Lactose intolerance: causes, symptoms and solutions
Overview
When your child ingests his milk, you notice that he is not in his normal state for a while... Is it lactose intolerance? How does it manifest itself? What solutions exist to relieve your child? We take stock of the situation.
What causes lactose intolerance in children?
The enzyme "lactase" is produced by the mucous membrane of the small intestine: it digests the lactose ingested during meals by cutting the lactose molecule into two simple molecules, glucose and galactose. Glucose and galactose are then absorbed through the lining of the intestine into the bloodstream. Lactose intolerance occurs when too little of this enzyme is produced, thus preventing proper digestion. The result? Various reactions that can affect the health of children.
True lactose intolerance, which is considered hereditary, is rare in babies. However, some babies may have difficulty digesting large doses of lactose because their lactase secretion is not quite sufficient. This is called lactose maldigestion. This can be seen with infant formulas whose carbohydrate fraction is exclusively (100%) or predominantly lactose.
A "temporary" intolerance to lactose can exist during an illness such as severe gastroenteritis or certain intestinal parasites such as Giardia.
On the other hand, in older children, a real intolerance to lactose may exist due to a decrease in the production of lactase because milk is no longer the main component of their diet. This "normal" intolerance is mostly seen in children of African and Asian origin, but it is rare in European or North American children who tolerate milk as they grow up, despite the natural decrease in production of this enzyme.
Rest assured, there are solutions to help parents deal with their child's lactose intolerance.
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Is lactose intolerance hereditary ? If you, mom or dad, are lactose intolerant, this does not mean that your child will be too, even if it seems that this intolerance is more frequent in certain families. Only true total lactose intolerance in infants seems to be hereditary. However, do not confuse this intolerance with a milk allergy because they are two completely different diseases. |
What are the symptoms of lactose intolerance in children?
If your child is lactose intolerant, you may notice the following symptoms
- Bloating (tense, swollen belly...)
Abdominal pain
Gas
Acid and foamy diarrhea
Diaper rash (due to the acidity of the stool)
These symptoms begin within half an hour of taking a bottle and vary in duration depending on the amount of lactose swallowed by the child.
Be sure to consult a health professional if your child does not seem to be in his normal state. A diagnosis will be made and a suitable treatment will be prescribed if necessary.
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Lactose intolerance or cow's milk protein allergy (CMPA)? Lactose intolerance and cow's milk protein allergy must be differentiated:
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How to treat lactose intolerance in children?
Discover our tips and tricks to remedy the pain of lactose intolerant children.
The different situations must be determined:
- True lactose intolerance, which is exceptional in babies, requires a strictly lactose-free diet. There are lactose-free infant formulas.
In case of lactose maldigestion in the baby, it is sufficient to choose a milk with less lactose and more maltose dextrin, like Modilac Actigest 2.
Temporary" intolerances during severe gastroenteritis or certain intestinal parasites such as Giardia require the temporary use of a lactose-free milk, but they will heal with the treatment of the disease in question. Once cured, your child will regain his or her tolerance to lactose and will be able to return to his or her normal eating habits.
Lactose intolerance in older children requires a low-lactose diet and the choice of a lactose-free milk (e.g. "Light Morning").
Contact your child's doctor to obtain a diagnosis and a treatment adapted to the observed disorders. In case of a lactose-free or low-lactose diet, you should be guided by your child's doctor, with the possible help of a dietician.
Annexes :
Bocquet A, Dupont C, Chouraqui JP, et al, Comité de nutrition de la Société française de pédiatrie (CNSFP), Efficacité et sécurité des formules hydrolysées à base de protéines de riz dans le traitement de l'allergie aux protéines du lait de vache, Arch Pediatr 2019 May;26(4):238-246.
Dupont C, Chouraqui JP, De Boissieu D, et al, Comité de nutrition SFP, Prise en charge diététique de l'allergie aux protéines du lait de vache, Arch Pediatr 2011;18:79-94.
Dupont C, Chouraqui JP, Linglart A, et al, Comité de nutrition de la Société française de pédiatrie, Prise en charge diététique de l'allergie au lait de vache chez l'enfant : une mise à jour, Arch Pediatr 2018, 25, 236-43.
Fiocchi A, Schunemann H, WAO Special Committee on Food Allergy, Diagnosis and Rationale for Action against Cow's Milk Allergy, The DRACMA guideline, WAO Journal 2010 ; S1 (April), 1-105
Mpedia, APLV : l'Allergie aux Protéines du Lait de Vache, https://www.mpedia.fr/art-aplv-allergie-proteines-lait-vache/
Passeport santé, L'intolérance au lactose chez le bébé, https://www.passeportsante.net/fr/grossesse/Fiche.aspx?doc=intolerance-lactose-bebe
Vandenplas Y, Marchand J, Meyns L, Symptômes, diagnostic et traitement de l'allergie au lait de vache, Curr Pediatr Rev 2015;11(4):293-7.
