. This will vary from person to person, but in most cases, lactose intolerant people can eat some dairy products, for example, hard cheeses and yogurt.

When it comes to babies, experts say that weaning isn’t usually necessary for a lactose-intolerant infant and advise against the use of soy-based formulas for babies under 6 months.

Jack is now an 11 year old boy who is super fit and healthy. He has learned to manage his own lactose intolerance by limiting his dairy intake. He can enjoy the occasional ice cream or milkshake, but he also knows his limits and can make good choices.

Thank goodness we were able to have him diagnosed quickly. I hate to think about the pain and discomfort he experienced as a baby, and I’m grateful that this is an easily manageable condition. If your child is facing the same issue, try these delicious kid-friendly dairy free recipes.