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The Lactose Lowdown: What Parents Need to Know About Baby Digestion and Tools to Help

Writer's picture: JessicaJessica

Updated: 1 day ago


Understanding Lactose: What Parents Need to Know About Recent Study Findings

Lactose has been a topic of conversation for many parents navigating the world of infant feeding. Whether your baby is exclusively breastfed, formula-fed, or transitioning to solid foods, understanding how lactose impacts infant nutrition and digestion can provide clarity and confidence in your feeding journey.


What is Lactose?

Lactose is a naturally occurring sugar found in milk and dairy products, including breast milk and many infant formulas. It’s made up of two simple sugars, glucose and galactose, which are broken down by the enzyme lactase in the small intestine. This process allows the body to absorb and use these sugars as energy.


Cartoon cow holding a milk bottle with a straw, smiling. Background is blue with a search bar displaying "LACTOSE" and small breastfeeding icon. Infant Feeding Milk Baby Food and Fun Registered Dietitian


The Role of Lactose in Infant Nutrition

Lactose plays a vital role in infant growth and development. Here’s why:

  • Energy Source: Lactose provides a quick and efficient source of energy, crucial for babies' rapid growth.

  • Calcium Absorption: It aids in the absorption of calcium and other minerals essential for bone development.

  • Gut Health: Lactose supports the growth of beneficial gut bacteria, promoting a healthy microbiome.


  • Lactose in Breast Milk: The study reaffirmed that lactose is the primary carbohydrate in breast milk and a critical component of human milk’s nutritional profile. Even in cases where infants exhibit temporary discomfort, reducing lactose intake should be a carefully considered decision.

  • Formulas with Lactose: Many formulas, including goat milk-based options, incorporate lactose to mimic the composition of breast milk. The study emphasized that lactose-based formulas are generally well-tolerated and beneficial for most infants, including those with mild sensitivities.

  • Benefits of Lactose in Early Development: Researchers noted that lactose contributes to brain development, as galactose is a building block for certain lipids in the brain. This underscores the importance of including lactose in infant diets whenever possible.



Supporting Parents Through Feeding Choices

If your baby experiences digestive issues, such as gas, bloating, or loose stools, it’s essential to consult a healthcare provider before making changes to their diet. Temporary issues are often manageable without eliminating lactose entirely. Options such as partially hydrolyzed or goat milk-based formulas can be gentle alternatives that still provide the benefits of lactose.




Key Takeaways for Parents

  • Lactose is a natural and beneficial component of infant nutrition.

  • True lactose intolerance in infants is rare.

  • Lactose supports energy, calcium absorption, and brain development.

  • Consulting a healthcare provider is crucial before modifying your baby’s diet.



Did You Know?!


Lactose intolerance prevalence varies significantly among different ethnic groups, largely due to genetic factors influencing the production of lactase, the enzyme required to digest lactose. Here's a general breakdown:

  1. East Asian Populations: Lactose intolerance is highly prevalent, affecting 70-100% of adults in some East Asian countries. This is among the highest rates globally.

  2. African and African-American Populations: Rates vary by region but tend to range from 60-80%.

  3. Hispanic and Latino Populations: Prevalence ranges from 50-80%, depending on ancestry and regional factors.

  4. South Asian Populations: Approximately 60-80% of individuals are affected, with variability across regions.

  5. European Populations: Northern Europeans tend to have the lowest prevalence, often less than 10%, due to a genetic mutation that allows lactase production to persist into adulthood. Southern Europeans have slightly higher rates, ranging from 20-40%.

  6. Indigenous Populations: Many Indigenous groups in North and South America, Australia, and the Pacific Islands have high rates of lactose intolerance, often exceeding 70%.


Despite these differences in prevalence in lactose intolerance amongst different ethnicities, these patterns are not the same in infants and *true lactose intolerance in infancy*. Infants are naturally born to digest lactose, with a good storage of the lactase enzyme to help, despite their ethnic background.


 


Medical Terminology:


Understanding Lactase Deficiency in Infants

Lactase deficiency, often referred to as lactose intolerance, is a condition where the body has difficulty breaking down lactose, the sugar naturally found in milk and dairy products. While it’s much more common in older children and adults, lactase deficiency in infants is rare but can still occur. This will break down the basics of lactase deficiency, including causes, symptoms, and management strategies for parents.


Lactase is an enzyme produced in the small intestine, and its role is to break lactose into simpler sugars, glucose and galactose, for easier absorption. Lactase deficiency happens when the body doesn’t produce enough of this enzyme, leading to undigested lactose passing into the large intestine. This can result in symptoms such as gas, bloating, and diarrhea.


Types of Lactase Deficiency in Infants

  1. Congenital Lactase Deficiency

    • A very rare genetic condition where infants are born without the ability to produce lactase. This is usually identified soon after birth because affected babies cannot tolerate breast milk or standard infant formulas.

  2. Developmental Lactase Deficiency

    • Seen in preterm infants due to an underdeveloped digestive system. The ability to produce lactase typically improves as the baby grows.

  3. Secondary Lactase Deficiency

    • Caused by damage to the small intestine from infections, allergies, or other conditions like celiac disease. This form is usually temporary and resolves as the underlying issue heals.


Signs and Symptoms

Infants with lactase deficiency may show the following symptoms:

  • Persistent diarrhea, particularly after consuming milk or formula.

  • Gas and bloating.

  • Fussiness or discomfort during or after feedings.

  • Poor weight gain or growth (in severe cases).

It’s important to note that these symptoms can overlap with other conditions, so consult a pediatrician for an accurate diagnosis.



Diagnosing Lactase Deficiency

Doctors may use the following methods to diagnose lactase deficiency:

  • Symptom history and observation: A detailed look at the baby’s feeding habits and symptoms.

  • Stool tests: To check for acidity, which indicates undigested lactose.

  • Elimination diet: Temporarily removing lactose from the diet to see if symptoms improve.

  • Breath tests: Older children may undergo hydrogen breath testing, but this is not typically used for infants.


Management Strategies

  1. For Breastfed Babies:

    • Breastfeeding should continue whenever possible. In rare cases of congenital lactase deficiency, lactose-free formulas may be necessary.

  2. For Formula-Fed Babies:

    • Lactose-free or low-lactose formulas are recommended. Formulas with hydrolyzed proteins or based on amino acids may also help.

  3. Secondary Lactase Deficiency:

    • Address the underlying cause (e.g., treating infections or managing allergies) to resolve symptoms.

  4. Enzyme Supplements:

    • Some pediatricians may recommend lactase enzyme drops to help break down lactose in breast milk or formula.


Supporting Infant Nutrition

Infants with lactase deficiency still need a balanced intake of nutrients for healthy growth and development. If breastfeeding isn’t an option, work with a healthcare provider or registered dietitian to find a suitable formula. It’s also essential to monitor the baby’s growth milestones and overall health closely.


When to Seek Medical Advice

Always consult your pediatrician if your baby shows persistent symptoms of gastrointestinal discomfort, especially if they’re not gaining weight or meeting developmental milestones. Early intervention is key to ensuring your baby stays healthy and happy.

Woman holding a sleeping baby in a cozy room with soft lighting. Both are wearing white, creating a calm and tender atmosphere. Infant Feeding Support Parent Motherhood Baby Food and Fun Registered Dietitian

 



So, if it's not the lactose... what is most likely the culprit?

  • The proteins! = breastmilk is naturally made of whey and casein proteins. This ratio can differ in formulas, which makes a difference!

    • Casein is more difficult to digest than whey!


Learn more on those specifics & details in the caption below!

 



Resource Time:


And make sure to check out my Formula Comparables Guide - the breakdown of types/brands and terms to know! Use this list as a tool to find the best formula for your baby!



Formula Feeding Infant Nutrition W Eating First Foods Bottle Feeding Combofeeding Parent Support Husband Motherhood Registered Dietitian Motherhood Baby Food and Fun

 


Final Thoughts

As parents, you want to make informed choices that support your baby’s health and happiness. The recent study findings reaffirm the value of lactose in infant nutrition and provide reassurance that most babies thrive with it in their diet. Whether breastfeeding, formula-feeding, or a combination of both, understanding lactose can help you feel confident in your feeding journey.


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I truly enjoy sharing this information and I hope you find the information provided valuable. If you do find this information helpful, I kindly ask that you consider sharing - via social media, word of mouth, email, etc. I would love to help support as many out there as I can! <3

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Jessica Enderle, R.D., L.D.

Enderle Family Photo Registered Dietitian Motherhood Feeding Babies Baby Food and Fun | Photography By Jenna Fisher Photography





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