How is lactose intolerance diagnosed in infants?

The article was professionally consulted by resident Doctor Duong Van Sy - Department of Pediatrics - Neonatology - Vinmec Hai Phong International General Hospital. Doctor has 09 years of experience in the field of Pediatrics.

Lactose is the main sugar found in milk and dairy products. In the small intestine, the enzyme lactase is responsible for breaking down lactose. Children with lactose intolerance will make the digestive system work poorly, and at the same time have symptoms such as diarrhea, flatulence, vomiting, ... when sucking milk.

For people with lactose intolerance, the body will not be able to produce enough lactase - the enzyme needed to digest lactose (the sugar in cow's milk and other dairy products). As a result, undigested lactose stays in the intestines and causes gastrointestinal problems. These problems are uncomfortable, but not dangerous.
Lactose intolerance is common in older children and adults, especially in certain ethnic and racial groups. Approximately 30 to 50 million people in the United States are lactose intolerant. Asian Americans, African Americans, Hispanics, Jews, and Native Americans are more likely to be lactose intolerant than people of Nordic descent.

Lactose intolerance in infants is very rare, because most babies are born with the enzyme lactase already in their intestines to digest breast milk. Sometimes, infant lactose intolerance occurs for one of the following reasons:
Genetic disorders: Very rarely, babies are born with lactose intolerance due to a lack of lactase enzyme. The condition is that both parents must pass this gene for lactose intolerance to their children. Right from birth, babies will have severe diarrhea and cannot tolerate the lactose in breast milk or canned cow's milk. Your baby will need a special, lactose-free formula. Premature birth: Babies born prematurely sometimes cannot produce enough lactase. This condition usually resolves soon after birth, and most babies can tolerate breast milk and lactose-containing formula after a short time. Viral infection or illness: If your baby has severe diarrhea, the body will temporarily have difficulty producing lactase. Children may experience symptoms of lactose intolerance for 1 to 2 weeks while waiting for their intestinal tract to recover. Celiac disease: The disease causes inflammation of the intestines and can lead to lactose intolerance when babies around 6 months old start eating foods containing gluten. Typical symptoms include diarrhea, poor appetite, abdominal distension and pain, and weight loss. This form of lactose intolerance should go away with treatment for the underlying celiac disease.

If lactose intolerant, your baby may show the following symptoms about 30 minutes to 2 hours after breastfeeding or eating dairy products like cheese or yogurt:
Diarrhea Colic Stomach bloating Fullness steam, fart. Some people with lactose intolerance can consume small amounts of milk without showing symptoms. Others will experience discomfort every time they eat foods that contain even a small amount of lactose.

Tell your doctor if you think your child has signs of lactose intolerance. To diagnose lactose intolerance in infants, your doctor will ask about your child's symptoms and:
Suggest that you eliminate all sources of lactose from your baby's diet for a few weeks to see the symptoms are relieved or not. Lactose intolerance test, which measures blood sugar before and after a child drinks a lactose solution. Stool pH testing can also help detect problems with the absorption of lactose or other carbohydrates. Sometimes children will be referred to a gastroenterologist for further evaluation.

Treatment for lactose intolerance depends on the underlying cause and severity of the symptoms and may include:
Dietary changes : When lactose intolerance is diagnosed in an infant Avoiding milk and dairy products will reduce symptoms. Your baby needs lactose-free and reduced-lactose formula, which is widely available in supermarkets. When starting solids, you need to reduce or eliminate dairy products from your baby's diet. Lactase enzyme supplements: Your doctor may recommend these foods to help your child digest foods that contain milk. Referral to a dietitian: If your child cannot tolerate any milk, your doctor may refer you to a dietitian to make sure your child's diet is getting enough calcium and vitamin D.

You can help manage infant lactose intolerance by:
6.1. Read nutrition labels Some foods that appear to be harmless, actually contain lactose, such as: pancakes (donuts/pancakes), cookies, breakfast cereals, cans of potatoes and soups instant noodles, margarine, salad dressings, breads and cold cuts...
So you need to check the packaging carefully for ingredients such as whey, curds, dairy by-products, dried milk and nonfat milk powder. The law requires that products containing dairy ingredients (or common allergens) be clearly stated on such labels.
6.2. Observe how your baby reacts to milk Some people with lactose intolerance can digest small amounts of lactose, while others are very sensitive to even very small exposures. You will probably have to try a few dairy foods and see how your baby reacts.
If your baby is very sensitive, you need to avoid all sources of lactose. If not, you can give your baby small amounts of the dairy foods you've tried. Babies may tolerate dairy products more easily if eaten with other foods.
6.3. Make sure your baby's nutritional needs are met If you must eliminate dairy products from your child's diet, you need to make sure he or she has other sources of calcium, which helps keep bones and teeth healthy. Non-dairy sources of calcium include:
Green vegetables Calcium-fortified juices and soy milk Tofu Broccoli Canned salmon Orange Calcium-fortified bread. In addition, lactose-free dairy products are also available in many supermarkets, containing all the nutrients of regular milk without the lactose.
Other nutrients to consider are vitamins A and D, riboflavin and phosphorus. It is helpful to consult a specialist if you do not know how to give your child all the nutrients he needs without dairy products. Consult your doctor before you want to give vitamins or supplements to your child.

Lactose intolerance is different from a milk allergy. An allergy is an immune response, while lactose intolerance is a lack of digestive enzymes, but the symptoms can be similar. Cow's milk allergy is very common in children, affecting about 2% of children under 4 years of age.
Your child may have a milk allergy if the following symptoms appear when consuming dairy products:
Wheezing or difficulty breathing Itching and swelling of the face, lips or mouth Hives Eczema Eczema Colic Stomach cramps Reverse Crying Constipation. Babies with a milk allergy usually show symptoms within the first 6 months of life. Fortunately, allergic reactions tend to subside as your baby matures. This is in contrast to lactose intolerance, which usually gets worse with age.
Vinmec International General Hospital is the address for receiving and examining respiratory diseases that infants and young children are susceptible to: viral fever, bacterial fever, respiratory infection, pneumonia in children, .... With modern equipment, sterile space, minimizing the impact as well as the risk of disease spread. Along with that is the dedication from the doctors with professional experience with pediatric patients, making the examination no longer a concern of the parents.
Customers can directly go to Vinmec Health system nationwide to visit or contact the hotline for support

Reference source: babycenter.com