(To be used with the Lactose Free Formula Milk Supporting Information sheet)

Lactose in breast milk is usually well tolerated and breast feeding should be encouraged.

Standard formulas are made from cow’s milk and contain lactose. Some babies do not tolerate the lactose in the standard formulas. Lactose intolerance in infants is usually a short-term problem often coinciding with colic or following gastroenteritis and usually lasts for 2 – 8 weeks. Symptoms usually include loose, green, watery, smelly stools with lots of wind. Lactose free formula can be helpful to control these symptoms whilst the gut recovers. A small number of infants have a longer term problem with lactose.

A lactose free diet should not be followed for longer than 3 months without being reviewed by a health visitor, doctor or dietitian.

Weaning

Solid food should be introduced by 6 months of age (not before 17 weeks of age).

Start with a few teaspoons once/twice a day of baby rice, puréed plain fruit and/or vegetables. Gradually increase the amount and range of foods to include foods from the ‘allowed’ list overleaf. From 6 months onwards introduce eggs, fish, meat, citrus fruit and cereals with gluten (bread, pasta, rusks, biscuits, cakes).

When weaning your baby they should drink 600ml (20 ounces) a day of a lactose-free formula to receive sufficient nutrients (especially calcium). Avoid lactose in any solid foods being introduced.

From 7 months, gradually increase texture of food to mashed consistency and finger foods. Do not add sugar or salt to your baby’s food and honey should not be given until 1 year of age. By 1 year of age, most infants can manage to eat chopped up family meals.

Cooking

Lactose free formula such as SMA LF or Enfamil Lactofree can be used in cooking. Alternatively

supermarket calcium enriched soya milk or soya infant formula can be used in cooking. Rice milk is very low in calories and protein and is not recommended for children under 5 years.

Can I give other drinks?

The main drink for your baby needs to be lactose-free formula and/or breast milk. If other drinks are needed then water is the best drink to give. Baby juices are not necessary and they could

encourage your baby to have a sweet tooth. Tea should not be given to babies and small children as it prevents iron absorption.

Food labeling:

Manufactured products often have milk added. Products have to state if they contain milk.

Ingredients to be avoided are:

Milk sugarCaesin / CaesinatesYogurt

Demineralised wheyNon – fat milk solidsWhey / hydrolised whey Milk solids Soft cheeses Lactose

Milk (goats, cows, sheep)Milk powder/skimmed milk powderButter

Foods Allowed / Foods to avoid
Fruit &
Vegetables / All plain fruit and vegetables – puree, mashed and finger foods. Vegetables mixed with sauces (made from milk substitute). Fruit mixed with soya yoghurt, soya cream, soya desserts, or custard (made from milk substitute). / Vegetables mixed with sauces made from cow’s milk.
Fruit mixed with ordinary yoghurt/custard/cream/ice-cream
Baby jars / packets / All baby jars/packets/risks which state ‘milk/lactose free’ / All baby jars/packets/rusks which do not state ‘ milk/lactose free’
Meat / fish /eggs / pulses / Plain meat/fish/eggs/pulses or in sauce made with lactose free milk. / Meat/fish/eggs/pulses in sauces made from cow’s milk
Dairy
products / Lactose free infant formula, soya yoghurts and desserts, soya milk can be used in cooking. Hard cheese* e.g. Cheddar, Edam, Dairy-free or Vegan foods e.g. Pure Spread, supermarket own dairy-free brand spread.
* lactose is removed during the maturing process in hard cheeses / Cows, goats and sheep milk and any products made from these. Soft cheese e.g. cheese spread, cream cheese, mozzarella, ice-cream, cream, yoghurts.
Milk chocolate, chocolate spread.
Cereals / Bread (if not made with milk)
Pasta in milk-free sauces
Rice, oats, flour,
Breakfast cereals (if milk/lactose free, e.g.rice krisipes, cornflakes, weetabix) (check label)
Biscuits/cakes if milk-free / Bread made with milk or cheese
Pasta in milk based sauces
Breakfast cereal which contain milk or chocolate.
Biscuits/cakes that contain milk

How long does my baby need a lactose free diet?

Most babies have grown out of lactose intolerance by 6 - 9 months of age, following gastroenteritis after 2 – 8 weeks the gut has usually recovered and can tolerate lactose again. To test this, try giving small amounts of dairy products or standard formula.

Firstly give food made from cow’s milk, e.g. rusk or cheese sauce on vegetables, or give milk feeds made up with 30mls (1oz) standard formula per bottle of Lactose free formula.

If your baby tolerates this, then over the next few days give them soft cheese or yoghurt within their meals, or their feeds made up with ½ of lactose free formula and ½ of standard formula.

Finally, if they tolerate this use standard formula feed and resume a normal diet.

Some babies can tolerate more lactose than others and their tolerance may gradually improve.

Should your baby’s symptoms come back then return to the lactose free formula and diet then try again in 1 – 2 months time. All babies under 1 should remain on an infant formula as their main drink.