How to regulate diarrhea caused by infant lactose intolerance

Written by Tong Peng
Pediatrics
Updated on March 07, 2025
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Children with lactose intolerance exhibit symptoms of diarrhea and must be treated through diet and medication. Lactose intolerance indicates an insufficient secretion of lactase by the child's digestive system. Therefore, the diet should consist of light, liquid, and easily digestible foods, avoiding hard-to-digest and lactose-containing foods. Additionally, dietary adjustments are necessary. If the child is breastfed or formula-fed, it is advisable to temporarily switch to lactose-free formula until symptoms subside and then gradually return to a normal diet. It is also important to use probiotics and related supportive medications. Attention should be paid to the child's stool, skin turgor, and urine output, as prolonged diarrhea can lead to malnutrition and electrolyte imbalances, with severe cases possibly resulting in dehydration. Hence, ongoing monitoring is essential.

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Written by Yan Xin Liang
Pediatrics
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What should I do if the baby is lactose intolerant?

If the baby is lactose intolerant and does not have frequent bowel movements and it does not affect their growth and development, then no special treatment is needed. If there is frequent diarrhea and slow weight gain, then an adjustment in diet is necessary. If there is significant acute diarrhea accompanied by dehydration, we should initially rehydrate the infant either intravenously or orally to correct the dehydration. At the same time, you can start with some lactose-free formula and, after the diarrhea stops, gradually increase the amount of breast milk or other formulas based on the child's condition. Regardless of whatever food substitute is used, the overall principle is to not decrease the nutritional needs of the child. As solid foods are introduced and breast milk or cow's milk is decreased, diarrhea will gradually cease. If diarrhea does not subside, oral lactase enzyme preparations can also be provided to supplement lactase enzyme therapy.

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Written by Li Jiao Yan
Neonatology
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Symptoms of baby lactose intolerance

If a child has lactose intolerance, the main symptoms are related to the digestive system, such as frequent bloating. Children may experience bloating and restlessness at night, and even signs of intestinal colic. There are abnormal bowel movement frequencies, such as constipation for several days, as well as diarrhea with a noticeable increase in stool frequency and a looser stool consistency. Sometimes, there may be symptoms of bloody stools, which should alert caregivers to the possibility of lactose intolerance. Lactose intolerance is divided into primary and secondary forms. Primary lactose intolerance is more common in Chinese due to genetic factors. Secondary lactose intolerance is mainly due to other reasons that lead to a deficiency of intestinal lactase, with infections and acute gastroenteritis being common causes. For children with lactose intolerance, lactase can be added to breast milk or lactose-free formula can be used. It is also advised to regularly recheck urinary lactose levels. If levels return to normal, breastfeeding can continue. If abnormalities persist, gradually introduce solid foods, as a normal diet usually does not significantly affect the child.

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Written by Tong Peng
Pediatrics
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Can infant lactose intolerance be self-healing?

Whether infant lactose intolerance can self-heal needs to be identified as either congenital or secondary. If it is congenital lactose intolerance, it means that the baby's own intestines cannot produce lactase, and thus the symptoms of lactose intolerance cannot be alleviated. However, secondary lactose intolerance, such as that caused by chronic diarrhea or infection which leads to a reduction in lactase, can be recoverable. The reduction in lactase production caused by chronic diarrhea does not mean that the intestines have lost their normal function to secrete lactase. Therefore, by using lactose-free formula or avoiding foods containing lactose, the normal intestinal flora can be repaired, achieving relief from the symptoms of lactose intolerance. Additionally, if there is a viral infection, particularly rotavirus infection-induced lactose intolerance, it can also be alleviated through dietary adjustments to promote the repair of the intestinal flora. Therefore, the treatment of lactose intolerance should vary from person to person, and it is important to identify early whether it is primary or secondary.

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Written by Tong Peng
Pediatrics
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What are the effects of lactose intolerance in infants?

Lactose intolerance in children primarily causes an imbalance in the gut microbiome, leading to digestive system symptoms such as bloating, diarrhea, and abdominal pain. The main mechanism is the insufficient secretion of lactase in the baby's intestines, which fails to digest and absorb lactose in food, resulting in symptoms of lactose intolerance. In such cases, the intake of probiotics orally and reducing the intake of foods containing lactose can be helpful. If the baby is fed with formula or breast milk, taking lactase orally or switching to lactose-free formula milk for feeding can be considered. If the child has already started on solid foods, halt the intake of dairy products and simply continue feeding with solid foods, such as porridge, noodles, or rice flour. If a baby shows signs of lactose intolerance, it is crucial to monitor for symptoms of dehydration. If there are signs like poor skin turgor, low energy, or reduced urine output, it is essential to seek medical attention promptly from a specialist to manage and prevent the aggravation of dehydration symptoms.

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Written by Tong Peng
Pediatrics
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Do infants with lactose intolerance need to switch to a different formula?

Whether to switch formula for infants with lactose intolerance should be assessed based on the specific condition of the baby. If the baby's symptoms of lactose intolerance are mild, they can be managed by adding lactase and probiotics. However, if the baby has had diarrhea for a long time, frequent bowel movements, and also shows signs of reduced urine output, decreased skin turgor, and lethargy, it indicates a more severe dysfunction in the digestive system. In this case, it is necessary to switch to lactose-free formula to prevent exacerbation of gastrointestinal dysfunction. It is also important to pay attention to the baby's food hygiene and hand hygiene in daily life, especially during the peak season of diarrhea in autumn. It is advisable to get vaccinated in advance to prevent the transmission of other digestive system diseases.