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Tips of the Week for February, 2013

Lactose Intolerance in Children

I think my child might be lactose intolerant. How can I tell?

Lactose intolerance occurs in people who can't digest lactose. Lactose is the sugar found in milk. It also is found in other dairy products, such as ice cream and soft cheeses. People who are lactose intolerant don't make enough lactase. Lactase is a natural enzyme made by your intestinal tract that digests lactose. When there isn't enough lactase, lactose that is eaten isn't digested and stays in the intestines causing gas, bloating, stomach cramps, and diarrhea.

Many parents confuse the terms lactose intolerance and milk allergy. While they may share similar symptoms, they are entirely different conditions. Lactose intolerance is a digestive problem, while milk allergy involves the immune system. Your child can be tested for milk allergy or lactose intolerance.


Common symptoms of lactose intolerance include

  • Stomach cramps
  • Bloating
  • Gas
  • Diarrhea
  • Nausea

These symptoms usually begin about 30 minutes to 2 hours after drinking or eating foods containing lactose.

How to tell

One way to check if your child has trouble digesting lactose is to take all milk products out of your child's diet for 2 weeks and see if symptoms improve. After 2 weeks, slowly reintroduce them in small amounts each day to see if symptoms return. Because many non-dairy and prepared foods contain lactose, it may be hard to remove all of these food from your child's diet.

If you think your child is lactose intolerant, talk with your pediatrician. Your child may need to be tested. The most common test for lactose intolerance is the lactose breath test. It's also called the hydrogen breath test. This test measures hydrogen levels in the breath after a lactose solution is swallowed. Normally, hydrogen is found only in low levels in a person's breath. However, when lactose isn't digested, it ferments in the intestines and produces hydrogen, which then will be exhaled through the lungs.

Your pediatrician may refer you to a specialist. If needed, a specialist can measure lactase and other enzymes from a small intestine sample. The sample usually is obtained during a diagnostic endoscopy. This procedure lets doctors view the inside of the intestines and obtain tissue samples.

What helps

There is no cure for lactose intolerance. However, if your child is lactose intolerant, diet changes can make a big difference. You can help decide what changes are best for your child.

  • By trial and error. In time your child will learn, by trial and error, how much milk or milk-based foods she can handle. Younger children with lactose intolerance should avoid foods containing lactose. These foods include milk, ice cream, and soft cheeses, such as cottage cheese, American cheese, and mozzarella. Older children usually can eat small amounts of lactose-containing foods, particularly if the foods are eaten as part of a meal and not alone. Many children can keep eating yogurt and aged cheeses, such as Swiss, cheddar, and Parmesan.
  • Over-the-counter lactase. Give your child over-the-counter lactase right before each meal. This may help her body digest foods that contain lactose.
  • Lactose-free or lactose-reduced. Offer your child lactose-free or lactose-reduced milk and other dairy products. Lactose-reduced milk retains all the ingredients of regular milk. You can store it in the refrigerator the same length of time.


Lactose intolerance doesn't have to make your child's life miserable. There are many options for children who are lactose intolerant. Talk with your pediatrician about what products or diet changes would be best for your child.

AAP Clinical Report:

Additional Resources from the National Dairy Council:

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Lactose Intolerance and Your Child (Copyright © 2004 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


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