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Lactose intolerance in babies


Lactose intolerance in children and babies is an issue of increasing concern to parents, who find it difficult to tell whether their young child or baby has symptoms of lactose intolerance or might have an allergy to milk. 

In this post we will tell you what lactose intolerance is, what symptoms it presents in children and babies, and how pediatricians diagnose it.

We'll also tell you about the characteristics of lactose-free infant formulas designed especially for babies and children who suffer from this intolerance and how they help.


PROBLEM: Lactose intolerance

What is lactose intolerance?

Lactose is the name given to the sugar found in milk.

It is present in all mammalian milks: cow, goat, sheep and human.

In order to transform lactose into energy, the body must break it down into smaller portions that can be absorbed.

The small intestine contains an enzyme called "lactase", which is a chemical substance whose function is to break down lactose.

Lactose intolerance occurs when a person's small intestine does not produce enough "lactase" to digest the lactose that is eaten.

When lactose reaches the large intestine (colon) it becomes a breeding ground for the bacteria that normally reside there.

These bacteria fractionate lactose, producing gas and a small amount of acid.

The combination of gas and acid can produce symptoms of pain, bloating, flatulence, nausea and diarrhoea.

These symptoms may begin shortly after a meal or several hours later.

Lactose intolerance can occur at any age, although lactose intolerance is extremely rare from birth and becomes more common after age 5.

Why do some children suffer from lactose intolerance?

Most babies produce lactase at birth and can digest lactose. Lactose is the main sugar in breast milk.

A baby can become lactose intolerant if an infection or allergic reaction damages the small intestine, causing a shortage of lactase production.

Usually this damage is temporary, but it may take weeks or even months before the child can tolerate dairy products again.

Other more chronic diseases, such as celiac disease, Crohn's disease, or infection with parasites can also cause temporary lactose intolerance.

In other cases, lactose intolerance develops spontaneously over time.

When children reach 3-6 years of age, their bodies naturally go on to produce lower amounts of lactase than those produced in the first or second year of life.

In some children, lactase production continues to decline or even stops altogether.

How do doctors diagnose lactose intolerance?

When an infant or child has symptoms of lactose intolerance, removing all foods containing lactose from the diet for about 2 weeks may help solve the problem.

After two weeks, milk can be re-introduced into the diet in small amounts.

If the child's symptoms improve during the lactose-free diet and return within 4 hours of drinking milk, a diagnosis of lactose intolerance is considered.

Another way to diagnose lactose intolerance is by a lactose in breath test (hydrogen in breath test).

The child takes a solution of lactose in water and blows it into a collection bag every half hour.

Breathing samples are analyzed to measure the amount of hydrogen, one of the gases produced in the large intestine.

Lactose intolerance is diagnosed when a significant increase in the level of hydrogen in the breath is detected.

Lactase deficiency is sometimes tested by endoscopy.

The test is done while the child is under anesthesia or sedation.

A fiber optic tube is inserted by mouth into the stomach and small intestine. 

A small sample of tissue (biopsy) is taken from the small intestine.

The cells in the sample are tested to see if the activity of the enzyme lactase is normal.

Infant formulas lactose free (LF)

How do lactose-free infant formulas help?

Special lactose-free infant formulas are indicated for infants or young children who have lactose malabsorption or clinical signs of lactose intolerance.

In these preparations, the lactose has been totally or partially replaced by dextrinomaltase (DTM) or glucose polymers, the rest of the nutrients complying with the recommendations of the Pediatric Nutrition Committees.

Lactose deficiency is usually transient, and due to the beneficial effect of lactose on calcium and magnesium absorption, and its low iron content, these formulas should be kept temporary (2-3 weeks).

In children over 2 years of age, milk is not an essential food, so these formulas are not indicated for adult lactose intolerance.

After two weeks, milk can be re-introduced into the diet in small amounts. Each day parents can give their child larger amounts of milk, or other milk products while watching for the return of symptoms.

Important note on special infant formulas

Remember that the use and consumption of special infant formulas must be under the supervision and control of a paediatrician.

Your pediatrician will consider your baby's health status, age and other nutritional needs and then recommend the special formula or treatment best suited to your particular case.


Lactose intolerance is the inability to digest lactose, a type of sugar found in milk and other dairy products.

There is a wide range of special infant formulas indicated for special situations, among which LF formulas are intended for babies and young children with lactose intolerance.

The use and consumption of special infant formulas should be done under medical supervision.

Sources: Spanish Association of Pediatrics - Special infant formulas European Society for Paediatric Gastroenterology Hepatology and Nutrition Lactose intolerance in infants & children

SCCALP Bulletin


The information presented on is not intended to provide or replace the advice of your pediatric physician or medical nutritionist. 

The information presented in this post is not intended to diagnose, treat, cure or prevent any disease. Full medical clearance must be obtained from a licensed physician before modifying a child's diet. 

The authors assume no liability to any person or entity for any liability, loss or damage caused or alleged to be caused directly or indirectly as a result of the use, application or interpretation of the information presented in this post.


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ESPGHAN (European Society of Gastroenterology, Hepatology and Nutrition) guidelines.

WHO | FAO - Food and Agriculture Organization | Codex Alimentarius - infant formula


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