Lactose Intolerance in Kids: Causes, Symptoms & Treatment

August 11, 2021September 12, 2022 | Shilpi

How to tell if your child is lactose intolerant? Does your child experiences diarrhea, stomach pain or bloated stomach after drinking milk? Are you hit with questions as to what to feed the child other than milk? Hold on! Firstly, let’s understand the problem. What is the lactose intolerance, its causes, symptoms and treatment?

WHAT IS THE LACTOSE INTOLERANCE?

Lactose intolerance is a condition occurring when the digestive system has trouble digesting lactose, found in milk and milk products. This is different from that of milk allergies. So, let’s understand, what exactly happens if a child is lactose intolerant. Lactose is composed of two simple sugars namely, glucose and galactose. Normally, when we consume lactose rich foods, an intestinal enzyme called lactase digests lactose into its simple counterparts (glucose and galactose). This helps in its easier absorption in the small intestine as well as the bloodstream.

However, in the case of lactose intolerant people, the ineffective lactase enzyme doesn’t break down the lactose. So this undigested lactose reaches the large intestine where colonic bacteria converts them into short-chain fatty acids and gas including hydrogen, carbon dioxide and methane, causing bloating, child stomach pain/ cramps and diarrhea. (What are other causes of stomach pain?)

What are the causes/types of lactose intolerance?

Depending on different factors, the causes/types of lactose intolerance are as follows:

Primary lactase deficiency: It is most commonly observed and it is also called as lactase non-persistence. Here, the production of the enzyme lactase declines with time (usually around age 2 or 5). Children start experiencing the unpleasant symptoms of lactose intolerance in their adulthood. In some cases, offsprings inherit from their parents.
Secondary lactase deficiency: This usually occurs due to an infection, injury or disease involving the small intestine. Secondary lactase deficiency is temporary and can be improved on treating the disease or infection. A well-known example of this is a digestive disorder called celiac disease which impairs the small intestine and causes temporary lactose intolerance. Once the intestinal damage heals, people with celiac disease can tolerate milk and milk products. (What are the foods good for digestion?)
Developmental lactase deficiency: Premature babies or babies born before 34 weeks with poorly developed gastrointestinal tract lacking enzymes are more likely to have developmental lactase deficiency. This condition lasts only for a short period after birth since developmental changes happen as the child grows. However, the majority of premature infants will be able to tolerate breast milk and lactose-containing formula. (What is developmental delay in a child?)
Congenital lactase deficiency: In this type of deficiency, the small intestine doesn’t produce the enzyme lactase from birth. Affected parents pass on this disorder to their offspring which results in severe diarrhea and weight loss when lactose-containing foods are fed.

What are lactose intolerance symptoms?

If your child is lactose intolerant, he/she might show the below mentioned symptoms/signs. These symptoms can depend on the amount of milk and milk products consumed and lactase that their body produces. Generally lactose intolerant child will show symptoms 30 minutes or 2 hours after food consumption.

Symptoms include:

Stomach pain/ cramps
Nausea
Bloating
Gas formation
Diarrhea
Vomiting

How to diagnose lactose intolerance?

Firstly, the paediatrician looks into the medical, family and diet history of your child. Secondly, the doctor might prescribe the following tests:

Hydrogen breath test: The child takes a lactose drink and breathes in the hydrogen breath tester tube. The level of hydrogen in the breath will be measured before and after consuming a high lactose drink. If the breath shows high levels of hydrogen, then it means that the child is lactose intolerant.
Lactose tolerance test: This test determines how well the lactose is absorbed by the child’s digestive system. After fasting, the child drinks lactose liquid and the stool test is carried out for the next 24hours.
Biopsy test: This test involves lactase analysis and is done based on the severity of the child’s symptoms. A small tissue sample is drawn from the small intestine to measure the levels of lactase present.

Treatment of Lactose Intolerance:

The treatment of lactose intolerance depends upon the child’s symptoms, age and health. It also depends on the severity of the condition. Mostly the treatment of lactose intolerance will not help the child’s body to produce more lactase but the child’s symptoms can be managed by limiting the lactose intake. The pediatrician may also suggest lactase enzymes for your child.

Other tips to manage lactose intake in a child’s diet:

Introduce small amounts of milk and milk products to the child’s diet and observe if the child has any symptoms. Moreover, note down the foods causing symptoms and avoid them.
Try milk and milk products with a combination like milk with cereal or cheese with crackers. The symptoms may be fewer when consumed in this way.
Consume products that naturally contain low lactose like hard cheeses and yoghurt.
Pick lactose-free or lactose-reduced milk and milk products at the supermarket. Unlike regular milk and milk products, they have lactase enzymes added to them. It is also a better option to get calcium in the diet.
Check the ingredients of any packaged foods before giving them to your child.

Foods that can help:

The child with lactose intolerance consumes little or no milk in their diet, which is a great source of calcium. Calcium aids in bone growth, repair and prevents certain diseases. The required amount of calcium has to be provided to the child through calcium rich non diary foods. For the body to absorb calcium, Vitamin D is needed. (Why calcium & vitamin D are important?)

Below is the Recommended Dietary Allowances (RDA) for calcium and vitamin D to be present in child’s diet based on their age:

Age	Amount of Calcium/day	Amount of vitamin D/day
0-6 months	200 mg	400 IU
7-12 months	260 mg	400 IU
1-3 years	700 mg	600 IU
4-8 years	1000 mg	600 IU
9-18 years	1300 mg	600 IU

Recommended Dietary Allowances for calcium and vitamin D

The calcium rich non dairy foods that can be included in a child’s diet:

Green veggies like turnip greens, broccoli, kale and collard greens.
Soft and edible bone containing fishes like salmon and sardines
Ragi
Moringa
Tofu
Calcium-fortified juices and cereals
Almond and soy milk with added calcium
Dried figs
Papaya

You can also talk to a pediatrician and provide calcium supplements to the child if he/she doesn’t get sufficient calcium from the diet.

Vitamin D: Since Vitamin D is required for calcium absorption in the body, it is necessary that the recommended dietary allowances (RDA) for vitamin D is also met in the child’s diet. Vitamin D food sources include eggs and liver.

How to live with lactose intolerance?

Unpleasant symptoms can be caused by lactose intolerance. However, it is not necessary that you avoid all the foods containing lactose. You can figure out which food your child can handle and not. If you remove any food, then make sure the required nutrients are met with other foods. You can also talk to your child’s pediatrician about the diet plans and changes that may help your child.

Lactose intolerance vs Milk allergies:

Many parents get confused between the terms – lactose intolerance and milk allergies. Although, both the terms sound similar- they describe two distinct digestive disorders, one being severe than the other. (What are common food allergies faced by kids?)

Main differences between Lactose intolerance and milk allergies are:

	Lactose Intolerance	Milk Allergies
Mechanism	Enzyme deficiency	Immune mediated reaction
Onset of symptoms	Usually in adulthood	During first year of life
Caused due to	Lactose, the carbohydrate present in milk	Cow’s milk proteins
Symptoms	Stomach pain, gas, bloating, diarrhea, vomiting, nausea	Stomach pain, vomiting, diarrhea, abdominal pain, itching, wheezing, shortness of breath, anaphylaxis
Dietary treatment	Low or no lactose diet	Cow’s milk protein-free diet

Lactose intolerance vs milk allergy

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Different type of food allergies in kids

August 6, 2021November 21, 2022 | Shilpi

Are you worried about food allergies in kids? As a parent, it is necessary that you are aware of the culprit foods that cause allergic reactions. And also replace them with healthy and nutritious choices. Firstly, let us understand what is food allergy and what are the common type of food allergies that kids face.

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What is food allergy?

Food allergy is an abnormal/adverse reaction that takes place in the body after the ingestion of certain foods. According to the National Health Survey conducted in 2016, around 6% of children have food allergies. In some cases, they also cause severe and life-threatening reactions. Mostly, parents are not aware of the food allergy in their kids until they get a reaction after giving the food for the first time. Hence, it is really important for every parent to know about the different type of food allergies and their symptoms. (Introducing solids to babies?)

TYPE OF FOOD ALLERGIES COMMONLY FOUND in kids:

Culprit foods that cause different type of food allergies in kids are as follows:

Milk
Eggs
Peanuts
Tree nuts such as almonds, pistachios, hazelnuts, walnuts, cashews
Fish and shellfish
Soy
Wheat

Milk Allergy:

The most commonly occurring food allergy in kids is milk allergy. Children below 3 years of age are more allergic to milk than other age groups. The milk proteins i.e. casein and whey proteins present in milk cause milk allergy. If the children are allergic to cow’s milk, they may also have allergic reactions to milk from other animals like sheep, goats. However, milk allergy is not similar to lactose intolerance. Moreover, children are most likely to overcome milk allergy by the age of 16, which is not the same as lactose intolerance.

Also check, Which milk is good for kids?

Egg allergy:

Children develop allergic reactions to an egg when their immune system sensitizes the proteins in egg whites or yolks. Children with egg allergy are allergic to either egg white or yolk or sometimes both. Since the egg is used in the preparation of many foods such as bakery products, salad dressings, ice cream, care should be taken to eliminate these foods completely from the diet.

Also check, What are the other source of protein rich foods?

Peanut and tree nut allergy:

The peanut and tree nut allergy are always confusing. Peanut belongs to the legume family as that of soybeans, peas while tree nut do not. Kids allergic to peanuts may also be allergic to at least one of the tree nuts. Therefore, giving candies, cereals and, baked goods containing peanut and tree nuts to kids is not advisable.

Fish and shellfish allergy:

Fish and shellfish allergy are not as common as the other allergies in kids. A shellfish allergy is caused when body attacks proteins from the crustacean and mollusk families of fish, commonly known as shellfish. In addition, they can cause a serious and potentially fatal allergic reaction with symptoms like vomiting and diarrhea.

Wheat allergy:

Wheat allergy is one of the type of food allergies which occurs as an allergic response to any of the proteins found in wheat. It affects mostly children but they usually outgrow this allergy by the time they reach ten years of age. It is known to be acquired from parents (i.e. if a parent is allergic to wheat, the child may also be allergic). Wheat allergy is different from gluten sensitivity or celiac disease.

Soy allergy:

Soybean, a member of the legume family causes allergy in young children below 3 years of age. Soy allergies are triggered by a protein found in soybeans. However, almost 70% of the children overcome this allergy when they reach adulthood.

What are the symptoms TO food allergIES?

When a particular food that is allergic is ingested into the body, it is considered a foreign particle. The body’s immune system starts producing chemicals called histamines against the food allergens which triggers the allergic responses.

These allergic responses vary from person to person and can appear immediately or after several hours following the food intake. Reactions can be mild or severe affecting one or more parts of the body. This might involve skin (eczema), gastrointestinal system (child stomach pain), cardiovascular system (fainting), and respiratory system (shortness of breath).

The mild symptoms to food allergies include:

cough
runny nose
diarrhea
itching
nausea
red rashes
shortness of breath
child stomach pain
sneezing
vomiting
wheezing
itchy bumps or hives on the skin

Severe allergic reactions called anaphylaxis are also developed in children like:

chest pain, low pulse
wheezing and difficulty breathing
swelling in tongue, lips, and throat
hives – an itchy and bumped rash
fainting
nausea or vomiting
turning blue

Tests for food allergies

Pediatrician will prescribe appropriate tests for food allergies. This might include blood test, skin prick test or dietary review. The doctor might conduct an interrogative session to know the child’s symptoms. Like how often the reaction occurs, the onset of symptoms from the time of food intake, and family history for allergies, before running the test.

Skin prick test: Tests for food allergies by pricking the forearm skin and exposing it to the food allergens. If reddish raised spots or bumps appear within 15 minutes, it means that the child is allergic to that particular food.
Blood test: To check the presence of IgE antibodies in the blood after the consumption of particular food.
Dietary review of foods: To understand the symptoms and identify the food allergens.

A food challenge test might also be conducted where the amounts of the food allergen are increased slowly, and the symptoms are noted down by the doctor. This is usually done to check if the child has overcome an allergy.

Treatment for food allergies

The child diagnosed with food allergies will have to eliminate the food causing allergic responses from the diet completely. Parents should always check the allergen labels of all the packaged food products.

Though it is not possible to cure food allergies, but the symptoms can be treated. Antihistamines are administered to kids to treat the symptoms such as itchy rashes, runny nose or child stomach pain. In case the child faces severe allergic symptoms, parents should consult the pediatrician.

Also check, What are the natural remedies for children’s allergies

Difference between food allergy and food intolerances

Parents are often confused with the terms “food allergies” and “food intolerances”. Food allergy induces an immunological response whereas food intolerances do not. Food intolerance is related to the digestive system and the body finds it difficult to digest a certain food. Both of them might show similar symptoms but the treatment varies. The best way to prevent both of the conditions is to avoid the foods causing allergies.

Some examples of food intolerances are lactose intolerance, celiac disease, etc. In the case of lactose intolerance, the lactose sugar found in cow’s milk is not digested by the body. Celiac disease causes an immune reaction damaging the lining of the small intestine when gluten protein is taken. The symptoms are normally observed over time when the food that is allergic is consumed more. The best treatment for food intolerances is to avoid the foods that cause symptoms mainly child stomach pain. The doctor may also advise different ways to prevent or overcome the reactions.

Also check, Foods for healthy gut?

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