Lactose free diet for babies

Some babies temporarily do not tolerate the natural milk sugar 'lactose' which is found in breastmilk and ordinary infant formula (made from cow's milk, and also in goat's and sheep's milk). Lactose intolerance in infants is usually a short-term problem. It occurs most often following a bad bout of gastroenteritis (stomach bug) and can last for up to 2-4 months. Lactose should only be avoided if the symptoms cause significant distress to the baby (e.g. crying, pain, nappy rash etc.)

Lactose-free infant formulas are available such as SMA LF, Aptamil Lactose Free or Enfamil 0-Lac. These taste similar to ordinary formulas and are available from pharmacies to buy. Until the age of 1, it is important your baby drinks at least 600ml (20 ounces) a day of a lactose-free formula to receive sufficient nutrients, especially calcium.

General advice for introducing solids (although this will not be dairy free specific, more detailed information is available at: (https://www.nhs.uk/start4life/baby/first-foods/)

  • Solid food should be introduced around 6 months of age, when your baby shows signs that he/she is ready (sitting up, holding head, reaching for food...).
  • First foods can include a wide range of simple, unprocessed foods (rice, oats, barley, semolina, peas, beans, lentils, meat, fish, eggs, ground nuts fruit and vegetables).
  • Babies progress at different paces. You can offer different consistencies: smooth, soft, mashed foods or finger foods.
  • Gradually increase the amount and range of foods to include foods from the 'allowed' list below.
  • Never add sugar or salt to your baby's food, and avoid processed foods (foods with more than a handful of ingredients of the label).
  • Wheat, nuts, seeds, fish, shellfish, eggs and soya should not be introduced until 6 months of age.
  • Never leave a baby unsupervised with foods.
  • By 1 year of age, most babies can manage to each chopped up family meals.

Can I give other drinks?

The main drink for your baby needs to be breastmilk and/or lactose-free formula. If other drinks are needed, cooled boiled water is the best drink to give. Baby juices are not necessary and they would encourage your baby to have a sweet tooth. Tea should not be given to babies and small children as it reduces iron absorption from your child's diet.

Milk substitutes to be used in cooking

If your baby is having a Lactose Free Formula, these can be used in cooking. The lacto-free brand milk and products can also be used. Alternatively soya, oat, hemp or nut milks can be used in cooking (as long as they are calcium enriched and not used as main drink until 1 year of age). Please note rice milk is not recommended for babies and children under 5 years.

Lactose and cheese

Lactose is found in soft cheeses, e.g. cream cheese and cheese spreads, mozzarella, feta, etc. However, due to the maturing process of hard cheese, most of the lactose has been removed. Therefore, hard cheeses such as cheddar and Edam are usually tolerated on a lactose-free diet.

Check labels - all milk-containing products must now clearly state 'milk' in the ingredient panel on the label. Most supermarkets will provide a list of milk free foods.

*consistency given appropriate to age

  Lactose free foods Foods to avoid or check labels for 'milk' in the ingredient list
Fruit and vegetables All plain vegetables and fruit - puréed, mashed and finger foods
Fruit mixed with dairy-free alternative to custard, cream
Vegetables mixed with sauces made from cow's ilk
Fruit mixed with ordinary yogurt/custard/cream/ice-cream
Meat/fish/eggs/pulses/nuts* Plain meat/fish/eggs/pulses/nuts/quorn/tofu Processed meat/fish/eggs/pulses/nut products
Or in sauces made from cow's milk
Some meat alternative (vegetarian) products
Dairy products Lactose-free infant formula
Lacto-free brand products (can be used in cooking from 6 months)
Dairy-free yogurts and desserts
Hard cheese e.g. Cheddar, Edam
Cow's, goat's, sheep's milk and all products made from these
Ordinary yogurts
Soft cheese e.g. cheese spreads, cream cheese, mozzarella, feta
Starchy foods Bread and flour
Potatoes, sweet potatoes
Pasta, rice
Breakfast cereals (check label)
Milk breads, brioche
Pasts in cow's milk based sauces
Breakfast cereals which contain milk/chocolate
Others Any oils, lard, dripping
Dairy-free margarine e.g. Pure, Vitalite, Tomor, Flora dairy-free supermarket own dairy-free brand
Biscuits/cakes if milk-free
Butter, ordinary margarine
Ice-cream, cream
Milk chocolate, chocolate spread
Biscuits/cakes that contain milk
Baby jars/packets All baby jars/packets/rusks which do not have 'milk' in the ingredient list All baby jars/packets/rusks which have 'milk' in the ingredient list

How long does my baby need a lactose-free diet?

Most babies grow out of lactose intolerance once their gut has recovered. To test this, try giving small amounts of dairy products e.g. ordinary yogurt or food made from cow's milk. If your baby has loose nappies and is unsettled, stop lactose-containing foods and try again in 1-2 weeks. It will take a bit of time for your baby to regain his/her ability to digest lactose, so increase the amount gradually.

If your child is still lactose intolerant at 1 year of age, please ask your Health Visitor/GP to refer her/him to a registered Dietitian.

What about Vitamin D?

Vitamin D is needed by the body to absorb calcium and the best source is from the action of sunlight on the skin, however young children should not be exposed to the sun for long. Vitamin D is only found in a few foods so a supplement is recommended for everyone.

Note: micrograms (mcg) can also be written as µg.

 

Target group Recommended supplement (SACN 2016) Do not exceed
Breastfeeding mothers Equivalent to 10 micrograms/day or 400IU 100 micrograms/day
Breastfed babies up to 12 months Equivalent to 8.5-10 micrograms or 350-400IU 25 micrograms/day
Formula fed babies up 12 months Only if taking less than 500mls or formula/day 25 micrograms/day
Ages 1-4 years Equivalent to 10 micrograms/day or 400IU 50 micrograms/day
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