Switching from Lactose-Free to Regular Formula: Key Considerations for Parents

Switching from lactose-free formula to regular formula?

Hello Doctor: My baby is currently ten months old.
He had diarrhea for over a month, and after seeing a doctor, he has been drinking lactose-free formula for about eight weeks.
Two weeks ago, we stopped medication, and now he only takes probiotics (Bacillus coagulans) once a day.
His bowel movements are once every one to two days, which seems normal.
Recently, I want to switch back to regular formula, but considering that my baby will soon be eleven months old, a pharmacy staff member suggested continuing with lactose-free formula until he turns one, and then switching to toddler formula for ages 1-3.
However, I have heard that toddler formula lacks the nutrition found in infant formula for ages 6-12 months, and that lactose-free formula shouldn't be consumed for too long (Note: my baby has not started any solid foods, so milk is still his main source of nutrition).
My thoughts are: (1) Can I let my baby drink regular infant formula for ages 6-12 months until he is one and a half years old before switching to toddler formula, or should I follow the pharmacy staff's advice and switch directly to toddler formula at one year? (2) During the transition to new formula, what solid foods can I give my baby? The previous doctor suggested rice porridge, but my baby refuses to eat more than a few bites each time.
Are there any gentler solid foods I could try? (Note: I am very cautious about trying new foods due to my baby's previous diarrhea).
Should I wait until the formula transition is fully completed before introducing solid foods? (3) When switching from lactose-free formula to regular formula, how often should I introduce the new formula? The pharmacy staff suggested half a scoop per week, which seems very slow to me.
Is it okay to switch more quickly as long as there are no adverse reactions? I would appreciate it if you could take the time to answer these three questions! Thank you!

yiwen, 30~39 year old female. Ask Date: 2007/03/14

Dr. Pei Rensheng reply Pediatrics

Hello,
(1) Growth formula for children aged 1 to 3 years is not less nutritious than infant formula for those aged 6 to 12 months.
Once a child turns one year old, they can start drinking the 1 to 3 years growth formula, which may even have a higher protein concentration compared to the formula consumed before their first birthday.
I recommend gradually transitioning from lactose-free formula to regular formula, and once the transition to regular formula is complete, it is important to continue incorporating other complementary foods.
(2) During the transition period, suitable complementary foods for the baby include plain rice porridge, to which you can add low-fat foods such as shredded meat, seaweed, and finely chopped tofu.
Starchy foods like bread and steamed buns are also acceptable.
Additionally, applesauce is a fruit that is less likely to cause diarrhea.
(3) When switching from lactose-free formula to regular formula, the transition can be as quick as one teaspoon per day.
If gastrointestinal stability is an issue during this period, revert to the previous mixing method used yesterday.
The transition can typically be completed in about a week.

Wishing you health and happiness!
Sincerely,
Pei Ren-Sheng

Reply Date: 2007/03/14

More Info

Switching from lactose-free formula to regular formula for your baby is an important decision that requires careful consideration, especially given your baby's recent history of diarrhea and current dietary habits. Here are some key points to consider regarding your questions:
1. Timing of Transition to Regular Formula: It is generally acceptable to transition your baby from lactose-free formula to regular formula around the age of 11 months, especially since your baby has been stable for the past few weeks. The recommendation to continue with lactose-free formula until one year is often made to ensure that any potential lactose intolerance is fully resolved before introducing regular dairy. However, if your baby has shown no signs of lactose intolerance (such as diarrhea, bloating, or discomfort) after being on lactose-free formula, you can consider introducing regular formula. You can choose to use a standard infant formula (6-12 months) until your baby is 1.5 years old, as this formula is specifically designed to meet the nutritional needs of infants. After one year, you can transition to toddler formula (1-3 years) which is formulated for older children.

2. Introducing Solid Foods: Since your baby has been hesitant to eat rice porridge, it might be beneficial to explore other gentle, easily digestible foods. You can try pureed fruits (like bananas or applesauce), soft-cooked vegetables (like carrots or sweet potatoes), or even oatmeal. Gradually introducing a variety of textures and flavors can help your baby become more accustomed to solid foods. It's important to introduce new foods one at a time and wait a few days before trying another to monitor for any adverse reactions. You do not necessarily have to wait until the formula transition is complete to start introducing solids; you can do both simultaneously, but proceed with caution and observe your baby's reactions.

3. Transitioning from Lactose-Free to Regular Formula: The process of switching formulas should be gradual to minimize any potential digestive upset. A common approach is to mix the two formulas, starting with a small amount of regular formula added to the lactose-free formula. For example, you might start with a ratio of 1 part regular formula to 4 parts lactose-free formula for a few days, then gradually increase the amount of regular formula while decreasing the lactose-free formula over the course of a week or two. If your baby tolerates this well, you can continue to increase the regular formula until you are fully transitioned. If you notice any signs of discomfort, such as increased fussiness, diarrhea, or vomiting, it may be wise to slow down the transition process.

In summary, transitioning your baby from lactose-free to regular formula can be done safely with careful monitoring and gradual changes. It’s essential to pay attention to your baby’s reactions during this process and consult with your pediatrician if you have any concerns or if your baby shows signs of distress. Additionally, introducing solid foods can be done alongside the formula transition, focusing on gentle, easily digestible options. Always prioritize your baby's comfort and health during this transition.

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