Is Lactose-Free Formula Safe for My Baby's Digestive Issues?

Lactose-free milk powder?

Hello, doctor.
My baby is currently 11.5 months old, measuring 76 cm and weighing 10.5 kg.
She is lively, cheerful, and active, showing good growth.
However, we have been facing persistent issues with her bowel movements.
Three months ago, she had roseola and experienced severe diarrhea.
The doctor recommended switching to lactose-free formula (Nestlé AL-110) until her stools became formed.
After more than a month, when we gradually transitioned back to her original formula (on the fifth day), she suddenly started vomiting and having diarrhea again.
Initially, her stools were acidic and watery, then they became mucous.
After a hospital examination, they noted some blood traces but found no bacterial or viral infections.
The doctor advised us to continue with the lactose-free formula and not to switch formulas again.

Since she has been on medication for a long time, her stools still haven't formed.
For the past month, after stopping the medication, she has been having 2-3 bowel movements a day, but they are all soft and mushy.
I have also tried giving her probiotics that claim to treat diarrhea and soft stools (trying six different brands), but not only did they not help, her stools became even more watery.
I attempted to switch back to her original formula twice, but it didn't work, and her stools became more watery again.

She has been on lactose-free formula for almost three months now, and she will soon be one year old.
Can she continue drinking this? Is her nutrition sufficient? I have been diligently preparing a variety of solid foods for her, but she only eats a few bites.
It’s quite frustrating.
Would it be okay to switch to a hydrolyzed formula for children over one year old? Thank you for your attentive service, doctor!

Fanrao de Mami, 30~39 year old female. Ask Date: 2006/03/21

Dr. Zhang Yingwen reply Pediatrics

1.
The nutritional composition of lactose-free formula is similar to that of regular infant formula, so it can be continued even if the baby is nearly one year old.
Babies over one year old can also obtain balanced nutrition from the addition of complementary foods.
2.
Hydrolyzed protein formula still contains lactose, which may not be very helpful for patients with lactose intolerance or those who have lost lactase due to enteritis, but it can be beneficial for patients with cow's milk protein allergy.
3.
The shape of the stool being loose and watery does not necessarily indicate a problem; however, if there is a sour smell or blood streaks, it is recommended to visit a pediatric gastroenterology clinic to check the stool for any signs of carbohydrate or fat malabsorption.

Reply Date: 2006/03/21

More Info

When it comes to managing digestive issues in infants, particularly regarding the use of lactose-free formula, it is essential to consider both the nutritional needs of the baby and the potential underlying causes of their gastrointestinal symptoms. Your baby, at 11.5 months, has been experiencing ongoing issues with bowel movements since a bout of roseola, which can complicate the situation.

Lactose-free formulas, such as the one you mentioned (Nestlé AL-110), are designed for infants who have difficulty digesting lactose, a sugar found in regular milk. This can be particularly beneficial for babies who have temporary lactose intolerance following gastrointestinal infections, which is not uncommon. The use of lactose-free formula can help alleviate symptoms like diarrhea and abdominal discomfort, allowing the digestive system to recover.

However, it is crucial to monitor your baby's overall health and nutritional intake while on a lactose-free formula for an extended period. Lactose-free formulas are generally nutritionally adequate for infants, but they may lack certain components found in standard formulas, such as specific prebiotics or probiotics that can support gut health. If your baby has been on lactose-free formula for nearly three months and is still experiencing soft stools, it may be worth discussing with your pediatrician the possibility of introducing a different formula or a hydrolyzed formula designed for older infants.

The fact that your baby has been experiencing soft stools and has had episodes of vomiting and diarrhea raises a few considerations. First, it is essential to ensure that there are no underlying infections or food intolerances that could be contributing to these symptoms. Since your doctor has ruled out bacterial or viral infections, it may be beneficial to explore other potential causes, such as food allergies or sensitivities, particularly if you have a family history of such issues.

In terms of transitioning back to a standard formula, it is advisable to do so gradually. If you decide to switch to a formula suitable for one-year-olds, ensure that it is a high-quality option that meets your baby's nutritional needs. Many formulas for older infants are designed to be easier to digest and may contain added probiotics that can help with gut health.

Additionally, it is important to consider the role of solid foods in your baby's diet. Since you mentioned that your baby is not eating much of the solid foods you prepare, it may be helpful to explore different textures and flavors to encourage more intake. Sometimes, babies may prefer certain types of foods over others, and offering a variety of options can help identify what they enjoy.

Lastly, if your baby continues to have soft stools or if you notice any other concerning symptoms, it is crucial to follow up with your pediatrician. They may recommend further evaluation or testing to rule out any underlying conditions that could be affecting your baby's digestive health. Keeping a food diary to track what your baby eats and any corresponding symptoms can also be a useful tool for discussions with your healthcare provider.

In summary, lactose-free formula can be safe and appropriate for your baby, especially if they have shown signs of lactose intolerance. However, ongoing digestive issues warrant careful monitoring and possibly further evaluation to ensure your baby is receiving adequate nutrition and to address any underlying concerns. Always consult with your pediatrician before making significant changes to your baby's diet or formula.

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