Lactose intolerance

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What is lactose intolerance?

Lactose intolerance is often confused with milk allergy. It happens when the sugar in milk, called lactose cannot be digested.
 A baby or a small child may develop temporary lactose intolerance after suffering from gastroenteritis (sickness and diarrhoea). They may have tolerated cow’s milk or standard infant formula before the gastroenteritis but now, if they eat lactose containing foods they may develop symptoms such as watery diarrhoea, wind and be unsettled. The lactose intolerance is often temporary and usually resolves after a period of time.
 To help stop the symptoms of lactose intolerance, we would recommend your baby stops standard infant formulas based on cow’s milk and starts a lactose-free infant formula. These are widely available in supermarkets and pharmacists. Older children (over the age of 1 year) should swap from fresh cow’s milk to lactose-free milks which are also widely available in supermarkets. We would not usually recommend soya milks for children under one year of age.

Avoiding milk in food
The following information will help you to ensure that your baby or child avoids lactose in their diet. You will also need to check the ingredients of all the foods you buy. EU food regulations require that all foods that contain cow’s milk must have this clearly emphasised on their labelled ingredients list.

You will need to avoid all cow’s milk, and foods which are made from cow’s milk, such as:
 Butter
 Cheese
 Cream
 Chocolate
 Cream fraiche
 Custard
 Fromage frais
 Ice cream
 Margarine
 Milk powder
 Rice pudding
 Yoghurt

Calcium is vital for the normal growth and strengthening of bones but since our bodies cannot make it, we need to get it from the foods that we eat and drink. If you are following a cow’s milk or lactose-free diet it is important to look for foods that are fortified with calcium since milk and dairy products are major sources. It is now easier to avoid cow’s milk in cooking and preparing foods thanks to the large number of ‘Free from dairy’ and lactose-free versions of common place foods and ingredients available.

You may also find it helpful to adjust your own recipes by using lactose-free substitutes such as:

 lactose-free and dairy-free margarines
 calcium fortified lactose-free milk and ‘milk’ substitutes such as oat,
almond, hazelnut, coconut, soya and hemp milks
 lactose-free cream, yoghurt, custard and ice cream
 lactose-free cheese and cheese spreads

When should I retry lactose?
 Once your child’s symptoms have resolved you can try some of their usual infant formula or fresh cow’s milk (if over 1 year of age). If their symptoms of diarrhoea come back then go back onto a lactose-free diet and wait a few weeks and try again.

 Unless you know a food is lactose-free, leave it out.
 Ingredients of products change from time to time, so you should check the ingredients label on all the foods you purchase every time.
 Some of the dairy-free ‘milks’ and products are great sources of calcium but they may also contain high amounts of sugar. Always look after your child’s teeth by brushing them at least twice a day and be mindful of the different foods and drinks they eat containing sugar. Keep sugary foods and drinks to mealtimes to keep their teeth and gums healthy.
 Some of the organic milk-free foods available are not fortified with extra calcium. Read the label to ensure that you are choosing the version of foods and drinks that are fortified with calcium where possible.