Dietary Advice for Lactose Intolerance What is a lactose intolerance? Lactose intolerance is when you are unable to digest the natural sugars found in milk or formula milk which is made from cows milk. Lactose is also found in goats and sheep's milk. It is also in breast milk but this is usually well tolerated in most infants. Large amounts of lactose can cause diarrhoea, wind and tummy pains. It is usually a short term problem that coincides with colic. Commonly in children, the intolerance may last a short time (2-4 months) following a stomach upset. Sometimes it is an inherited life-long condition but this is very rare. To find your tolerance level you need to cut out all lactose from your diet and then slowly reintroduce it over a number of days. Where is lactose found? Lactose is found in all animal milks. Having lactose intolerance does not mean you have to cut all dairy products out of the diet, but you should avoid: Fresh milk - all types Dried milk - all types Condensed and evaporated milk All sauces and desserts made from milk You can have milks made from soya, nuts, coconut or oats. Rice milk is not suitable for children under 5 years. However, these milks are sometimes low in vitamins and calcium, so find one which has these added. Under the age of two, it is best to use a lactose free formula (SMA LF, Aptamil Lactose Free or Enfamil LF) as these have the correct levels of vitamins and minerals, protein and energy which a growing baby needs. Your dietitian can help you with this. If there is a family history of allergy ie. asthma, eczema, hayfever or food allergy, nuts and nut products should also not be given under 3 years of age. Source: Nutrition & Dietetics Reference No: 5779-1 Issue date: 17/11/17 Review date: 17/11/19 Page 1 of 6
What about other dairy products? You may find you are able to tolerate small amounts of yoghurt and cream. If you can t, try soya ones, such as Provamel and Sojasun. Hard cheeses such as Cheddar, Edam and Red Leicester have hardly any lactose in, but cottage and goats cheese and cheese spread all contain lactose, so avoid these. If you like ice cream try a soya or oat one such as First Glace, Provamel, Swedish Glace or Tofutti. General advice for introducing lactose-free solids 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 or baby rice, pureed plain fruit and/or vegetables. Gradually increase the amount and range of foods to include foods from the allowed list overleaf. Eggs, fish, meat, citrus fruit and cereals with gluten (bread, pasta, rusks, biscuits, cakes) and nuts should not be introduced until 6 months of age. 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. Honey should not be given until 1 year or age. By 1 year of age, most infants can manage to eat chopped up family meals. Can I still eat sweets and chocolate? Some companies make lactose-free sweets and chocolate. You can find them in health food shops or by mail order: Allergy Care: Jelly beans, chocolate eggs Carob: Alternatives to chocolate D&D: Chocolate drops Plamil: Plain, orange and mint chocolate Tropical Sauce: Chocolate covered raisins and nuts. What should I remember? Remember tolerance levels vary a lot from person to person. You may find you can tolerate some milk but not a lot. If you have any further questions or worries about lactose intolerance, please contact your dietitian whose name and number you will find on the front of this leaflet.
Lactose-free weaning diet Fruit & Vegetables Baby Jars Packets Meat/fish/ eggs/pulses Food Allowed All plain vegetables and fruit - puréed, mashed and finger food* Vegetables mixed with sauces made from milk substitutes. All plain fruit, puréed, mashed and finger foods* Fruit mixed with soya yogurt, soya cream, soya desserts, custard made from custard powder and milk substitute. All baby jars/packets/ rusks which state they are milk/lactose-free and do not have Milk in bold on the ingredients list. Plain meat/fish/eggs/pulses or in sauce made with lactose-free milk. Foods to avoid Vegetables mixed with sauces made from cows milk Fruit mixed with ordinary yogurt/custard/cream/ icecream. All baby jars/packets/rusks which do not state milk/lactose-free. Any products which state Milk in bold on the ingredients list. Meat/fish/eggs/pulses in sauces made from cows milk. Dairy products Cereals Lactose-free infant formula, soya yogurts and desserts, soya milk can all be used in cooking. Hard cheese eg Cheddar, Edam. Dairy-free margarine eg Pure, supermarket own dairy-free brand. Bread (if no milk added) Flour Pasta in milk-free sauces Rice Breakfast cereals (if no milk in ingredients) with lactose-free formula eg Rice Krispies, Cornflakes, Weetabix Biscuits/cakes if milk-free consistency given appropriate to age Cows, goats, and sheep's milk and all products made from these. Soft cheese eg cheese spreads, cream cheese, mozzarella. Ice-cream, cream, ordinary yogurts,. Butter, ordinary margarine. Chocolate, chocolate spread. Bread with milk added Pasta in cows milk based sauces Breakfast cereals which contain milk/chocolate Biscuits/cakes that contain milk
Names of lactose to look for on labels: Butter fat Milk sugar Milk solids Demineralised whey Non-fat milk solids Skimmed milk powder Lactose Whey Yoghurt All foods containing milk must state Milk in bold on the ingredients list. Calcium content of foods Cutting dairy foods out of your diet can result in a reduced intake of calcium. Calcium is needed to help build and maintain healthy bones and teeth. Please see below for foods that can contribute to your calcium intake and the amount of calcium that they contain. Food Glass of skimmed milk (280ml, ½ pint) Glass of semi-skimmed milk (280ml, ½ pint) Glass of whole milk (280ml, ½ pint) Pot of yogurt (150g) Cheddar cheese (30g) 2 tablespoons grated hard cheese (20g) Cheese snack (eg cheese string, mini Baby-bel) Semi-skimmed milk on cereal (100ml) 1 large cheese spread triangle (23g) 1 pot fromage frais(100g) 1 scoop ice cream (60g) Calcium content 355mg 345mg 340mg 225mg 220mg 150mg 1 125mg 120mg 85mg 75mg
Food Glass of calcium enriched soya milk (280ml, ½ pint) Lactofree milk (280ml, ½ pint) Glass of calcium enriched rice milk (280ml, ½ pint) Glass of calcium enriched oat milk (280ml, ½ pint) Pot of soya yogurt Soya custard (120g) Pot of soya dessert 1 scoop of soya ice-cream Fruit juice with added calcium (250ml) 2 tinned pilchards 2 tinned sardines with bones Fortified cereal bars (per bar) Danone water (500ml) 4 white bait (16g) 1 tablespoon of tahini (sesame seed paste) 2 larges slices of bread (white or brown) Shelled prawns (60g or 20 prawns) Small can baked beans (150g) 2 large slices wholemeal bread 1 large orange (210g) 2 tablespoons cooked spring greens 3 tablespoons Swiss style muesli (50g) 1 original Rusk 7 dried apricots (56g) 2 spears of broccoli (90g) 1 egg (57g) 1/6 of a small cabbage, boiled Bag of peanuts (50g) 3 tablespoons of boiled lentils 1 tablespoons of kidney beans 1 tablespoon of hummus Calcium Content 370mg 342mg 335mg 335mg 150mg 145mg 135mg 6mg 300mg 275mg 260mg 180mg 150mg 140mg 1 1 100mg 80mg 75mg 70mg 70mg 65mg 60mg 40mg 25mg 25mg 12mg
Calcium content of foods Daily requirements The amount of calcium you need varies at different stages of life. Infants under 1 year= 525mg Children 1-3 years = 350mg 4-6 years = 450mg 7-10 years = 550mg Adolescents 11-18 years girls = 800mg 11-18 years boys = 1000mg Adults 19 years and over = 700mg Breastfeeding = 1250mg Useful Internet Addresses Lactofree.co.uk www.tofutti.com www.swedishglace.com www.alprosoya.co.uk www.provamel.co.uk If you would like any information regarding access to the West Suffolk Hospital and its facilities please visit the disabledgo website link below: http://www.disabledgo.com/organisations/west-suffolk-nhs-foundation-trust/main West Suffolk NHS Foundation Trust