Can breastfeeding cause lactose intolerance?

Written by Tong Peng
Pediatrics
Updated on February 07, 2025
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Breast milk can also cause lactose intolerance, primarily because it also contains lactose, which plays an important role in the nutrition of infants, promoting the development of the brain's nervous system and providing energy for the growth and development of the baby. However, conditions such as rotavirus gastroenteritis or chronic diarrhea can trigger a dysbiosis of the gut flora, leading to insufficient secretion of lactase in babies. Once lactose intolerance occurs and is not alleviated in time, it can prolong the course of the baby's diarrhea, cause digestive and nutritional absorption disorders, often resulting in watery stools increasing in frequency, and the baby may also experience nausea, vomiting, abdominal bloating, and other uncomfortable symptoms. Therefore, in such cases, it is necessary to temporarily stop breastfeeding, administer lactase or switch to lactose-free formula milk for management, and resume normal diet once the symptoms are relieved.

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Written by Wu Ben Rong
Pediatrics
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Does lactose intolerance cause constipation?

If a child has lactose intolerance, they usually do not experience constipation. Lactose intolerance typically refers to a deficiency of lactase in the small intestine mucosa of newborns, which leads to the impaired digestion and absorption of lactose in milk and causes related symptoms. The clinical symptoms mainly include diarrhea, bloating, and abdominal pain, often accompanied by increased bowel sounds and spasmodic diarrhea. In severe cases, dehydration, vomiting, or acidosis may occur. The stools are usually watery or frothy, acidic, and contain lactose. The child's weight usually does not increase, and symptoms such as malnutrition, anemia, and emaciation may occur. Constipation refers to reduced frequency of bowel movements, difficulty in defecating, or hard stools; lactose intolerance usually does not lead to such symptoms.

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Written by Quan Xiang Mei
Pediatrics
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Can infant lactose intolerance cause bloody stools?

When infants experience lactose intolerance, there is a possibility of bloody stools. With lactose intolerance, infants will exhibit symptoms such as an increased frequency of bowel movements, diarrhea, and bloating. If the frequency of bowel movements is particularly high, for instance more than ten times, or even more, especially over a prolonged period, the gastrointestinal function of the infant is not very perfect. An increase in bowel movements can exacerbate damage to the gastrointestinal mucosa, potentially leading to bloody stools. Additionally, when the frequency of bowel movements is very high, it could lead to damage to the perianal skin, which might also result in bloody stools. Or, when an infant has lactose intolerance, if they are also suffering from other viral or bacterial infections in the gastrointestinal tract, the likelihood of bloody stools may increase. Therefore, if we consider that an infant has lactose intolerance, it is crucial to promptly add lactase for treatment and to switch to a different formula for oral administration.

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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 Wu Hai Wu
Gastroenterology
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How to deal with nausea from lactose intolerance?

Patients with lactose intolerance who experience nausea can consider using some medications for symptomatic treatment. For example, they can use meclozine orally or by muscle injection. They may also use medications that promote gastric motility, such as domperidone, mosapride, and itopride, to treat impaired gastric motility. Patients with lactose intolerance may also experience bloating, vomiting, abdominal pain, diarrhea, and constipation. Appropriate symptomatic treatments can be taken according to different symptoms. Lactose intolerance, if due to a secondary disease such as Crohn's disease or ulcerative colitis, requires active treatment of the primary disease. (The use of medications should be under the guidance of a professional doctor.)