Lactose Intolerance and Acid Reflux in Babies

Lactose intolerance and acid reflux in babies is very common. Lactose intolerance is the leading cause of acid reflux in babies. Acid reflux in babies is caused due to the weak or loose sphincter muscles. Most of the time intake of dairy products or intolerance to lactose causes acid reflux in babies. Infant acid reflux solutions are present either through medications or modification in daily dietary habits. As the parents are concerned with their child’s health question comes to their mind like how to help baby with acid reflux? Is reflux related to lactose intolerance? Yes, lactose intolerance and acid reflux in babies are interlinked.

What is lactose intolerance and Acid Reflux?

Milk and Acid Reflux:

  • Milk
  • Milk by-products
  • Whey
  • Dry milk solids
  • Curds
  • Cheese
  • Non-fat dry milk powder
  • Lactose

Lactose is found in milk and dairy products like cow’s milk, goat’s milk, yogurt, cheese, ice cream, bread, cereal, lunchmeats, salad dressings, mixes for baked goods, etc.

Lactose Intolerance and Milk Allergy?

Milk allergies or dairy sensitivity show up in infants and stay forever while Lactos intolerance can first show its symptoms in toddlers into adolescence. Dairy sensitivity leads to lactose reaction. Lactose intolerane starts in your childhood and with ageing into adulthood it becomes more and more prominent.

What Causes Lactose Intolerance and Acid Reflux?

There are three different types of lactose intolerance depending upon the cause or origin of deficiency of lactase in the small intestine, intestinal enzyme lactase is one of the most important lactose digestion enzymes:

Primary lactose intolerance

In infants, the body produces enough amount of lactase but with growing age and feed changes, lactase amount drops and it becomes difficult as it causes discomfort and many other symptoms that cause enough problems for you to go see a physician.

Secondary lactose intolerance

The secondary form of lactose intolerance rises because of lactase deficiency which is caused when your intestine drops the amount of lactase production in your body after some injury, illness, or surgery involving your small intestine. Diseases that can lead to the second type of lactose intolerence include the given names below:

Treating these diseases will help with the symptoms but the process takes time even after the disease has been recovered.

Congenital or developmental lactose intolerance

What risk factors are there for your child to get lactose intolerant?

Factors that increase the risk for you or your child to get lactose intolerant are given below:

Age:

Geographical and environmental factors:

Sometimes some health conditions are related to a specific gene pool or geographical location which is basically because of the gene variants present in the genome of the masses living in that specific area or the environmental factors that help in the development of the particular disorder or condition. In the case of Lactose intolerance, people of African, Asian, Hispanic, and American Indian are at most risk to develop this disorder because of their gene pool and environment.

Birth:

Premature birth can put your child at utmost risk to develop this condition because in the third trimester of pregnancy the development of the digestive tract of the fetus occurs, but when the child is given birth prematurely, the cells that produce lactase don’t develop enough to work efficiently after birth. So this risk factor is very dangerous but rare.

Diseases of the small intestine:

Problems of the small intestine like bacterial overgrowth, celiac disease, and Crohn’s disease are a greater risk to make anyone get lactose intolerant. These diseases affect the cells in the small intestine that produce lactase and then the small intestine is not strong enough to produce digestive juices and therefore the patient becomes lactose intolerant.

Cancer Treatment:

Who is at risk of becoming lactose intolerant?

A child is more at risk to get lactose intolerant if he or she:

  • Is a baby that was born prematurely. This causes the developmental type of lactose intolerance which is mostly a temporary problem and goes away ultimately. It is mainly because the baby did not go through the developmental stages of the third trimester of pregnancy which gives birth to secreting cells of GIT of the fetus.
  • Is Mexican American, Jewish, African American, American Indian, or Asian American.
  • Has some other family members going through the same disorder. In such cases, symptoms of lactose intolerance can develop in teenage or adulthood.

What are the Symptoms of Lactose Intolerance and acid reflux?

In American children with lactose intolerance, signs of lactose intolerance appear after the age of 5 years while in African-American children, lactose intolerant symptoms start appearing at the age of 2 years. Symptoms of lactose intolerance appear after half an hour of consumption of the food containing lactose. Lactose intolerance symptoms in adults are somehow similar to the toddlers. Signs and symptoms vary from person to person. Lactose intolerance symptoms are given below:

How to confirm if your child is lactose intolerant or not?

A simple way to check if your child is suffering from lactose intolerance or not, is to remove all the milk products from your child’s diet for about a couple of weeks and then see if his or her symptoms improve or not. If your child was lactose intolerant and drank milk lactose intolerant symptoms might worse. After that couple of weeks, add some products in smaller quantities to the child’s diet every day to see if the symptoms reappear or not. A hydrogen breath test is also helpful in such cases. So, you must go to see your pediatrician instead of experimenting on your child.

Lactose intolerance in infants:

Is everyone lactose intolerant? No, not everyone have intolerance to lactose. Lactose sensitivity symptoms are very rare to be found in infants as all children are born in full-term with enough amount of lactase in their small intestines, later the production rate of lactose in their small intestines fall after the age of 3 to 5 years, and at that age they are less lactose sensitive. The chances of lactose intolerance in infants raise when the child is born prematurely.

Another type of lactose intolerance found in infants is congenital lactose intolerance. It is a very rare condition that is inherited in case both the parents pass on the gene variant. It is a recessive disorder that is passed on an inheritance from generation to generation. This condition leads to severe diarrhea. If the condition is kept unchecked and the baby is not fed lactose-free milk, it can lead to severe dehydration and weight loss.

Deficiency of Calcium:

Lactose intolerant children or teenagers do not get enough amount of calcium that their body needs because milk and dairy products are the basic sources of calcium for children at growing age. If your child is suffering from this disorder, you will need to make sure that your child gets enough amount of calcium in its diet from sources other than milk or dairy products. Calcium is necessary for your child’s growth and his bones’ strength. It also prevents many diseases related to hypocalcemia.

The amount of Calcium varies depending upon the age of the consumer:

  • Babies of age 0 to 6 months need 200mg of calcium in their feed per day.
  • From 7 to 12 months of age, the amount raises to 260mg of Calcium per day.
  • 1 to 3 years old child needs 700mg of Calcium per day.
  • While 4 to 8 years old toddlers need 1000mg of calcium per day.
  • And 9 to 18 years old teenagers will be needing up to 1300mg of Calcium in their diet per day.

Here are given the non-dairy options of calcium sources that you can add to your child’s diet to make sure that he gets enough amount of calcium to avoid bone weakening or diseases related to hypocalcemia:

  • Some green vegetables are a good source of calcium that include collard greens, turnip greens, broccoli, and kale.
  • Fish are a good source of calcium mostly which have soft and edible bones. Examples are salmon and sardines.

Other non-dairy good sources of calcium are tofu, orange juice with added calcium, soy milk with added calcium, and breakfast cereals with added calcium. Using milk that have high-degree of lactose tolerance like soy milk.

Always consult your paediatrician before adding any synthetic or supplemental form of calcium source to your child’s diet. If the child does not get enough or the required amount of calcium in his/ her diet, the supplements must be included in the diet after consulting a doctor. The prescription will tell the right name, amount, dosage, frequency, and periods for the calcium supplements to be taken.

Deficiency of Vitamin D:

If your child has to avoid milk or dairy products to treat lactose intolerance that means he is not getting enough amount of Vitamin D in his diet. Vitamin D is found in the liver and eggs which are a good non-dairy source of Vitamin D and they are affordable too from an economical point of view. Children under the age of 1 year must have 400IU of Vitamin D per day in their diet and those with age over 1 year must have 600IU of Vitamin D per day.

Milk Substitutes:

There are so many options that can replace milk in your child’s diet which include soy, almond, rice, hemp, and oat milk if your child is lactose intolerant. Soy milk is a very popular option for lactose-intolerant children as an alternative to milk or dairy products because it contains calcium and so many proteins. Almond milk is not just a popular alternative to cow’s milk for your lactose intolerant child but also the safest option. It is also used by people as a milk substitute who are allergic to Cow’s milk protein. Although Almond is a good source of calcium and a better milk substitute it can never match the composition of cow’s milk obviously because that contains much more protein than Almond milk. Before adding any milk substitute to your child’s diet, you must consult your paediatrician about the type, quantity, and frequency of the milk substitute.

How is Lactose Intolerance Diagnosed?

Hydrogen breath test:

A hydrogen breath test is very helpful in case of lactose intolerance diagnosis. A child is fed a specific amount of beverage that contains a known amount of lactose. Then the child is asked to breathe into a container that measures the hydrogen exhaled after consumption of that beverage. Normally a hardly detectable amount of hydrogen is exhaled by a person who can digest lactose in the diet but it raises when lactose is not digested.

The pH of the stool:

When the child is too young to perform a hydrogen breathe test, the acidity of the stool is checked. When lactose is not digested and absorbed in the intestines, the stool has a very low pH i.e acidic stool. Another stool test for infants is glucose in the stool which signifies the amount of glucose in the stool. When lactose is not digested and absorbed well, there is a minor amount of glucose in the stool.

Endoscopy of the child:

If the symptoms persist and the child’s condition does not get better, a pediatric gastroenterologist (GI) is consulted for further evaluation. Depending upon the severity of the symptoms and reaction that the child is given, the gastroenterologist (GI) might perform an endoscopy on the child to measure the amount of lactose from contents directly taken from the intestine by biopsy.

How is Lactose Intolerance and Acid Reflux Treated?

Here are some tips for managing lactose in your child’s diet:

  • Start slowly and after restriction of milk and dairy products for a few weeks, start adding those products back in minute quantities and check what your child’s gastrointestinal tract can handle and what it can’t.
  • Try consuming milk or dairy products with other meals. Try having cheese with crackers or milk with cereals. This might help your child digest it easily.
  • Select those milk and dairy products that are low in lactose. Such products include hard cheese and yogurt.
  • Look for lactose-free products when buying from the market.
  • Ask your health care provider about lactase pills for your child.
  • Always consult a registered dietitian or pediatrician about such problems. Quacks can make the situation worse instead of improving it.

Conclusion:

Problems related to our health must always be taken seriously no matter how big or small they are. No matter what causes lactose intolerance and acid reflux in babies, if it is left unchecked it can cause serious dehydration and weight loss in your child. So, if you see symptoms of dairy intolerance in your child, you must go see your pediatrician before it is too late.

References:

Ms. Tayyaba Akhtar

Doctor of Veterinary Medicine

University of Veterinary & Animal Sciences


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