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Lactose intolerance is the inability to properly digest lactose, a sugar found in milk and other dairy products such as yogurt, ice cream and soft cheeses. It is caused by lack of an enzyme called lactase.
Normally, lactase is produced in the small intestine, where it breaks lactose down into a form that can be absorbed by the intestine and deliver glucose into the blood. Without adequate lactase, the body can't digest lactose. As a result, lactose stays in the intestines and causes gas, bloating, stomach cramps and diarrhea.
Many parents confuse lactose intolerance with milk allergy. While they have similar symptoms, they are completely different conditions. Lactose intolerance is a digestive problem, while milk allergy involves the immune system. Your child can be tested for milk allergy or lactose intolerance.
It's very rare for babies to be born without the ability to produce lactase. For most people, lactase deficiency develops naturally over time. In some populations — such as Latinos and African Americans — the body begins to produce less lactase after about age 2. In other groups, such as Northern Europeans, this occurs around 3 to 4 years of age. However, many children, and even adults, may not experience symptoms until they are much older.
In addition, certain digestive diseases and injuries to the small intestine can reduce the amount of enzymes produced.
Symptoms of lactose intolerance differ for each person. The severity of symptoms may depend on how much lactose is consumed and the amount each person can tolerate. Common symptoms, which usually begin 30 minutes to two hours after consuming foods with lactose, include:
Other digestive disorders can cause similar symptoms. If your child frequently experiences the symptoms listed above, it's important to visit a qualified pediatric gastroenterologist for a proper diagnosis.
The tests most commonly used to diagnose lactose intolerance are:
A stool acidity test also may be performed. Undigested lactose fermented by bacteria in the colon creates lactic acid and other short-chain fatty acids that can be detected in a stool sample. Sugars, including lactose, also may be detected in the stool by a simple test.
Although lactose intolerance can't be cured, symptoms can be controlled with a modified diet that reduces dairy intake or, if necessary, avoids dairy altogether. Most children don't require a completely lactose-free diet. Our team's doctors and dietitians will work closely with you and your child to develop a diet that best meets your child's nutritional needs.
Studies show that the following strategies can help control symptoms:
A calcium supplement may be recommended if your child can't get enough calcium from diet alone. Vitamin D is necessary for the body to absorb calcium, so your child's diet should also provide an adequate supply of vitamin D. Vitamin D sources include eggs, liver and sunlight.
UCSF Benioff Children's Hospitals medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your child's doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your child's provider.
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