Lactose Intolerance in Infants: Choosing the Right Formula

Gastrointestinal II

Doctor, I would like to ask if my baby might have lactose intolerance, since the formula "金可貝可" contains lactose and galactose.
How can I determine if my baby has lactose intolerance? The S-26 formula does not contain lactose, only sucrose, but many people say that sucrose is too sweet for infants.
My baby has been drinking "金可貝可" for two months; if I switch to another brand of formula, will it be too much of a burden on his digestive system? Could you recommend a better brand of formula? If it is lactose intolerance, would "low-lactose" formula be better, or should I switch to lactose-free formula? However, I have heard that lactose-free formula should not be consumed long-term and may not provide adequate nutrition.

Hui Di, 20~29 year old female. Ask Date: 2009/02/25

Dr. Xiao Kaiwen reply Pediatrics

Congenital lactose intolerance is a rare condition (thus the likelihood is low).
The diagnostic methods for lactose intolerance in infants include lactose tolerance tests, hydrogen breath tests, stool acidity tests, and even intestinal biopsy, among others (if necessary, please consult a pediatric gastroenterologist at a medical center).
In principle, infant formula from reputable brands that has passed health department inspections can be given to infants, provided they can tolerate it (without developing rashes or diarrhea).
There should not be any issues with excessive sweetness, and switching to other approved infant formulas should not pose significant problems; the only concern might be that the baby may refuse to drink if the taste changes.
Lactose-free formula can be consumed long-term without concerns about nutritional deficiencies; however, it is a specialized formula that should only be used under medical guidance.

Reply Date: 2009/02/25

More Info

When it comes to understanding lactose intolerance in infants and selecting the right formula, it’s essential to consider several factors, including the symptoms of lactose intolerance, the nutritional content of different formulas, and the potential impact of switching formulas on your baby's digestive system.

Understanding Lactose Intolerance in Infants
Lactose intolerance occurs when the body lacks sufficient amounts of lactase, the enzyme needed to digest lactose, the sugar found in milk. In infants, true lactose intolerance is relatively rare, as most babies are born with the ability to digest lactose. However, some may experience temporary lactose intolerance due to gastrointestinal infections or other underlying issues. Symptoms of lactose intolerance can include:
- Frequent diarrhea
- Bloating or gas
- Abdominal pain or cramping
- Foul-smelling stools
If you suspect your baby may have lactose intolerance, it’s crucial to consult with a pediatrician. They can perform tests or evaluate your baby's symptoms to determine if lactose intolerance is indeed the issue.

Choosing the Right Formula
If your baby has been consuming a formula that contains lactose, such as the "金可貝可" (Jin Ke Bei Ke), and you notice symptoms that align with lactose intolerance, switching to a formula with lower lactose content or a lactose-free formula may be beneficial. However, it’s important to note that not all babies who experience digestive discomfort have lactose intolerance, and switching formulas can sometimes lead to additional digestive issues.

When considering a switch to a different formula, such as S-26, which contains no lactose but includes sucrose, it’s essential to weigh the pros and cons. While sucrose is sweeter than lactose, it is generally considered safe for infants in moderation. However, excessive sugar intake should be avoided, as it can lead to dental issues and unhealthy eating habits later in life.

Impact of Switching Formulas
Switching formulas can sometimes lead to digestive upset, as infants may need time to adjust to new ingredients. If you decide to change formulas, it’s advisable to do so gradually. Start by mixing the new formula with the current one, gradually increasing the proportion of the new formula over several days. This method can help minimize digestive disturbances.

Considerations for Lactose-Free Formulas
If your pediatrician confirms lactose intolerance, a lactose-free formula can be a suitable option. These formulas are designed to provide the necessary nutrients without the lactose that can cause discomfort. However, there is some debate about the long-term use of lactose-free formulas. While they can be nutritionally adequate, some experts suggest that prolonged use may not be necessary for all infants, especially if they can tolerate small amounts of lactose.

Nutritional Content and Ingredients
When selecting a formula, consider the following nutrients:
1. DHA and ARA: These are essential fatty acids important for brain development. Look for formulas that include these nutrients.

2. Iron: Iron-fortified formulas are crucial for preventing iron deficiency anemia.

3. Probiotics: Some formulas contain probiotics, which can support gut health.

4. Vitamins and Minerals: Ensure the formula meets the recommended dietary allowances for infants.

Regarding palm oil, its inclusion in formula is a topic of discussion. While some parents prefer formulas without palm oil due to concerns about its digestibility, research indicates that palm oil is generally safe and can provide essential fatty acids.

Conclusion
In summary, if you suspect your baby may have lactose intolerance, consult with a pediatrician for a proper diagnosis. If lactose intolerance is confirmed, switching to a lactose-free formula may be beneficial. When choosing a formula, focus on the nutritional content and consider your baby's specific needs. Gradual transitions between formulas can help ease digestive adjustments. Always prioritize your baby's health and comfort, and don’t hesitate to seek professional guidance when making dietary changes.

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