The following is an excerpt from an upcoming article in Dream Magazine. Thrive reporter Melissa Jeltsen spoke with Children’s Hospital Boston gastroenterologist Richard Grand, MD, about many of the misconceptions and half-truths surrounding lactose intolerance and kids.
Q. I think my child is lactose intolerant—should I eliminate all milk products from my child’s diet?
A. Many adults and children avoid milk products because of misperceptions and myths about lactose intolerance. But long-term lactose restriction is a mistake and can result in low levels of calcium, vitamin D and other essential nutrients. The National Institutes of Health recently released findings on lactose intolerance. Among their conclusions is that it’s generally unnecessary to fully restrict lactose. Most people with lactose intolerance can adapt to lactose when it’s given in small doses over time.
Q. What percentage of children is actually clinically lactose intolerant?
A. The easy answer is very few, no matter what the genetic or ethnic background of the child. In fact, up to age 5 to 7, no child in the United States is lactose intolerant unless he has an intestinal infection or another injury to the lining of the small intestine. That is called secondary lactose intolerance, and it generally heals within six weeks of the infection. What we call adult type lactose intolerance is genetically and ethnically determined. In populations derived from Northern European countries, around one quarter of the population is lactose intolerant, after age 5 to 7. In Asian children, lactose intolerance may appear earlier, and can be found in about 90 percent of adults.
Q. If my child is lactose intolerant, is there a benefit to giving him milk products?
A. Parents should understand that even if their child is clinically lactose intolerant, they can become lactose tolerant by ingesting small amounts of milk with meals and slowly increasing the amount of milk up to eight ounces a day. Each patient will have a different threshold for ingesting lactose without symptoms. Have your child take milk with meals and increase the amount of lactose until he experiences symptoms. Once the limit is identified, your child should ingest just below that amount so he gets adequate levels of dairy in his diet.
Q. If my child isn’t ingesting any milk products, do I need to supplement his diet?
A. When lactose is removed from a diet, even for brief periods of time, efforts should be made to supplement with calcium, vitamin D and protein. Dairy products without lactose, including live culture yogurt, many hard cheeses and some ice creams, can be great sources of calcium, vitamin D and protein. With the help of a nutritionist, patients can find a satisfactory diet that provides all the nutrients they need from dairy food without uncomfortable gastrointestinal symptoms.