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Milk allergy vs lactose intolerance: Lactose Intolerance vs. Milk Allergy in Babies


Lactose Intolerance vs. Milk Allergy in Babies

APR. 23, 2018


In this series, our experts answer nutrition questions to help you nourish your best life at every age. 

Here, Abbott research scientist Jan Kajzer, MS, RD, LD explains how to spot the signs of each plus discusses when you should get advice from a doctor.

Happy baby, happy parents. But, when tummy troubles strike that balance can be upset. And it’s important to get to the root of the problem so you can help your baby feel better and feed comfortably as soon as possible.

Both a lactose sensitivity and a cow’s milk allergy can cause tummy troubles in infants, but how do you tell them apart? Read on.

Q: What Is The Difference Between Cow’s Milk Allergy And Lactose Intolerance?

JK: Lactose intolerance and cow’s milk allergy may have similar symptoms — you might see nausea, vomiting, stomach cramps or diarrhea. It can be tricky to distinguish between the two but they’re actually completely different conditions.

  • A food allergy, such as cow’s milk allergy, is an immune reaction to the protein in milk.
  • A lactose intolerance is caused by the inability to break down lactose, which is the sugar in milk.

Lactose sensitivity can be uncomfortable for your baby, but it’s otherwise harmless.

A food allergy, on the other hand, can be very dangerous and might also cause additional symptoms. There could be some mild reactions like flushing, rash, hives or a runny nose. Others can be much more serious, like trouble breathing, wheezing, swelling of the tongue and throat and even loss of consciousness. To stay safe, milk-allergic infants need to completely avoid all foods with milk-containing ingredients.

Q: What Should Parents Do If They Suspect Their Baby Is Milk Allergic Or Lactose Intolerant?

JK: When a baby has trouble tolerating formula, many parents automatically assume that it’s because of a milk allergy. Don’t try to diagnose the symptoms. The very best thing you can do is speak to your child’s doctor. They’ll be able to do a thorough exam, take a full history of any symptoms and order additional tests or refer you to a pediatric allergist.

Related: Download My Child’s Symptom Diary Log

Q: Do Babies Who Have Lactose Intolerance Or Cow’s Milk Allergy Need To Have A Dairy-Free Diet?

JK: If your baby is diagnosed with a cow’s milk allergy, they will need to avoid all milk products completely, but lactose intolerance is a little different.

Infants are rarely diagnosed with lactose intolerance. However, it’s not uncommon for babies to experience lactose sensitivity due to diarrhea from a virus or antibiotic use. The good news is this type of secondary lactose intolerance usually goes away on its own shortly after the illness resolves. Because it’s almost always short term, there’s typically no need to change your baby’s diet, but while your little one is experiencing symptoms they might be more comfortable with a reduced lactose formula such as Similac Pro Sensitive or Similac Total Comfort.

*Note: This column is for general educational and informational purposes only. The information and the opinions of the author expressed do not constitute medical advice. Speak to a medical professional if you need personal health advice.

Lactose Intolerance Versus Dairy Allergy: Danvers Family Doctors, P.C.: Family Medicine

Although both require the elimination of dairy products from your diet, and some of the symptoms overlap, lactose intolerance and dairy allergy are not the same thing. Lactose intolerance is a problem of the digestive system; dairy allergy is a problem of the immune system.

Lactose Intolerance

Lactose intolerance has two main causes: lactase deficiency and lactose malabsorption. Lactase is an enzyme in the small intestine that breaks down milk sugar — lactose. Lactose malabsorption can be caused by lactase deficiency and occurs when undigested lactose moves to the colon, where bacteria begin to break down the lactose, creating fluid and gas.

Like many conditions, lactose intolerance varies from person-to-person. Most people can consume a certain amount of lactose without having symptoms, but that amount varies by individual. There are four different types of lactose intolerance:

  1. Primary lactase deficiency – the most common – involves a decline of lactase production over time, usually beginning about two years old
  2. Secondary lactase deficiency – results from an injury to the small intestine
  3. Developmental lactase deficiency – affects premature babies and is usually temporary
  4. Congenital lactase deficiency – the rarest form, in which the small intestine produces very little or no lactase from birth

Particular populations are more likely to have lactose intolerance. About 65% of all humans have some level of lactose intolerance, and it’s most common in people of East Asian descent. People of Northern European descent, however, are far less likely to be lactose intolerant, and only about 5% of that population has the condition.

Most people with lactose intolerance can manage it with dietary modifications. Some dairy products, such as hard cheese, contain little lactose, but others, such as milk, contain more. Many people with lactose intolerance can consume yogurt but not milk, even though the two contain roughly similar amounts of lactose.

The experts at Danvers Family Doctors can help you create a dietary plan that meets your nutritional needs and helps you avoid discomfort.

Dairy Allergy

Although dairy allergy may result in some of the same symptoms as lactose intolerance, it is a problem of the immune system and can be more serious, even life-threatening. In addition to gas, bloating, cramps, nausea, and diarrhea, people with dairy allergy may experience breathing problems, hives, and swelling of the throat and lips.

Dairy allergy is one of several food allergens that are responsible for the most serious reactions. It is entirely possible to have an allergy to cow’s milk, but not to other dairy products.

Dairy allergy appears most often in children, and approximately 2-3% of children under the age of three years is allergic to milk. About 80% of children grow out of milk allergy by the age of 16.

The only way to manage a dairy allergy is to avoid dairy products, particularly anything containing casein and whey, both of which are types of milk protein. About 30% of children with a food allergy are allergic to more than one food.

Anaphylaxis, a severe, life-threatening allergic reaction, can result from dairy allergy. The healthcare providers at Danvers Family Doctors may suggest having injectable epinephrine on hand for anyone with dairy allergy.

Lactose Intolerance vs. Milk Allergy

Milk allergy is one of the “big eight” food allergies. “Big eight” foods account for about 90 percent of food allergy reactions. In addition to milk, they include, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish.

Milk allergies are particularly prominent in children and can cause a litany of symptoms including gastrointestinal discomfort. Many adults develop an aversion to milk later in life. While it may be a bona fide milk allergy, it could also be lactose intolerance.

What’s the Difference

Milk allergy is an immune reaction to protein found in cow’s milk and other dairy products. Even though these proteins are harmless, the immune system misjudges them as dangerous invaders such as germs or bacteria. The immune system attacks with an allergic reaction, unleashing chemicals like histamine into the body than can lead to stomach problems, hives, hay fever and other allergy symptoms.

On the other hand, lactose intolerance is a digestive issue stemming from low levels of the enzyme lactase. Lactase is the enzyme produced in the small intestine that processes the sugar (lactose) in milk. Without lactase, you’ll often feel crampy and gassy shortly after eating or drinking milk products. You may also develop diarrhea. Lactose intolerance varies. Some people can digest small amounts of milk products without repercussions. Others can’t stomach any foods that contain lactose.

Treatment options

For lactose intolerance, some people may find relief through taking supplements such as enzymes. However, most people are simply limited to controlling the amount of lactose-based products that they eat. Fortunately, there are quite a few lactose-free food alternatives to help people steer clear of trigger foods while still eating a reasonably normal diet.

For those with milk allergies, a treatment known s sublingual immunotherapy (SLIT) offers allergy sufferers another option besides avoiding ubiquitous milk products. SLIT works like allergy shots, desensitizing the body to allergens in the environment so that it can tolerate them without reactions. In the case of SLIT for milk, the body learns to tolerate milk proteins, but instead of relying on allergy shots to deliver antigen to the body, SLIT uses under-the-tongue allergy drops for allergy treatment. Click here to read more about milk allergy treatment for kids and adults.

Lactose Intolerance and Milk Allergy – Scientific Evidence

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How Does Milk Allergy Differ from Lactose Intolerance?

The conditions lactose intolerance and milk allergy, which together affect around 30 to 50 million Americans, are often confused. However, the conditions have very different causes and symptoms.

Lactose intolerance or milk intolerance

Lactose intolerance describes a digestive condition that prevents a person being able to digest lactose, a type of sugar present in milk and dairy products.

Normally, lactose is broken down by an enzyme called lactase. Lactase breaks down the lactose into two simple sugars, glucose and galactose, which are readily absorbed into the blood stream to be utilized in bodily functions.

People with lactose intolerance have a deficiency of the lactase enzyme meaning that much of the lactose remains in the gut without being absorbed. It is then fermented by bacteria within the gut which causes a build up of gas and leads to bloating and flatulence. The fermented lactose irritates the inner walls of the gut causing nausea, vomiting and diarrhea.

Milk allergy

In the case of milk allergy, a person is allergic to the proteins present in milk rather than to the lactose in milk. Individuals with milk allergy can therefore ingest lactose if it is separated from milk proteins, which is the case with some processed milk products. Milk allergy describes an actual allergy as opposed to an intolerance.

Difference in age of onset

Lactose intolerance may develop in either children or adults but rarely before the age of two. Lactose intolerance is a lifelong condition and is more common in certain ethnic groups, specifically American Indians, African Americans and Asians.

Milk allergy on the other hand, is more commonly seen in babies before 1 year of age with symptoms usually subsiding once the child grows older and rarely persisting into adulthood. Onset is rare after the age of two. Unlike lactose intolerance, there are no special racial or ethnic groups that show a higher prevalence of milk allergy.

Difference in symptoms

People with lactose intolerance usually develop symptoms such as diarrhea, nausea, vomiting, bloating and increased flatulence when they ingest milk or milk products such as cheese, yoghurt or butter.

In contrast, milk allergy gives rise to typical symptoms of allergy when milk is ingested such as hives, swelling of the face, lips and tongue, and skin reactions such as atopic dermatitis. In babies, the symptoms are often severe colic, vomiting and eczema around the mouth or diaper area. The baby may also cough, wheeze and in cases of severe reaction where there may be a swollen throat and larynx, the baby can have difficulty breathing and start to turn a bluish colour. This is called anaphylaxis.

Difference in treatment

One similarity in the management of both milk allergy and lactose intolerance is avoidance of milk and milk products. For lactose intolerance, lactase enzyme tablets and drops are available that can substitute for the lack of the enzyme. Milk allergy however, is treated using anti-allergy medications such as antihistaminics and adrenaline injection in the case of severe allergic reactions.

Further Reading

Cow’s milk allergy versus cow milk intolerance


Although cow’s milk allergy (CMA) and cow’s milk intolerance (CMI) are two different terms, they are often used interchangeably, resulting in confusion both in clinical practice and in research reports.


To promote the appropriate differential use of the terms CMA and CMI.


Highlighting the differences in clinical and laboratory findings between CMA and CMI. Information was derived from reviewing the literature on these two topics, supplemented by the clinical experience of the author.


CMA is an immunologically mediated reaction to cow’s milk proteins that may involve the gastro-intestinal tract, skin, respiratory tract, or multiple systems, ie, systemic anaphylaxis. Its prevalence in the general population is probably 1 to 3%, being highest in infants and lowest in adults. Even though it can cause severe morbidity and even fatality, dietary elimination is associated with good prognosis. However, CMI should refer to nonimmunologic reactions to cow’s milk (CM), such as disorders of digestion, absorption, or metabolism of certain CM components. The most common cause of CMI is lactase deficiency, which is mostly acquired during late childhood or adulthood. It has high racial predilection, being highest in dark-skinned populations and lowest in northern Europeans. Lactose intolerance is generally a benign condition, with symptoms limited to the gastro-intestinal tract, yet the primary acquired type lasts for a lifetime. Symptoms can be well ameliorated by reducing the intake of CM or using lactose-hydrolyzing agents.


Adverse reactions to CM should be differentiated into immunologic (CMA) and nonimmunologic (CMI). The latter is still a general term that comprises several conditions and requires further differentiation.

Lactose Intolerance vs. Dairy Allergy

Lactose intolerance and milk allergy are two issues that face people all over the world, but you may not realize how different the two conditions actually are. Although they will both keep you from consuming dairy, they are caused by different problems within the body, have different symptoms, and are sometimes treated differently as well. If you have any symptoms of an intolerance to dairy or know anyone with either of these conditions, then it can be tricky to maneuver the dairy free lifestyle, but have no fear! We have compiled all the information you need to tell the difference between a milk allergy and lactose intolerance, as well as helpful tips on how to deal with either condition.

Lactose Intolerance

Lactose intolerance is caused by your body not producing enough lactase, which needed to breakdown a sugar found in many dairy products called lactose. When the lactose does not get broken down, it moves into your colon, where it causes bloating and gas–whereas in most people it is broken down earlier in your stomach or small intestine, with no negative consequences. Lactose intolerance is an affliction of the digestive system, and is typically not dangerous, although it can be quite uncomfortable. Lactose intolerance is somewhat genetic, but can also be developed throughout your life.

Dairy Allergy

A dairy allergy can be a lot more severe than lactose intolerance, in most cases, as it involves the immune system, not just the digestive tract. Your body will react negatively to milk or dairy products, treating them as a harmful substance, and produce histamines that cause allergic symptoms. These can be as mild as a rash but could also be as dangerous as anaphylaxis, depending on how severe your allergy is. Typically, a dairy allergy is a more immediate danger than lactose intolerance. You are more likely to develop a dairy allergy if you have any other allergies, eczema, or your family has milk allergies.

Symptoms of Lactose Intolerance or Dairy Allergy

The symptoms of both lactose intolerance and dairy allergy are quite similar and typically involve bloating, nausea, abdominal pain, or diarrhea. However, allergies may also include your usual allergic symptoms such as rashes, trouble breathing, congestion or itching, so if you experience any of these associated with consuming dairy, then visit your health care professional as soon as possible for an allergy panel. The symptoms of lactose intolerance often take around 30 minutes up to two hours to take effect within your body, whereas allergic symptoms can appear much more suddenly in most cases.

Commonality of Both

Both of these conditions are fairly common in America, although they have somewhat different target patients. Dairy allergies are one of the most common allergies and seems to be especially common in children under the age of five. In fact, about 2% of children under the age of three have developed a dairy allergy, but the good news is that most children do outgrow their dairy allergies by the age of five. Lactose intolerance, on the other hand, is more commonly developed with age. Most lactose intolerance patients develop it by the time they are around 20 years old, but it gets increasingly common the older you get, and is found in a high percentage of elderly patients. Somewhere around 30 to 50 million Americans are thought to have lactose intolerance. Of note, lactose intolerance seems to affect certain racial groups more than others–African Americans, Asians, and Native Americans have especially high percentages of lactose intolerance.

Getting Tested for Lactose Intolerance or Dairy Allergy

A dairy allergy test is fairly straightforward–if you or your doctor suspect a dairy allergy, you can undergo a typical allergen panel or blood test done to confirm the existence of your allergy. For lactose intolerance, the test is a little different, and there are a few options. You may consume a liquid that is high in lactose, after which your doctor will measure your sugar levels before and after consumption. If your blood sugar levels do not increase, then the lactose is not being digested, and you probably do not have quite enough lactase being produced. You also could consume the same liquid and have your doctor measure your breath hydrogen levels. If your stomach does not break down the lactose, then your colon will do it, producing enough hydrogen to measure in your breath. Babies are typically tested with a stool acidity test, measuring the amount of lactic acid in their stool. Either way, all three of these tests will determine if you have lactose intolerance. From there, you can move on to treatment options for lactose intolerance.

Treating Your Dairy Intolerance

Depending on which type of intolerance you have, your treatment options are slightly different, although both are best treated by simply avoiding milk or dairy products altogether. Most people with lactose intolerance can enjoy the occasional dairy product, but should still limit their consumption of milk to increase general digestive comfort. There are lactase enzyme pills that can be taken with food that simulate some of the enzymes you need to break down the lactose in the stomach. If you are allergic, on the other hand, then you should never consume milk or dairy if you can avoid it. Depending on how severe your allergy is, you may need to carry an Epi-Pen for emergencies or keep some antihistamines handy in case of a surprise allergic reaction. Allergies can worsen over time in some patients, so be careful to stay up to date on your allergy medications, even if you have not had a reaction in a long time.

Eating a Dairy Free Diet

Luckily, eating dairy free has become easier than ever in the past 10-plus years. The prevalence of health food stores, restricted-diet options, and general awareness of restricted diets have made this the best time to be on any kind of dietary plan. You will want to avoid any foods that contain milk, include butter, ice cream, yogurt, cheese, and any other dairy products. One of the toughest to avoid is butter, which is used to cook almost anything these days–veggies, meat, and so much more. As someone who is avoiding dairy, you can use plenty of dairy free alternatives, like olive oil spread, soybean margarine, or coconut oil, but this will be tougher when you eat out or eat at someone else’s home. The best thing you can do is to notify your host or your waiter that you are allergic to dairy or have an intolerance–if you are lactose intolerant, this could be a great time for one of those helpful lactase pills. If you are allergic, then just be extra cautious and explain the situation to whoever is preparing your food as early in the process as possible.

If you love milk but have found out you are intolerant, then this part should be exciting to you! There are actually a ton of different milks out there that you can eat safely and comfortably. Our favorite is almond milk, made from almonds, which does not contain any of the sugars or proteins that cause issues with dairy. You can also enjoy coconut milk, soy milk, or other nut milks like cashew milk, just to name a few. If you are allergic to milk, this typically refers to cow’s milk only, but you can be more susceptible to other allergies, so test these milk varieties out before going all-in! As an extra bonus, many of these milks are less fatty than cow’s milk and provide extra nutrients that your body needs!

As you can imagine, if there are safe milks for lactose intolerance or dairy allergic folks, then there are also safe variations of all your favorite dairy products. You can find dairy free cheese, ice cream, yogurt, coffee creamer, and whipped cream, just to name a few of our personal favorites. If you are lactose intolerant, then there are some products out there made especially for you, like lactose-free milk, for instance, but as someone with a dairy allergy, these products will still cause a reaction as you are more than likely allergic to the protein (casein) in milk, not the lactase itself. Make sure you only enjoy products that are made specifically for those with dairy allergies.

Overall, living with an allergy to milk or an intolerance for lactose can be slightly tough, but is becoming easier every day as our society becomes more aware of dietary restrictions. If you have exhibited any signs of having trouble consuming milk or dairy products, then make sure you contact your health care professional immediately, as this could be a sign of a life-threatening allergy. Most people who cannot eat dairy are able to self-treat their condition to avoid almost all symptoms, but just make sure you approach any new foods with caution, as we recommend to everyone, because you never know how you will react. If you take a safe approach to your new diet, then you will be living large and dairy free in no time!

90,000 What is the difference between cow’s milk protein (CB) allergy, cow’s milk intolerance and lactose intolerance?

Cow’s milk protein allergy and lactose intolerance are completely different conditions. However, they have similar symptoms, making them difficult to diagnose.

In the case of a confirmed diagnosis of cow’s milk protein allergy (CMPA), an immune reaction to protein takes place, when the body reacts to the cow’s milk protein in the shortest possible time (within an hour or several hours).This is expressed in the following moderate to severe symptoms:

  • Swelling in the mouth
  • Difficulty swallowing
  • Nausea and regurgitation
  • Severe stomach upset
  • Refusal to eat
  • Insufficient weight gain
  • Severe colic
  • In rare cases – anaphylactic shock, which can be fatal.

Cow’s milk intolerance is a condition when its components or their combination (fats, proteins) are poorly digested by the body.It manifests itself in various types of symptoms (from moderate to severe) – skin rashes, indigestion, breathing disorders:

  • Eczema – mild to moderate
  • Diaper dermatitis
  • Gastrointestinal dysfunction
  • Gassing
  • Flatulence
  • Constipation
  • Liquid stool
  • Colic
  • Redness of the nasal mucosa and pneumonia

Lactose intolerance results from poor digestion of lactose, the main carbohydrate in milk.Lactose, or milk sugar as it is also called, is present in the milk of all mammals, including breast milk. Impaired lactose digestibility in many cases appears after the introduction of supplementary feeding and complementary foods and, in the case of demonstrating the following symptoms, may become the basis for the diagnosis of lactose deficiency:

  • Abdominal colic and flatulence
  • Accumulation of gases in the stomach and intestines
  • Diarrhea
  • Nausea
  • Rumbling in the stomach
  • Vomiting

With such a diagnosis, enzymes or a special therapeutic diet (lactose-free mixtures) are usually prescribed.Remember that only an experienced pediatrician will be able to make the correct diagnosis and help you choose the food you need to correct this disease.

90,000 Lactase deficiency and cow protein allergy. What is the difference?


What is the difference between lactase deficiency and cow protein allergy? To understand this, you first need to know about these two problems in more detail, as they are often confused with each other and are simply called milk allergy.
Lactose is a carbohydrate, milk sugar found in milk and dairy products. In order for lactose to be absorbed when it enters the body, it must be broken down into its constituent parts.
A special enzyme breaks down lactose – lactase, which is located on the surface of the intestinal villi in the small intestine. If lactase is not enough, then the breakdown of lactose is disturbed and lactase deficiency is diagnosed in a child or adult.
Lactose intolerance (lactase deficiency) does not apply to infectious and inflammatory diseases.But the root cause of this condition is often previous intestinal infections, both bacterial (salmonellosis, dysentery) and viral (most often rotavirus infection).
A doctor may suspect a child is lactose intolerant based on symptoms such as frequent watery stools 6-8 times a day or more, gas, anxiety, and abdominal pain.
For babies with lactase deficiency, instead of the usual mixture, a low-lactose or lactose-free mixture is prescribed, for example, Bellakt NL or Bellakt BL.With a properly selected diet, the child’s stool quickly normalizes and the symptoms disappear. It takes a certain time to restore lactase activity, 4-6 weeks, sometimes more.
Lactase deficiency is not always a congenital problem, it can appear at any age. The older a person is, the lower the amount of lactase enzyme in his body, which can lead to the progression of lactase deficiency. If the disease is diagnosed immediately after birth, then do not worry, most often babies quickly outgrow this problem.

What is cow protein allergy?

A cow protein allergy or milk allergy is one of the most common food allergies in toddlers. On average, its frequency in children of the first or second year of life is 3-5%. More often, CMPA in children occurs in those families where one or both parents or close relatives (grandmothers, grandfathers, older children) have this or that (any) allergic disease.
Parents are allergic to cow protein when their baby first tries formula milk.Sometimes the allergy also manifests itself through breast milk if dairy products are present in the mother’s diet.
Allergy manifestations can be skin (rash on various parts of the body, up to common forms – childhood eczema, atopic dermatitis) or from the digestive tract (regurgitation, colic, constipation, or diarrhea). If such symptoms occur, a consultation with a pediatric allergist and a pediatric nutritionist is necessary.
When breastfeeding, a mother is advised to exclude dairy products from her diet.If a baby is on mixed or formula feeding, then it is especially important to think about preventing food allergies, that is, trying to avoid symptoms before they arise. The choice should be made in favor of hypoallergenic mixtures, in which, due to partial hydrolysis, cow’s milk proteins have a low allergenic potential.
Examples of hypoallergenic mixtures are Bellakt GA 1 and Bellakt GA 2 (for children 0-6 and 6-12 months, respectively). These products contain all the necessary ingredients for normal development and meet the age-related needs of the child, but significantly reduce the risk of developing allergic reactions.

What is the difference between lactase deficiency and cow protein allergy?

What conclusion can be drawn from the above? People often confuse these two problems due to the similarity of symptoms. But you need to understand that these are completely different things. Milk protein allergy is the response of the body’s immune system, which rejects dairy products as harmful. And lactase deficiency is the reaction of the gastrointestinal tract to the ingress of lactose, which is not absorbed due to a lack of the enzyme lactase.Therefore, with insufficient lactase, the reaction occurs in an hour or later, but the allergy may appear immediately (but this is not necessary).
People with milk protein allergies should avoid all dairy products. And those who have lactase deficiency can consume lactose-free dairy products, because the immune system in this case will not be involved.
In both cases, both the diagnosis and the treatment plan must be determined by the doctor, since the success of the therapy or the prevention of food allergies depends on this.

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90,000 Lactose Intolerance, or Goodbye, Milk

As a child, we could drink milk in any quantity, but with age, many of us are forced to give up this product, because after using it we experience some discomfort.

Why such metamorphoses occur with our body, how to live with it, how to replace animal milk? Our expert answers questions

Marina Aryaeva

clinical immunologist, allergist, candidate of medical sciences, member of the Association of Honored Doctors of Russia

– Most often, the ability to assimilate milk (lactose) disappears at the age of 5-7 years, because we no longer produce a special enzyme for the breakdown of lactose.

This is a normal physiological mechanism. However, there are times when lactose intolerance
newborns suffer: the so-called hypolactasia of newborns. The reason for this problem is the lack of activity of digestive enzymes due to the immaturity of the digestive system. That is, when a child is born and begins to eat, organs that did not work before begin to function, but not in full. As a result, insufficiently active digestive enzymes are produced that are not able to break down lactose.

And now this is already a serious problem, because the physiological food for babies is mother’s milk. The way out in this situation is special mixtures with hydrolyzed (already split) proteins. In addition, these children are given a drug containing lactase, an enzyme that breaks down lactose.

Hypolactasia of newborns is relatively rare in Russia, accounting for one case per 50,000 newborns

More accurate with pills

Another source of lactose is pills.Look at their composition and you will see that lactose is found in most medicines. This would not be a big deal if there were no people who had to constantly take some kind of drugs. Which exit? Use non-tabletted dosage forms or medicines in capsules, since it contains lactase, not lactose.

Do not confuse allergies and intolerances

Milk allergy occurs when the immune system begins to produce specific antibodies against milk proteins entering the body.The immune system takes them for enemies and enters into a fight with them. This is due to insufficiently active enzymes and the body’s inability to digest (assimilate) milk sugar (lactose). As a result, large, undigested milk proteins (especially casein
) our immune system perceives as parasites, worms. And immediately begins to produce antihelminthic antibodies. It is these antibodies that cause allergies.

In children, the allergy manifests itself in the form of redness on the cheeks, on the hands in the folds.Severe itching occurs. The same reactions can occur on the mucous membrane of the gastrointestinal tract, that is, an immunological reaction begins there, which damages the mucous membrane.

Symptoms of lactose intolerance

  • Persistent bloating;
  • feeling of heaviness in the abdomen;
  • diarrhea after drinking milk or eating anything dairy;
  • belching and heartburn (less common).

The recommendation if you suspect lactose intolerance is to consult a doctor.Only a specialist can prescribe the necessary studies, correctly analyze the test results and assess the patient’s health.

How to choose milk – read HERE .

If you can’t milk, but you really want to

Try to use less milk and dairy products. As an alternative to cow’s milk, you can use dairy products with already hydrolyzed proteins or consume plant-based milk (soy, rice, coconut, etc.)etc.). This milk contains neither caseins nor lactose. Vegetable milk contains other sugars – fructose, glucose.

There is an opinion among consumers that people who are allergic to milk or who are intolerant to milk protein should consume milk boiled for 10-15 minutes. During this time, the allergen, β-lactoglobulin (milk protein
). But it’s better not to do that. Boiling causes protein denaturation and inactivation of all enzymes.It is better for such people to consume very rarely fermented dairy products, or plant-based milk, or hydrolyzed mixtures. Fermented milk products such as kefir, yogurt and cottage cheese are already fermented by bacteria during the souring process and are absorbed much better by most people. In addition, sourness changes other properties of milk: lactose is converted into lactic acid, casein is partially broken down.

Roskachestvo investigated milk from well-known brands.Details HERE

90,000 what is true and what is not?

This is the second article in a series on lactose intolerance. In it we analyze the most popular myths about this condition.

From the previous article, you could find out what causes lactose intolerance and what types it can be divided into. In this material, we understand how this condition differs from allergies, at what age it appears more often, as well as with what intolerance can be confused and how to diagnose.

If you have experienced intestinal discomfort after dairy products or have heard that milk is bad for adults – this series of articles is for you. In three articles, we will talk about what lactose intolerance is, what types it is divided into, we will analyze the most common misconceptions, and also clarify how to live with it.


Lactose intolerance and food allergies are not the same

Lactose intolerance occurs when a person’s small intestine does not produce enough of the enzyme lactase.This enzyme converts milk sugar (lactose) into simple sugars, which then enter the bloodstream through the lining of the small intestine.

If there is little or no lactase, lactose enters the large intestine with food. There bacteria begin to process it, and not sugars, but fatty acids, carbon dioxide, hydrogen and methane appear from lactose. Because of this, people feel bloating, stomach pain, and other symptoms of lactose intolerance.

In allergies, the body’s immune system reacts to milk protein, not milk sugar.Symptoms of this condition are also different – itching, rash, or swelling is more common.

If milk is an allergen for humans, then even a sip may be enough for symptoms to start immediately.

And most people with lactose intolerance can eat a small amount of lactose and not experience any problems (although this varies from person to person).

If a person has frequent diarrhea or bloating, this is not necessarily lactose intolerance

Other diseases such as irritable bowel syndrome or celiac disease can cause similar symptoms.And sometimes even lactose intolerance can be secondary – arising from some drugs or diseases that affect the intestines, such as ulcerative colitis.

Therefore, it is important to consult a physician to clarify the diagnosis before setting it yourself and excluding milk and dairy products from your diet.

Lactose intolerance does not always appear immediately from birth

Usually, lactose intolerance first occurs between the ages of 20 and 40.This is due to the fact that most often in the world, people are faced with primary lactose intolerance. And this condition progresses in adulthood, when, like children with it, they are able to digest lactose.

But congenital lactase deficiency in infants is a rare disease that can only be transmitted if both parents have a specific mutation in a particular gene.

Lactose intolerance can be diagnosed with tests

Doctors have ways to confirm this diagnosis.Most commonly, experts use diary, hydrogen breath test, and lactose tolerance blood tests.

The diary helps to track the correlation of symptoms and foods that a person eats over several weeks. The hydrogen breath test measures the amount of hydrogen before and after drinking a lactose-containing fluid. If there is more hydrogen, this indicates a lack of lactase in the body (since it means that lactose is processed not in the small intestine, but in the large intestine by bacteria).

During the blood test, you will also need to drink a liquid with lactose. If, after that, a low sugar level is found in the blood, this means that lactose has not been decomposed into simple sugars in the small intestine and, probably, a person has lactose intolerance.

In rare cases, doctors may use a biopsy of the small intestine to distinguish between primary and secondary lactose intolerance.

There is also a genetic test for primary lactose intolerance.

It does not take a long time to carry out, but can only be used among populations of Europe and North Africa.

In the final article, we will figure out how to live with lactose intolerance, what foods can and cannot be consumed by people with this condition.

According to the results of the Atlas Genetic Test, it is possible to obtain not only data on the risk of developing certain diseases and the status of the carriage of hereditary diseases, but also the characteristics of metabolism and a predisposition to intolerance to certain nutrients.This includes finding out if you have lactose-related gene breakdowns.

  • Mayo Foundation for Medical Education and Research, Lactose intolerance, 2021
  • National Health Service, Lactose intolerance, 2021
  • MedlinePlus, Lactose intolerance, 2021
  • UpToDate, Lactose intolerance: Clinical manifestations, diagnosis, and management, 2021
  • UpToDate, Patient education: Lactose intolerance (The Basics), 2021

90,000 Lactose Intolerance | Tervisliku toitumise informatsioon

Nature of the disease and frequency of manifestation

The cause of lactose intolerance, or hypolactasia, is the inability of the human body to produce enough lactase, that is, an enzyme that breaks down milk sugar called lactose.
Lactose, or milk sugar, is a disaccharide that cannot be absorbed through the walls of the small intestine, which is why it must first break down into two simple sugars – glucose and galactose.

After consuming products containing milk sugar, with a lack of lactase, lactose enters the large intestine, in the microflora of which it decomposes, forming gases (hydrogen, methane and carbon dioxide), as well as acids.

Adverse symptoms can range from mild abdominal pain to cramps and diarrhea.
People with low lactase activity tolerate lactose differently.

Most people can tolerate the amount of lactose equivalent to half to one glass of milk during the day. If milk is consumed with food, the patient tolerates lactose more easily, since lactose is absorbed more slowly. The same applies to fatty milk, since fat slows down the elimination of food from the stomach.

Lactase appears in the human digestive tract about eight weeks before birth and is most active during infancy.When other foods appear in the child’s diet and the need for such large amounts of lactase disappears, the activity of the enzyme begins to gradually decrease. Lactase activity is promoted by eating foods containing lactose.

Approximately three quarters of the world’s population, especially among the yellow and black races, have such low lactase activity that they cannot tolerate milk at all. The peoples of Northern Europe and their North American descendants, who have been engaged in cattle breeding for a long time, have preserved this activity better.

It is estimated that about a quarter of the Estonian population suffers from some lactose intolerance. However, many people simply do not know about this, and this is not a problem for them, because they do not drink so much milk that it gives them inconvenience.

Lactose intolerance occurs in two forms

Primary lactase deficiency is hereditary, dependent on age, and usually manifests itself between 5 and 20 years. Typically, 50–70% of the lactase activity is retained.It is not treated.

Secondary lactase deficiency is caused by temporary damage to the small intestine, which can be caused by malnutrition, celiac disease, inflammation of the small intestine, gastroenteritis and other diseases. Secondary lactase deficiency also occurs in infants and young children after bowel disease. The manifestations of the disease usually disappear within 2-4 weeks.

Diagnosis of lactose intolerance and disease control

Lactose intolerance can already be guessed on the basis of its manifestations.Since with lactose intolerance, it is necessary to reduce the use of dairy products containing it, which occupy a very important place in the human diet, you should first carefully make sure that it is this disease that is involved.

When diagnosing lactose intolerance, for example, a lactose tolerance test is used, during which the patient is given 50 g of lactose (an amount approximately corresponding to that contained in a liter of milk) and the blood glucose level is determined before taking the solution, after 20 and 40 minutes after.If your blood glucose does not rise, you are lactose intolerant.

Another option is to analyze the exhaled air. If the hydrogen content in it increases, this indicates that under the influence of the microflora of the large intestine, the process of fermentation of lactose is taking place, and the patient has its intolerance.

Depending on the severity of the disease, the amount of lactose in the diet should be reduced to a greater or lesser extent. Typically, a person with hypolactasia tolerates 2-3 g of lactose per day.

Preference should be given to fermented milk products in which part of the lactose is fermented into lactic acid. In particular, you should pay attention to foods containing probiotic bacteria, as some of them secrete lactase.

With lactose intolerance, when few dairy products are consumed, calcium deficiency may occur. Long-aged hard cheeses that are lactose-free are a good source of calcium. There are also lactase capsules that can be taken with food containing lactose.In the case of severe lactose intolerance, care should be taken with bioactive supplements and medications, as lactose is often used as a filler in them.

The final decision on which dietary recommendations to follow is made by the family doctor or gastroenterologist, as it all depends on the condition of the individual patient.

More on lactose intolerance

Milk allergy and lactose intolerance

Visiting the Good Morning program Yulia Melekhina, allergist-immunologist, Ph.M.Sc.

Is lactose intolerance a disease?

Lactose intolerance is very often confused with cow’s milk protein allergy. These are different states. Allergy is a pathological condition, a true food allergic reaction. It requires a selection of treatment and diets. And lactose tolerance is a condition caused by a lack of the enzyme lactase, which breaks down lactose in the body.

How to distinguish between these two states?

Lactase deficiency occurs quite often, in every fourth person.The highest activity of the lactase enzyme occurs in infancy, as nature intended. With age, due to changes in nutrition, the activity of the enzyme may decrease.

And how to understand whether it is worth being examined if there is any discomfort after drinking milk?

There are certain clinical signs. These are abdominal pain, diarrhea, and bloating. Then you should contact a specialist.

Or maybe you just don’t drink milk? You can do without it.

Now there is lactose-free milk, a fairly large selection. The second option is to reduce the amount of milk you consume. Somewhere up to 12 grams of lactose is a glass of milk. But this is individual. Someone normally tolerates up to 50 ml of milk, and more is already difficult. There are also foods that are low in lactose. These are sour milk products. Yoghurts, kefirs are fermented products, lactose is partially destroyed there, and they are better absorbed. The lowest lactose content in hard cheese and butter.

Does our body need lactose, or can we refuse it?

This is milk sugar, a complex carbohydrate. Also, lactose affects the intestinal biocenosis, so it more affects the health of children.

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How food intolerance differs from allergies

Symptoms of allergies and food intolerances are usually very similar – itching of the skin and mucous membranes, rash, abdominal discomfort, stool disorders – but the mechanisms are different.An allergic reaction to a product is the body’s immune response to an irritant; at the same time, the immune system perceives food proteins as foreign and develops protective antibodies – immunoglobulins E (IgE). The latter provoke an allergic reaction – most often to milk derivatives, eggs, fish and seafood, wheat protein, nuts or soy. As soon as contact with the allergen ceases, the immune system calms down – and the allergy symptoms subside.

In the case of food intolerance (it is also called “pseudo-allergy”), the immune system does not overreact.Sometimes they say that this condition is associated with the production of type G immunoglobulins (IgG), but Marina Vershinina notes that, unlike IgE, markers of allergy, class G antibodies are the result of a normal reaction of the immune system, that is, an indicator that the body has become acquainted with that or any other food product and is not going to react to it. The doctor emphasizes that laboratory tests for the determination of IgG are not cheap, but the detection of such antibodies in itself does not allow conclusions to be drawn about the sensitivity to some products.

If a small amount or even one smell of an allergen is enough for the appearance of allergy symptoms, then food intolerance is more complicated. In the case of pseudo-allergy, the reaction of the body is often delayed (sometimes by several days), and the manifestations are blurred. For example, abdominal pain can be accompanied by fatigue or nasal congestion, which can easily be attributed to overwork or a cold. At the same time, according to doctor Mikhail Gavrilov, food intolerance occurs in adults much more often than food allergies.At risk are those who have metabolic problems or diseases of the gastrointestinal tract, as well as smokers and people who do not exercise much.