Six-year-old Nishad loves milk; he readily gulps down a tall glass of it, in a flash, every day. But, a good thirty minutes after this, he starts complaining of uneasiness in the stomach. At times, he vomits out all the milk he has drunk; or, he complains of an acute stomach ache. Confused and concerned, Nishad’s parents consult a paediatrician. It turns out that Nishad has lactose intolerance, a digestive condition disguised in dairy.
What is lactose intolerance?
Lactose is the sugar found in milk and milk products. The small intestine secretes an enzyme called lactase that breaks down the lactose compounds and aids in their digestion. When there is insufficient lactase secretion, digestion of lactose gets difficult. This results in lactose intolerance in babies, which presents itself in the form of unpleasant health problems. In India, as per a research conducted by Sanjay Gandhi Post Graduate Institute of Medical Sciences, three out of four people show symptoms of lactose intolerance or milk allergy symptoms.
(Source: The Times Of India, March 11, 2015).
The most common form of lactase insufficiency is usually caused by a decreased secretion of lactase. “This is quite common among children, with about 50% of them being affected sometime during their childhood. Although this condition is reversible, the discomfort it causes children is quite annoying. However, most of the parents fail to recognise lactose intolerance, as there is very little awareness about it,” says Dr Kiran Kinger, a UK-certified paediatrician from Bengaluru.
An underlying problem in the small intestine, due to infection or disease, can also result in lactase insufficiency.
A premature baby with a small intestine that hasn’t developed completely could have the condition; but, it’s bound to get better as the baby grows. Lactase insufficiency can be congenital as well.
Identifying the problem in your child
How would you know if your child actually has lactose intolerance? Here are some common symptoms of lactose intolerance in infants.
- Diarrhoea/loose stools (the most common of them all)
- Stomach ache/cramps
- Stomach rumblings
- Gas formation/flatulence
- Nausea and vomiting
Usually, these symptoms appear around 30 minutes to 2 hours of your child consuming milk or any milk product. If your child complains of any of these, you can understand that there’s something wrong with his digestion. It’s good to reach out to a paediatrician to confirm that these are actually symptoms of lactose intolerance in your child.
“Our four-year-old son often used to have loose stools, especially on days when he drank a couple of extra glasses of milk. He also complained of stomach aches occasionally. Although we ignored these initially, we approached our paediatrician when the issues persisted. It was then that we found out that our child was actually intolerant to lactose,” says Radhika Sreenivas, a parent from Gurgaon.
Dr Kiran Kinger adds, “The first and the most common symptom of lactose intolerance is diarrhoea. My advice to parents is to avoid any lactose-containing food in the child’s diet if he has diarrhoea, irrespective of the cause.”
Diagnosis and treatment
Lactose intolerance can be confirmed by a couple of tests.
- The Hydrogen Breath Test is done to assess the amount of hydrogen exhaled from the body. Normally, a small amount of hydrogen is formed in the stomach after the digestion of lactose-containing food. In case of improper digestion, there will be an excessive amount of hydrogen exhaled. This will indicate the presence of lactose intolerance.
- The Stool Acidity Test in which the presence of excessive amounts of acid excreted with stools confirms the condition. (This test is preferred for infants and young children.)
The treatment for lactose intolerance is all about lesser intake of products that contain lactose, depending upon the intensity of the intolerance. There’s an absolute need for a restructured dietary plan, based on the paediatrician’s advice.
“Most cases of lactose intolerance are caused by acute infections, and can be treated easily with a change in food habits. Once you realise that your child has intolerance to lactose, it’s better to consult your paediatrician and nutritionist to determine his food chart. Regarding prevention, although there is no vaccination available specifically for lactose intolerance, a certain kind of gastroenteritis caused by rotavirus can be prevented by vaccination; and, that can be administered after consulting the paediatrician,” suggests Dr Kiran Kinger. Since you may not know if your child has milk allergy or lactose intolerance until the symptoms show up, it can be quite difficult to prevent it. But, once you know that your child has it, the wise thing to do is to switch to alternative food choices. It is also an opportunity to add more nutritious foods to your child’s diet schedule, and stop his overindulgence in milk. “Administering the right food is the only treatment for lactose intolerance. Parents can opt for soya milk, which is lactose-free and also a good source of protein. Other healthy foods can replace milk until the condition gets better,” adds Dr Kiran.
“When we found out that our child had lactose intolerance, we started changing his food habits altogether. We switched to lactose-free milk and also cut down on other milk products. We also started giving him more of green leafy vegetables, almonds and cereals, which substituted milk in providing him nutrients such as Calcium and Vitamin D,” says Radhika Sreenivas.
So, next time your child refuses to have a glass of milk or throws up after having it, think twice before forcing her to have it. For all you may know, she may be suffering from lactose intolerance.