Do lactose intolerant babies need to stop breastfeeding?

Question

Hello doctor,

My baby who is exclusively breastfed has just started her fifth month. For the past four days, she passes frothy liquid motion with little white like substance for a minimum seven times a day. The consultant doctor examined her stool and said that she has got lactose intolerance. He told me to stop breastfeeding and go with soya-based milk powder for three months from now on. Should I stop breast feeding? She is active and gaining weight.

Answer 1

Hello,

Welcome to icliniq.com.

I went through the details you have provided in the query. Lactose intolerance is the absence of lactose enzyme which helps to digest and break down sugars, mainly lactose in the diet.

Lactose intolerance is of two types:

1. Primary.

2. Secondary.

In primary lactose intolerance, there will be deficiency of this enzyme permanently and will have to avoid for life time or needs enzyme replacement for life. In secondary intolerance, deficiency is only transient and will regain the enzyme in a few days, this occurs mostly after episodes of gastroenteritis and needs to avoid lactose diet for a few days or weeks. Your child needs further evaluation to check if it is primary or secondary.

The reports you have sent are not clear (attachment removed to protect patient identity). The second one, culture if positive will need treatment with antibiotics. Though breast milk contains lactose and not easily digested by lactose-intolerant babies, it is not advised to stop breast feeding as advantage of continuing breast feeding outweighs problems due to lactose intolerance. Though giving lactose-free feeds reduces symptoms like loose motions and bloating.

My advice at this point is to continue breastfeeding but if loose stools are causing dehydration or weight loss in baby then go for lactose-free formula and repeat stool examination and tests for lactose intolerance again. Since it might be transient only and might improve in about one to two weeks and if repeat testing is normal then, normal breastfeeding can be given without any worry.

I hope this helps.