Last updated on Feb 2nd, 2021 at 09:30 am

“Lactose intolerance in children occurs when the body is unable to break down and digest the sugar that’s present in milk and milk products. This may be linked to having insufficient lactase enzymes,” explains paediatric dietician Kath Megaw.

The good news is, lactose intolerance is quite rare in breastfed babies, and has been reported to be low in children under the age of six, explains dietitian at the Oxford Healthcare Centre, Abby Courtenay. However, this condition can worsen throughout childhood and peak between ages 10 and 16 years.

In fact, around 75% of the world’s population struggles to synthesise the protein present in milk, despite being continually exposed to lactose. This is largely due to genetic factors, so if you’re lactose intolerant, there’s a good chance your child could be too.

ALSO SEE: 3 important facts about cow’s milk allergies in babies

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Signs and symptoms of lactose intolerance

Primary lactose intolerance can cause diarrhoea, abdominal pain, flatulence, or bloating in children. However, lactose intolerance can also flair up as a secondary problem due to a viral or bacterial infection, or an infection of the small intestine, inflammatory disorder, HIV, or malnutrition, explains Abby. Although these symptoms are unpleasant, there are good treatment options available for both primary and secondary lactose intolerance, and your little one doesn’t have to suffer through it.

Dairy substitutes for children with lactose intolerance

If you suspect your child has lactose intolerance, the first step is to see a healthcare provider who will assess your child accordingly. Your little one might need to go through a lactose elimination process to determine how bad the condition is. This often involves cutting out all major culprits and slowly introducing them over a period of a few weeks.

NOTE: It’s important that you don’t diagnose your child yourself. According to the American Academy of Paediatrics, if your healthcare provider (or registered dietitian) believes that your child needs to eliminate dairy products, other dietary sources of calcium or calcium supplements need to be provided.

Also remember that milk alternatives like soya, rice or goat’s milk etc, should not be offered to babies under a year old, as many are too high in manganese and too low in fat and protein, says Abby. Rice milk may also contain small amounts of arsenic, which is not good for babies. In this case, it’s best to see your child’s paediatrician for expert advice.

However, if your child is older and he’s been diagnosed with lactose intolerance, there are many lactose-free cow’s milk options available. These are generally cow’s milk products that have lactase added to them to reduce the lactose content, explains Abby. Soya milk resembles cow’s milk more closely than other milk substitutes (especially with regards to protein and calcium). When choosing a milk alternative, Abby says you should opt for an unsweetened and calcium fortified version. Cottage cheese and fermented dairy foods like yoghurt and kefir are naturally lower in lactose and are suitable for those with lactose intolerance.

ALSO SEE: The nutritional benefits of yoghurt for kids

“Children who suffer from lactose intolerance should still have small amounts of lactose on a regular basis to maintain their lactase levels (even though they are low),” says Abby. This would need to be supervised by a professional.

Dietician Ashleigh Caradas gives some alternatives for children who are lactose intolerant:

  • Lactose-free cow’s milk
  • Soya milk
  • Rice milk is another option, but it’s quite low in protein.
  • Coconut milk, which is a higher fat alternative, can also be used in smoothies and milky drinks or to make sauces.
  • Sorbet and tofu ice creams are an alternative to ice cream. Look for kosher products that contain the parev stamp as these will be milk-free.
  • You also get milk-free margarines (look for parev margarines).

Cheese substitutes

  • Cottage cheese has a lower lactose content than regular cheese and can be used in small quantities.
  • Tofu can be used as a cheese substitute in some recipes. There’s also a tofu cream cheese on the market.
  • Supermarkets now sell vegan and lactose free cheese slices made from coconut oil.
  • You can use vegan cheeses that are usually made from almonds, herbs and agar agar. They can be grated and melted in the same way as cheese.

For more information on lactose intolerance or to have your child assessed, call Abby on 011 282 0711 or email