"A lot of mothers don't know that breastmilk does have lactose," explains Chana Sidi, leader of the Delmar, New York, La Leche League. "There is a confusion about the age of onset [of lactose intolerance]," agrees Dr. Dan Thomas, a pediatric gastroenterologist at Children's Hospital in Los Angeles.
"It happens in the community all the time," says Dr. Jatinder Bhatia, chief of the neonatology section at the Medical College of Georgia and a member of the American Academy of Pediatrics' nutrition committee. Bhatia says he takes great pains to try to correct misinformation about lactose in his hospital practice and through collaborating on education campaigns, and notes, "As a matter of fact, formulas that have reduced lactose or claim to be lacto-free are not even stocked in my nursery."
Bhatia and his colleagues have got their work cut out for them, apparently. Nearly a quarter of babies in the United States are on soy formula (as compared to two-to-three percent in the U.K. and Australia). Rowena Bennett, a registered nurse and midwife in Australia for thirty years who has a consulting business helping primarily American parents with irritable or uncomfortable babies, reports that "lactose intolerance has always been in the top four medical diagnoses given for unexplained infant crying and sleep disturbance for as long as I am aware."
If these diagnoses are actually impossible, then what's going on with those babies?
Some of them have a cow's milk allergy. An allergy is a mistaken immune-system response to proteins. Since proteins differ between different mammals' milks, babies can be allergic to cow and even goat milk, while being fine with breastmilk — as long as the nursing mother hasn't been eating dairy herself, since cow's milk proteins will enter the breastmilk.
"Milk allergy is the most common food allergy in young kids," says Dr. Anna Nowak-Wegrzyn, assistant professor of pediatrics at the Jaffe Food Allergy Institute of the Mount Sinai School of Medicine. "It affects 2.5 percent of kids.
If these diagnoses are actually impossible, then what's going on with those babies?
Milk allergy can give you GI symptoms, but it will also give you skin symptoms like hives, eczema, runny nose." Milk allergies can range from severe (anaphylactic shock from trace amounts) to mild (discomfort that may never be recognized before a child outgrows it). With an allergy, reactions also happen almost immediately, she says, rather than the two or so hours it takes for gas to form from undigested lactose. An allergist can help you diagnose a milk allergy.
To make things more complicated, there is also a kind of milk allergy that only generates GI discomfort, not skin symptoms, and won't show up on tests. And one of the things such an allergic reaction does is damage lactase-producing cells, causing lactose-intolerant symptoms. This kind of allergy is hard to diagnose, but if the symptoms are alleviated when a nursing mother removes all traces of dairy from her diet for at least two weeks, that's a good sign. Fortunately, says Nowak-Wegrzyn, "most of those GI allergies go away in the first year of life." While some foods cause various non-allergenic problems for people who are "sensitive" or "intolerant" to them, Nowak-Wegrzyn says if milk causes a problem, it's pretty much either lactose intolerance or an allergy.
While milk allergy, unlike lactose intolerance, is a condition that really does affect a significant number of infants, it too may be less common than some of us think. A recent study of 800 families in the U.K. found that food allergies are not increasing in the same way that asthma and other allergies are, but that parents have become more aware of them and are seeing them even when they're not there. The study's senior researcher told BBC News that "Mums tend to put down every rash, tummy ache, diarrhea and crying to food allergy or intolerance."
©2008 Miriam Axel-Lute and Nerve Media
About the Author
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Miriam Axel-Lute is a freelance writer, editor and poet. She is an
award-winning columnist for Metroland, and lives in Albany with her two partners and daughter. Her website is mjoy.org. |
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