Lactose intolerance newborn

How to manage lactose intolerance in newborns

Lactose intolerance in newborns is a rare but clinically significant condition that may contribute to gastrointestinal discomfort and feeding challenges in the earliest stages of life. While lactose intolerance is more frequently identified among older children and adults, awareness of its possible occurrence in infants is important for early recognition and appropriate management. This article provides a structured overview of lactose intolerance in newborns, including types, typical symptoms, diagnostic approaches, and current management strategies.

Do you suspect that your newborn has lactose intolerance? Lactase drops is one of the only lactase supplements that can be taken at any age.

What is lactose intolerance in infants?

Lactose intolerance refers to a reduced ability to digest lactose, the main carbohydrate found in breast milk and standard infant formulas. This is due to decreased activity of the enzyme lactase, which is responsible for breaking down lactose into absorbable forms in the small intestine. In newborns, primary congenital lactase deficiency (also termed congenital alactasia) is exceptionally rare. More commonly, infants may develop secondary, or acquired, lactose intolerance following an acute gastrointestinal illness or injury to the intestinal lining.

symptoms of lactose intolerance in newborns

The presentation of lactose intolerance in infants can be nonspecific and may resemble other causes of gastrointestinal discomfort. Typical symptoms of lactose intolerance in newborns may include:

• Bloating and a distended abdomen
• Increased flatulence
• Watery diarrhea, sometimes with acidic stool
• Abdominal pain or cramping, which may manifest as irritability or excessive crying during or after feeds
• Poor weight gain or faltering growth

Sensitivity to lactose varies, and a newborn may experience symptoms after consuming different amounts of lactose, depending on the level of lactase present. It is important to note that lactose intolerance should be distinguished from cow’s milk protein allergy, which has a different underlying cause and management approach.

Diagnosing lactose intolerance in infants

A careful clinical evaluation is needed before considering the diagnosis of lactose intolerance in infants. The following steps are often recommended:

• Detailed Symptom Assessment: Tracking feeding history, timing and pattern of symptoms, and any recent gastrointestinal infections.
• Stool Analysis: Testing the stool for acidity (pH) and the presence of reducing sugars may suggest carbohydrate malabsorption.
• Elimination and Reintroduction: Temporarily removing lactose from the infant’s diet and observing for changes, followed by cautious reintroduction under medical supervision.
• Specialist Consultation: Consulting with a pediatrician or a registered dietitian is important for accurate assessment and safe dietary adjustments.

For further information on intolerance evaluation, see our intolerance test and the knowledge bank for additional resources.

Approaches for managing lactose intolerance in newborns

Care for lactose intolerance in infants depends on the underlying cause and individual needs:

1. Dietary adjustments

• Breastfed Infants: Since breast milk contains lactose, temporary cessation is generally not recommended except in rare cases of confirmed congenital lactase deficiency. For secondary lactose intolerance, continued breastfeeding is typically encouraged, as it supports gut health and recovery. Enzyme replacement or lactase-treated breast milk may be considered with specialist input.
• Formula-Fed Infants: Lactose-free or low-lactose formulas may be suggested for short-term use, especially when secondary lactose intolerance is suspected after gastrointestinal illness. Most infants gradually regain lactase activity, allowing for typical feeds to resume.

2. Use of enzyme supplements

For situations where temporary enzyme support is considered appropriate, lactase enzyme supplements may be used to support lactose digestion. Always look closely on the age that is recommended for a product. A lot of lactase supplements are not meant for newborns.

3. Monitoring and support

Most episodes of lactose intolerance in infancy are temporary. Regular monitoring of growth and symptom resolution is important. Persistent or significant symptoms should prompt a re-evaluation for other gastrointestinal or metabolic concerns.

When to consult a healthcare professional

It is important to seek medical advice if a newborn shows persistent diarrhea, refuses feeds, does not gain weight, or has signs of dehydration. Early consultation allows for timely assessment, adaptation of feeding plans, and helps reduce the risk of complications related to malnutrition or ongoing symptoms. Our team of specialized dietitians is available to provide personalized advice for managing infant feeding concerns and intolerance issues.

In summary:

Lactose intolerance in newborns, although rare, requires careful evaluation and an individualized care approach. Careful symptom observation, appropriate diagnostic steps, and personalized feeding plans under the guidance of healthcare professionals are key to positive outcomes.

---

For professional assessment of symptoms or individualized dietary planning, contact one of our dietitians or consult the knowledge bank for reliable, up-to-date information.