People with lactose intolerance do not have enough of the digestive enzyme lactase, which breaks down lactose. Lactose is the sugar in milk. It is found in dairy products and foods containing milk ingredients. People with lactose intolerance may experience discomfort or abnormal stools after eating foods containing lactose.
The small intestine makes the enzyme lactase. When it does not make enough of the enzyme, the body cannot break down the sugar found in milk and has trouble digesting milk or milk products. Most babies' bodies make the enzyme, making it possible to digest milk, including breast milk. Once milk intake slows down, the body may stop making lactase in some children. Some people may not experience a problem until early adulthood and others will never experience lactose intolerance.
Approximately 30 million American adults have some amount of lactose intolerance. The condition is most common among Asian, African, African-American, Native American and Mediterranean populations. People from northern and western Europe are less likely to be lactose intolerant. People with celiac disease or gastroenteritis (commonly called stomach flu) may also lack lactase. Temporary lactase deficiency may occur after a viral or bacterial infection that injures the cells lining the intestine.
Children with lactose intolerance will experience symptoms approximately 30 minutes to two hours after eating or drinking foods containing lactose.
Symptoms may include:
- Abdominal pain or cramping
- Diarrhea or loose stools
Diagnosis of Lactose Intolerance
If your child experiences symptoms of lactose intolerance, a pediatric gastroenterologist can perform the following tests to help make a diagnosis:
- Breath test. A hydrogen breath test is a lactose tolerance test that measures the amount of hydrogen in a person's breath. Your child will be asked to breathe into a balloon-type container to get a baseline reading. Next, your child will be asked to drink a flavored liquid that contains lactose. Breath samples will be collected at set time periods to test if the hydrogen level changes. If your child's body has trouble breaking down lactose, the hydrogen level in their breath will increase. Your child should not eat eight hours before the test.
- Upper endoscopy. Lactose intolerance may also be diagnosed by taking a biopsy of the small intestine during an upper endoscopy.
The best way to treat the symptoms of lactose intolerance is to avoid milk-based products. People differ in the amount of lactose they can eat without having symptoms. A dietitian can help you determine the best diet for your child. Treatment includes:
- Lactose avoidance. Some individuals need to avoid all lactose-containing foods. All food labels must be checked carefully to make sure a food does not contain lactose.
- Calcium supplements. If milk or milk products are not used, sufficient calcium and Vitamin D intake from other foods or supplements must be provided to your child.
- Lactose-free milk. Lactose-free milks such as LACTAID® or Dairy Ease® can be substituted for regular milk.
- Enzyme replacement medicine. A medicine such as LACTAID® or Dairy Ease® can be taken when lactose-containing foods are eaten.
Foods containing lactose that may be tolerated include:
- Small amounts of milk and milk products (less than 1/2 cup) eaten with other foods
- Yogurt with live cultures
- Certain cheeses
- Lactose-free milk
Foods to avoid include:
|• Acidophilus milk
||• Baked goods (e.g. bread, cookies, cakes, pancakes, etc.)
|• Beverage mixes, including those that contain chocolate
||• Cottage cheese
||• Cream cheese
|• Cream soups
||• Processed meats (e.g. cold cuts, hot dogs, etc.)
|• Ice cream
||• Ice milk
|• Instant potatoes
|• Malted milk
|• Milk, milk byproducts and milk solids
||• Processed breakfast cereals
|• Salad dressing
||• Sauces and gravies
||• Skim or non-fat dry milk powder
|• Sour cream
It is important that your child maintain a complete nutritional diet, including adequate intake of calcium and Vitamin D, while also avoiding foods that bring on symptoms. A dietitian is a great resource for nutrition education and can help you create a healthy diet for your child.
Key Points to Remember
Key Points to Remember
- Lactose intolerance is a condition in which the body cannot break down lactose (a sugar found in milk).
- Lactose intolerance is caused by a deficiency of the enzyme lactase.
- The condition can appear during early childhood all the way to early adulthood.
- The best way to treat lactose intolerance is to avoid foods containing lactose. Lactose-free milk and enzyme replacement medicines are available.
Support Services & Resources
Support Services & Resources
Visit the websites below to find support groups and services and learn more about lactose intolerance.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
This website offers an overview of lactose intolerance and additional resources.
This National Institutes of Health website provides in-depth information on lactose intolerance and related clinical trials.
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.
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