Kids and lactose intolerance

June 23, 2014 Uma Pisharody, MD, FAAP


Do you wonder if your child might have “lactose intolerance”?    Have you ever thought of removing dairy from your child’s diet?  If the answer to either of these questions is yes, here are a few things to remember when it comes to lactose intolerance in kids:

  • Lactose is broken down by lactase.

While lactose is the carbohydrate (sugar) found in milk, lactase is the enzyme that digests the sugar. This enzyme is found in the lining of the small intestine, breaks down lactose into simpler molecules that are easier to absorb.  When there isn’t enough lactase, the sugar isn’t properly absorbed, which leads to the symptoms of “intolerance”, which include gas, bloating, pain and diarrhea.

  • True lactose intolerance is rare in young children.

Although children as young as infants can “transiently” have less lactase in their digestive tracts (most often, this happens for a week or two after an infection), lactase production remains quite robust until children are at least 10-12 yrs old.    Children of certain ethnicities are less likely to develop lactose intolerance, even as they grow older, such as kids of European descent. 

  • All dairy does not have lactose.

Dairy products like aged cheese or sour cream have virtually no lactose.  That’s because the more fermented or “soured” dairy is, the less sugar (lactose) left in it!

  • Lactose intolerance is not the same as milk allergy.

Remember that a true allergy is typically induced by proteins.  Since lactose is a carbohydrate, it doesn’t cause an allergy.  A child with a true allergy to milk should not ingest even trace amounts of any form of dairy, whereas kids with lactose intolerance can consume some milk and other dairy products.

  • There are a variety of ways to make this diagnosis.

The easiest way to know if lactose bothers your child is to simply remove it for a few days, while checking to see if symptoms resolve. (Remember when removing lactose, you do not need to remove all forms of dairy.)  Sometimes, however, families find it helpful to have a “test” that can prove the diagnosis.  At Swedish, we offer 2 ways of diagnosing lactose intolerance: 

  1.  A simple breath collection test done in the office

  2.  Endoscopy with direct collection and quantification of the intestinal lactase level

If you have questions about your child’s diet, or would like to know more about having you child checked for lactose intolerance, the pediatric gastroenterology team at Swedish is here to offer help and support.


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