Lactose Intolerance

Lactose Intolerance in Infants: How Is It Different from Cow’s Milk Protein Allergy?

Lactose intolerance is sometimes confused with Cow’s Milk Protein Allergy (CMPA), but these are two very different conditions.

CMPA is an immune-mediated reaction to the proteins found in cow’s milk. Lactose intolerance, on the other hand, is a digestive condition caused by difficulty digesting lactose, the main natural sugar found in milk. It does not involve the immune system.

Because both conditions can cause digestive symptoms, distinguishing between them can sometimes be challenging. Common symptoms include:

• Bloating
• Excessive gas
• Abdominal pain
• Diarrhoea

What Is Lactose?

During the first months of life, lactose is the main carbohydrate in an infant’s diet.

Lactose is a natural sugar found in breast milk and the milk of mammals. To be properly digested and absorbed, it must be broken down by lactase, an enzyme produced in the small intestine.

In some infants—particularly those born prematurely—lactose digestion may be less efficient because lactase production is still immature. This usually improves naturally as the digestive system matures.

Is Lactose Intolerance Common in Infants?

Congenital lactose intolerance, a rare genetic condition in which babies produce little or no lactase from birth, is extremely uncommon.

In most situations, even when lactase activity is reduced, infants retain some ability to digest lactose. As a result, small amounts of lactose are usually well tolerated.

Primary lactose intolerance, which is relatively common in some adult populations, is uncommon in infants and young children.

How Is Lactose Intolerance Managed?

Management depends on the underlying cause and the severity of the symptoms.

In the rare cases of congenital lactose intolerance, a completely lactose-free diet may be required.

In other situations, a temporary reduction in lactose intake may sometimes be recommended while ensuring that the infant continues to receive appropriate nutrition for healthy growth and development.

Any changes to a baby’s diet should always be made under the guidance of a healthcare professional, who can ensure adequate nutritional intake and determine the true cause of the symptoms.

Key Takeaway

Although lactose intolerance and Cow’s Milk Protein Allergy (CMPA) can sometimes cause similar digestive symptoms, they are two distinct conditions.

An accurate diagnosis is essential to ensure the most appropriate nutritional management, support your baby’s comfort and promote healthy growth and development.

 

Reference:

Melvin B. Heyman, MD, MPH, for the Committee on Nutrition. Lactose Intolerance in Infants, Children, and Adolescents. PEDIATRICS Volume 118, Number 3, September 2006 . doi:10.1542/peds.2006-1721