Lactose-free Milk

I’m strongly committed to breast feeding, but I’m not sure how digestible my breast milk is because lately my baby has been colicky. One book I read said that my breast milk would be more digestible if I cut dairy products out of my diet. I really love dairy, so I’m wondering if there’s a way around this. Would it be OK for me to drink lactose-free milk instead of regular milk? What about taking a pill to help me break down the lactose in yogurt and cheese?
Committed but confused on the east coast

Dr. Greene’s Answer:

I’m glad about your decision to breast feed your baby. Although breast feeding can pose challenges (and joys), it is still true that mother’s milk is the perfect food for babies. Milk is, in fact, the basic food for all mammals. Why then do people often experience difficulty tolerating milk?

The difficulties can be caused by two different substances: milk sugar (lactose) and milk protein. Each of these substances produces its own particular problems. Lactose is the sugar in milk. It is the same for any kind of milk–breast, cow, goat, or sheep. A person who is lactose intolerant tends to have gassy symptoms, bloating, and diarrhea after eating dairy foods. These symptoms can be avoided if the person drinks lactose-free milk. Alternatively he or she could take pills such as Lactaid, which enable the intestines to digest lactose without any problem. There are far more people in the world who do not tolerate lactose than people who do. About 80% of all people over age 3 are lactose intolerant. This statistic applies to Native Americans, Asians from the Far East, Southeast Asians, Africans, African-Americans, and Native Australians. It does not apply to Caucasians, however: only 15% of Caucasians in the U.S. are lactose intolerant.

The statistic also does not apply to babies. Infants from all parts of the world do tolerate lactose–otherwise they couldn’t digest breast milk well. Their bodies make an enzyme, lactase, which enables them to digest the sugar in milk. As a result, in healthy full-term infants lactose intolerance is extremely rare. It is more common in premature babies, who are sometimes lactose intolerant until they begin to approach their original due dates. At that point, their bodies start making lactase. Newborn lactose intolerance is quite obvious, usually manifesting as discomfort with each feeding. Babies with lactose intolerance are treated with formula that is based on cow’s milk but is lactose-free, or else with a soy-based formula. Elemental formulas, which are much more “pre-digested” than usual formulas, also work well for these infants.

Healthy full-term babies can temporarily become lactose intolerant, though, during and after a bout of diarrhea, since diarrhea can cause them to lose the enzyme. Infants regain their tolerance after the diarrhea has ended and their bodies have had time to make more of the enzyme. Eventually, however, in most populations as the babies mature their bodies gradually make less and less lactase. As they grow into toddlerhood, they no longer tolerate milk of any kind.

The other component of milk that can cause people problems is its protein, which comes in two basic forms–casein and whey. The specific proteins differ slightly depending on which mammal the milk is from. The mammal whose milk most often creates digestive difficulties for humans is the cow. Intolerance to cow’s milk protein follows the opposite pattern from lactose intolerance, since it is not uncommon in newborns but becomes much less common the older children get. It is estimated that between 2% and 7.5% of healthy infants have significant intolerance to the protein in cow’s milk. The problem is particularly common in families with strong histories of eczema, allergies, or asthma.

Babies with this intolerance can have discomfort even if they are exclusively breast fed. The difficulty arises when the mother eats or drinks cow’s milk protein. The protein passes into her breast milk and from there into the baby’s digestive system. Antibodies to this protein have been found in infants who are intolerant, providing evidence of the link between the mother’s diet and her baby’s digestive troubles.

A study published in the January 1996 Journal of the American Dietetic Association looked carefully at infants’ symptoms of fussiness or colic and how they varied with maternal consumption of 15 different foods. Maternal consumption of cow’s milk was far more associated with the symptoms of colic than consumption of any other food. The study found that women who drank cow’s milk were twice as likely to have infants with colic compared to other breast feeding moms. Another study found that half of women with colicky babies who dropped cow’s milk saw marked improvement in their babies’ symptoms. A third investigation found that there were higher levels of cow’s milk protein in the mothers’ milk of colicky infants than in the milk of mothers whose babies were not colicky.

These studies strongly suggest that if your breast fed baby is colicky, it is worth a try to eliminate cow’s milk from your diet. You will want to avoid cheese, ice cream, milk in a glass or on cereal, yogurt, puddings, custards, cream sauces, and butter. This is not a quick fix, however. Cow’s milk protein can remain in breast milk for up to two weeks after the mother has stopped eating dairy foods. To see whether dropping dairy really makes a difference for your child, have your dietary experiment last about 3 weeks. If the change in your eating habits does improve your baby’s colic, you will probably want to remain off dairy at least until the typical colicky period is over, when your baby is 12 to 16 weeks old. If your child’s colic was severe and it turns out that he or she is especially sensitive to cow’s milk protein, you may want to avoid dairy even longer. Although many babies become tolerant of cow’s milk protein before their first birthdays, some children can take a full year or longer, and some never become tolerant.

During this period, as a mom you need to remember your own physical needs. First of all, you will need another source of calcium. You will need to take in at least 1200 mg daily. If you do not, the calcium you lack in your diet will be taken from your bones! Calcium is found in Tums, sesame seeds, bok choi (Chinese cabbage), canned non-boneless salmon and sardines, and dark green vegetables such as collard greens, spinach, turnip greens, and kale. Some brands of orange juice are fortified with calcium. Tofu is also a good source of calcium, but unfortunately as many as 20% of babies who are sensitive to the protein in cow’s milk are also sensitive to soy. You can try drinking almond milk, coconut milk, or rice milk in place of cow’s milk. Stores that sell vegan foods have non-dairy butters and cheeses available as well.

You may also need to be careful about your own body’s developing an intolerance to lactose. While avoiding cow’s milk protein, you will also have stopped consuming milk sugar. Your body may respond to the lack of milk sugar by stopping its production of the enzyme lactase. You would then start having digestive difficulties once you reintroduced milk to your diet. Ways to help prevent this problem are 1) try eating goat’s or sheep’s milk (for example, in French cheeses such as chevre). The proteins in these kinds of milk are less likely to cause your baby problems than the proteins in cow’s milk; 2) consume small amounts of cow’s milk used in recipes. Thorough cooking of cow’s milk alters the form of the protein, making it less likely to upset your baby’s digestion; and 3) when you do reintroduce dairy to your diet, do so gradually.

All of this may sound like a lot of work, but for parents with a colicky baby, the changes can be well worth the effort. There are other benefits to mom’s avoiding cow’s milk, too. According to the September 1993 Journal of Investigative Allergy and Clinical Immunology, studies have shown that the frequency and severity of asthma, eczema, and allergies are significantly reduced for as long as 5 years when breast feeding mothers give up cow’s milk for at least 3 months.

In answer to your question, then, your switching to lactose-free milk or taking Lactaid pills would not help your colicky baby, because those products still contain the protein in cow’s milk. Temporarily giving up the dairy products you love so much might make a real difference, however. You might find that what you lose in your diet will be made up to you in the smiles on your baby’s face.

Dr. Alan Greene

As a father of four himself, Dr. Greene has devoted himself to freely giving real answers to parents' real questions -- from questions about those all too common childhood conditions to those that address the most recent and rare pediatric illnesses. His answers combine cutting edge science, practical wisdom, warm empathy, and a deep respect for parents, children, and the environment. He is also an electrifying public speaker, and has personally touched many during his talks in North America, Europe, Asia, and the Middle East.

Dr. Greene is a graduate of Princeton University and the University of California at San Francisco. Upon completion of his pediatric residency program at Children's Hospital Medical Center of Northern California he served as Chief Resident. He entered primary care pediatrics in January 1993.

Dr. Greene is the Past President of The Organic Center and on the Board of Directors of Healthy Child Healthy World. He is a founding partner of the Collaborative on Health and the Environment. He also consults for the Environmental Working Group.

In 1995, he launched DrGreene.com, cited by the AMA as “the pioneer physician Web site” on the Internet. His award-winning site has received over 80 million Unique Users from parents, concerned family members, students, and healthcare professionals. In addition to being the founder of DrGreene.com, he is the Medical Director for HealthTap.

In 2010 Dr. Greene founded the WhiteOut Movement to change how babies in the United States are fed. In 2012 he founded TICC TOCC - Transitioning Immediate Cord Clamping To Optimal Cord Clamping. He is also the founder of KidGlyphs, a free iPhone app that provides a tool for young children to express themselves beyond their verbal skills while teaching them important language skills.

Dr. Greene is the Founding President of the Society for Participatory Medicine and has served as both President and Board Chair of Hi-Ethics (Health Internet Ethics. He is on the Board of Directors for Healthy Child Healthy World, The Lunchbox Project, and The Society for Participatory Medicine. He has also served as an advisor to URAC for both their inaugural and their updated health web site accreditation program. He is a founding member of the e-Patient Scholars Working Group, and a founding board member of the Center for Information Therapy.

Dr. Greene is a regular columnist for Parenting Magazine. He is also the Pediatric Expert for The People’s Pharmacy (as heard on NPR) and Healing Quest (seen on PBS stations). He was the original Pediatric Expert for both Yahoo! and iVillage.

Dr. Greene is the author of Feeding Baby Green (Wiley, 2009), Raising Baby Green (Wiley, 2007), From First Kicks to First Steps (McGraw-Hill, 2004), The Parent's Complete Guide to Ear Infections (People's Medical Society, 1997), and a co-author of The A.D.A.M. Illustrated Family Health Guide (A.D.A.M., Inc., 2004). He is the medical expert for three additional books, The Parent's Soup A-to-Z Guide to Your New Baby, (Contemporary Books, 1998) The Parent's Soup A-to-Z Guide to Your Toddler, (Contemporary Books, 1999), and The Mother of All Baby Books, (Hungry Minds, Inc., 2002).

Dr. Greene is a frequent keynote speaker at important events such as Health 2.0 2011 held in San Diego, CA, IFOAM 2008 (International Federation of Organic Agriculture Movements), held in Modena Italy, the first European Internet health conference, held in Maastricht, the first International eHealth Association Conference, held in Jeddah, and the largest e-Healthcare World Conference, held in Las Vegas, and the first Green Power Baby Shower, held in Hollywood. Dr. Greene also appears frequently on TV, radio, websites, and in newspapers and magazines around the world, including such venues as the TODAY Show, Good Morning America, Fox and Friends, The Dr. Oz Show, CNN, ABC, CBS, and NBC network news, NPR, The New York Times, The Wall Street Journal, USA Today, Time Magazine, Parade, Parenting, Child, Baby Talk, Working Mother, Better Home's & Gardens, and the Reader's Digest.

Dr. Greene loves to think about challenging ideas, he enjoys being where nothing manmade can be seen, and he wears green socks.

Get Dr. Greene's Wellness Recommendations

Sign up now for a delightful weekly email with insights for the whole family. Plus Dr. Greene's FREE Top 5 Wellness Tips For 2017.

  1. Bakhtawer

    Hi my son is 1.5 year old and he is having severe constipation i have started nido fortified but nothing change in his poop sometimes he get blood in his poop plz tell me any lactose free powder milk for my baby

    Added:
    Reply
  2. lesly masillones

    Is Nido lactobacillus protectus also a lactose free?

    Added:
    Reply
  3. maneesha

    Maneesha
    Hello sir
    My 1 month old baby is suffering from drop motions atleast 10 times a day, Doctor suggested me to stop breast feed and start soya milk what should I do?

    Added:
    Reply
  4. Molly Townsend

    I am 7 weeks pregnant with my third child. My second child was diagnosed with milk protein allergies at 4 weeks old. I cut out dairy and soy from my diet and breastfed him until he was 14 months old. He has continued to have auto immune issues and asthma. When should I cut out dairy and soy from my diet to ensure this baby’s health. I’m assuming I would need to start our dairy and soy free then introduce it to see if there is an allergy? If I am dairy free during my pregnancy, will it make this less likely?

    Added:
    Reply
    • Jenny

      No

      Added:
      Reply
  5. Shivam

    I am a father of a new born premature baby born on 31st january 2015. Its been over a month now, my premature baby is not digesting mothers milk. My baby is in NICU for about a month. She is now 32 weeks old, and will going to complete her 8 th month on 08th Feb 2015. Doctors had done many tests like die test etc but all going negative. Please help me as my baby. Doctors are giving her medicines like intralipid 20% and injections like aminoven, inj Capnea, inj Mertogyl , inj KCI, inj Calcium gluconate.

    Added:
    Reply
  6. Kids Nook

    There is a theory that proper breastfeeding prevents colic. It states that there are two kinds of milk in a breast. The fore milk and the hind milk and that only consuming the fore milk makes the baby colicky. I do not know why it is mentioned rarely :/

    Added:
    Reply
  7. tayyaba affandi

    i want to ask about the Baby lack lactose free milk….
    is this better to give those who are not gaining proper weight
    and from where i can buy?

    Added:
    Reply

Got an idea, tip or a comment?

Your email address will not be published. Required fields are marked *