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Low lactose diet for children

Lactose is the natural sugar found in milk, including breastmilk and formula. It is found in different amounts in all dairy products and any processed foods which contain milk. It is broken down to simpler sugars in the small bowel, by the enzyme lactase.

If there is not enough lactase, undigested lactose passes through to the large bowel.

Here, bacteria feed on the lactose, and this forms gas and water.

Much of the information in this topic comes from the diet sheet Low lactose diet prepared by the Nutrition Department of the Women's and Children's Hospital, South Australia.

Symptoms of lactose intolerance

Frequent, watery, frothy poos (bowel actions) and tummy (gut) pain are the typical symptoms.
Older children and adults with some lactose intolerance may just feel bloating, tummy discomfort and get more "wind" than usual if they have foods that are high in lactose.
Occasionally, symptoms like muscle pain, headache, fatigue and constipation may be due to lactose intolerance.

Causes of lactose intolerance

Lactose intolerance may be temporary, or may be a longer term problem.

Adults and children over the age of about 4 or 5 from most non-Caucasian races produce only a little lactase and are likely to be somewhat intolerant of lactose. (This includes Australian Aboriginal and Torres Strait Islander people and people from Africa and Asia).

Also after gastro (gastroenteritis) many people can be intolerant of lactose for a few weeks.

After gastroenteritis, a low lactose diet may be recommended for a few weeks to allow the digestive system to recover. After 4-6 weeks a normal diet can usually be reintroduced.

Milk substitutes

Milk is a very important source of calcium, energy, protein and vitamins in a child's diet.

There is no need to follow a cow's milk free diet if you or your child has lactose intolerance. Lactose intolerance can be easily managed by use of lactose free cow's milk which is available from the supermarket - use this as a drink, on cereal or in cooking.

The following infant formula and milk drinks are low in lactose.

Milks of choice

Suitable from birth for bottle fed babies

Karicare Delact*
Nan sensitive
S26 LF (Lacose Free)*

Breastfed babies

If your baby is being breast fed it is not necessary to stop breastfeeding, but discuss management with your doctor or dietitian.

These are suitable for children over 1 year of age.

There are a range of lactose free milks available as powdered, fresh or long life milk.

lactose free milk (e.g. ZymilTM or LiddellsTM)
calcium fortified soy milk (e.g. So GoodTM, Vita SoyTM or Soy FreshTM).

Goats' milk contains lactose, and is not suitable for children with lactose intolerance.

Soy milk does not contain lactose, but a child with lactose intolerance does not need to be on soy milk.

Other useful foods

lactose free yoghurts
soy yoghurts
lactose free ice-cream and cream.

Low lactose foods

Offer your child a variety of foods from each good group. Read ingredient labels on food products carefully and avoid foods which contain milk, milk solids, non fat milk solids, milk powder, lactose, casein, whey and cream.

Breads and cereals

Check labels on bread, breakfast cereals, instant rice and pasta meals, and tinned spaghetti.

Fruit and vegetables

Fruit and vegetables contain a different sugar and are not a problem for children with lactose intolerance.
Avoid instant mashed potato, and vegetables with white or cheese sauces.

Meat and protein foods

Check labels on fritz sausages, fish fingers, and baked beans.

Milk and milk products

Avoid regular milk, yoghurt, ice-cream, cream, custard, milk desserts, cream cheese, processed cheese, cheese spread, ricotta cheese and cottage cheese.
Use lactose free milk in place of ordinary milk for cereals, custards and sauces.
Lactose free yoghurts and custards are available from supermarkets.
Matured cheeses, (Cheddar, Edam, Tasty and Swiss cheese) are low in lactose and are suitable for a low lactose diet.

Fats and oils

Butter and margarine are allowed on a low lactose diet.

Other foods

Other foods that may contain lactose include biscuits, cakes, cake mixes, creamed soups, mayonnaise, milk chocolate, and milk flavourings such as Milo*, Actavite* and Ovaltine* as 'sometimes foods'.
Even though there is lactose in these foods your child may tolerate them in small amounts.

Important points

The ability to tolerate lactose varies from person to person.
If your child's symptoms do not improve or if there are on going issues, contact your doctor.

Reference

Much of the information in this topic comes from a pamphlet 'Low lactose diet' developed by the Nutrition Department of the Women's and Children's Health Network, South Australia.