Kids Health Info

Lactose intolerance

  • Lactose intolerance happens when the body cannot digest and absorb lactose. Lactose is the sugar found in milk and milk products and is often called 'milk sugar'. The symptoms of lactose intolerance include stomach pain and diarrhoea.

    For children aged seven to ten years, lactose intolerance is usually treated by avoiding milk or products containing milk or milk sugar. Some children develop a permanent intolerance to lactose and have to avoid these foods all their lives.

    Signs and symptoms:

    • stomach pain or bloating;
    • diarrhoea;
    • wind.

    Causes

    Lactose intolerance can be caused by some illnesses, such as gastroenteritis, which temporarily reduce the body's ability to digest lactose. Intolerance to other foods, infection or bowel surgery can also result in lactose intolerance.

    Treatment

    A low lactose diet is recommended for a few weeks. This means avoiding all milk and products that have milk or lactose in them. A normal diet can usually be reintroduced in consultation with your child's doctor or dietitian.

    Most Asian, African, Indian and Indigenous Australian children and a few caucasian children develop a permanent lactose intolerance as they grow up. These children will need to follow a low lactose diet for life.

    Avoid eating products/food with:

    • milk;
    • skim milk powder;
    • non-fat milk solids;
    • yoghurt;
    • milk protein;
    • milk solids.

    Read ingredient labels on commercial products carefully to avoid these ingredients. Check with your doctor or pharmacist whether any medication your child is prescribed contains lactose.

    Changing to a low lactose diet

    For infants:

    Use infant formula products that are low in lactose, such as those listed below. These can be used in place of your usual formula or cow's milk. They are available from the chemist or on prescription from your doctor.

    • Delact.
    • S26 LF.
    • Digestelact (for children older than 1 year).

    Soy formula is not recommended for infants younger than six months old.

    Appropriate soy formulas for older infants includes Infasoy, Karicare Soy and Isomil.

    For children:

    Select foods from each of the following groups each day for a nutritious, low lactose diet.

    Milk and milk products

    • Avoid milk, yoghurt, cream, ice-cream or milk desserts containing lactose. Also avoid cream cheese, processed cheese, cheese spread, cottage cheese and ricotta cheese.
    • All other cheeses, including hard cheeses such as cheddar and parmesan, contain a low amount of lactose and are usually well tolerated.
    • Milk is a very important source of calcium, protein and vitamins in a child's diet. You can replace regular milk with a lactose-free milk such as Liddells or Zymill. There are a number of low lactose milks available in the long-life section or dairy cabinet in most supermarkets. Calcium-fortified soy milk such as So Good, Vita Soy or Soy Fresh are also lactose-free.
    • Use lactose-free milk in place of regular milk for cereals, custards and sauces.
    • Low lactose cream and sour cream are now available.
    • Low lactose and soy-based yoghurts are also available in most large supermarkets, and come in a variety of flavours.


    Young children - aim for two to three serves of low lactose dairy products or lactose-free milk each day.
    Older children - aim for three serves of low lactose dairy products or lactose-free milk each day.
    Teenagers - aim for four serves of low lactose dairy products or lactose-free milk each day.

    Breads, cereals, rice and pasta

    • These provide energy, B vitamins and fibre. Check labels on breakfast cereal packets and avoid those containing milk or lactose.

    Fruit and vegetables (fresh, frozen, tinned or dried)

    • These provide energy, vitamins, minerals and fibre. Avoid instant mashed potato and vegetables with added milk, white or cheese sauces.

    Meat and protein foods (including fish, chicken, pulses and legumes)

    • These provide protein and minerals. 

    Fats and oils

    • Butter, margarine and oil provide energy and some vitamins.
    • Butter and margarine are low in lactose and are usually tolerated in small amounts.

     

    Other foods

    • Other foods that may contain lactose include milk chocolate, chocolate-coated biscuits, creamed soups and cakes.

    Lacteezedrops and tablets contain lactase and can be taken with, or added to, foods containing lastose. The lactase present in Lacteeze breaks down the lactose, making the product lactose-free. You can buy Lacteeze online from www.lacteeze.com.au or from chemists.

    Remember that small amounts of lactose are usually well tolerated. Large amounts of lactose usually produce symptoms.

    Follow-up

    Discuss with your child's doctor or dietitian the reintroduction of foods containing lactose. This needs to be done slowly, over the course of a week or longer.

    Key points to remember

    • Only change to a low lactose diet in consultation with your child's doctor or dietitian.
    • Read ingredient labels on commercial products carefully to avoid ingredients that contain large amounts of milk or lactose.
    • Check with your doctor or pharmacist whether any medications your child are using contain lactose.
    • Small amounts of lactose are usually well tolerated. Large amounts of lactose usually produce symptoms.
    • Discuss with your child's doctor or dietitian the reintroduction of foods containing lactose. 

    For more information

     

    Developed in consultation with the RCH Nutrition and Food Services Department and Gastroenterology. First published Feb 2007. Reviewed October 2010.

Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts.