Dairy
May Be Okay for Lactose Intolerant Children
The American Academy of Pediatrics has
a new attitude about consumption of milk and milk products by children with
lactose intolerance: Hey, give it a try.
New guidelines support use of dairy foods as an important
source of calcium for bone mineral health and of other nutrients that facilitate
growth in children and adolescents, according to guidelines reported in the
journal Pediatrics. Specifically, the new guidelines do not recommend eliminating
dairy products to treat lactose intolerance.
In practical terms, says Dr. Melvin B. Heyman, a member
of the committee that wrote the guidelines, the new advice is for parents of
children with lactose intolerance, in collaboration with pediatricians, to "test
the system and see how much milk, cheese, and ice cream they can tolerate."
Dr. Heyman, a professor of pediatrics at the University
of California, San Francisco, notes one reason for the new advice.
"We have more information about what people will tolerate.
We know that children who have lactose intolerance have a tendency to tolerate
some dairy products."
At least an equally important factor is the need for the
calcium in dairy products, he says.
"Young people have to get as much calcium as they can to
lower the risk of problems with bones as they get older,” explains Dr.
Heyman.
An estimated 30 million to 50 million Americans have some
degree of intolerance to lactose, the main sugar found in milk and other dairy
products.
They have a shortage of the enzyme lactase, which breaks
down the sugar, and can experience unpleasant symptoms, including nausea, cramps,
bloating, gas, and diarrhea if they ingest too much lactose.
The condition is relatively rare in Caucasians, but as many
as 75 percent of African Americans, 90 percent of Asian Americans and nearly
100 percent of Native Americans suffer from it. Symptoms generally start appearing
after age two.
When symptoms do appear, the first step should be to make
sure that they are not caused by another condition, such as irritable bowel
syndrome, celiac disease, an infection, or parasites, notes Dr. Heyman.
If lactose intolerance is the problem, it is important to
remember that the condition does not do bodily damage, however unpleasant the
symptoms might be, he says.
Careful testing can help determine which products affect
an individual and which are a lesser problem.
"Some people might tolerate yogurt but have problems with
milk," says Dr. Heyman.
The important point is that young people get an adequate
amount of calcium.
The guidelines note that the National
Medical Association, an organization of African-American physicians, “recently
recommended that black people consume three to four servings a day of low-fat
milk, cheese and/or yogurt," says Dr. Heyman.
"If lactose-free diets are used for treatment of lactose
intolerance, the diets should include a good source of calcium and/or calcium
supplementation to meet daily recommended intake levels," the guidelines state.
Always consult your physician for more information.
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Lactose intolerance is a condition caused by a lack of
an enzyme called lactase. Inadequate amounts of lactase cause the body to
be unable to digest lactose, a sugar found in milk products.
Lactase is normally produced in the small intestine where
it breaks lactose down into a form that can be absorbed by the blood.
A lack of lactase can cause uncomfortable symptoms for
some people. Those who do exhibit the symptoms are said to be lactose intolerant.
Digestive diseases or injuries to the small intestine
can reduce the amount of enzymes produced and is the usual cause of lactose
intolerance in young children.
However, most cases of lactose intolerance develop over
a period of many years in adolescents and adults.
Common symptoms, which begin about 30 minutes to two hours
after consuming foods or beverages containing lactose, may include:
- nausea
- cramps
- bloating
- gas
- diarrhea
The severity of symptoms varies depending on the amount
of lactose consumed and the amount each individual can tolerate.
The symptoms of lactose intolerance may resemble other
conditions or medical problems. Always consult your child's physician for
a diagnosis.
Common diagnostic tests (performed on an outpatient basis
at the hospital, clinic, or physician's office) are used to measure the absorption
of lactose in the digestive system.
A lactose tolerance test measures the absorption of lactose
in the digestive system. After fasting, the patient drinks a liquid that
contains lactose. The diarrheal stools are then tested for lactose for the
next 24 hours.
Undigested lactose fermented by bacteria in the colon
creates lactic acid and other fatty acids, which can be detected in a stool
sample, along with glucose as a result of unabsorbed lactose.
With a hydrogen breath test, the patient drinks a lactose-heavy
beverage. The breath is then analyzed at regular intervals to measure the
amount of hydrogen.
Undigested lactose in the colon is fermented by bacteria,
resulting in the production of various gases, including hydrogen. When high
levels of hydrogen are present in the breath, improper digestion of lactose
is diagnosed.
Always consult your physician for more information.
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