Choosing the Right Lactose-free Formula for Your Infant

Many parents often select infant formula derived from cow’s milk. 80% of baby formulas are made from cow’s milk. However, some infants are allergic to lactose or dairy. They are unable to digest the formula; hence they need a formula without milk. In some infants, there is a rare condition called galactosemia, where the lives of infants exposed to lactose or formula containing lactose are threatened.

What is a lactose-free formula?

The lactose-free formula is made from cow’s milk; it is refined by removing the lactose and replacing it with a different sugar type. While neither soy formula nor lactose-free formula is created from cow’s milk, it contains cow’s milk protein. However, these formulas are not tolerated by babies that are allergic to the protein.

Lactose intolerance in babies

The body needs to create an enzyme called lactase to digest lactose. Some babies do not develop enough of this enzyme. A primary or lifelong failure is rare to generate any lactase at all. Many babies and children experience a temporary decrease in the supply of lactase. It also happens after a bout of diarrhea, during which the intestinal lining is damaged. Typically, a transfer to a lactose-free formula is not needed. Other babies lack the long-term capacity to produce enough lactase, which causes lactose sensitivity symptoms such as gas, bloating, diarrhea, and colic. If it helps them avoid lactose malabsorption symptoms, infants with long-term lactase-producing problems can benefit from the lactose-free formula.

Milk protein allergy

One of the top allergens for children is cow’s milk. The protein usually causes this allergy in milk, not lactose (sugar). When a child grows up, a milk-protein allergy may be present at birth or may develop. In young children, two years of age and above, lactose intolerance is more common.

Hives, runny nose, diarrhea, vomiting, and irritability are the signs of a milk-protein allergy. Parents often confuse milk-protein allergy symptoms with those of babies with colic, gas, or other common digestive problems. Different severe reactions may include swelling of the mouth, tongue, and throat and anaphylaxis. If your baby has a severe reaction to a suspected allergen, you should contact a medical professional.

Does your infant require lactose-free formula?

An infant that is allergic to the protein allergen found in cow’s milk may also be allergic to soy, in which case a specific formula is recommended for the infant. Research has shown that few children require lactose-free food. A study published in 2015 found that lactose-free formulas do not minimize the fussiness of children.

Babies with a rare, hereditary medical condition called galactosemia do need a lactose-free formula. However, galactose cannot be safely digested by infants with the disease. The situation is diagnosed at birth through screening tests for newborns or maybe identified prenatally. Babies cannot handle breast milk with galactosemia. Hence lactose-free formula that is not extracted from cow’s milk must be given.

How is lactose intolerance diagnosed?

To better understand and diagnose lactose intolerance in the baby, your pediatrician may first look at your child’s medical record, family history, and diet charts. The physician will order the following tests after the initial examination.

Hydrogen Breath Test

It tests the hydrogen level in the breath of a child before and after he drinks a drink. When consuming dairy products, a small amount of hydrogen is ordinarily present, but if this level is irregular, the test results are positive, suggesting lactose intolerance.

Test Acidity

To analyze the acidity levels, you need to obtain a sample of your child’s stool. It is understood that children with lactose sensitivity have acidic stools. A further test is available that tests the amount of glucose in the stool and shows whether the lactose remains undigested.

An endoscopy

It is a form of biopsy where an instrument can peer into your child’s intestine and be used directly to measure lactase levels. If your pediatrician or GP suggests this, you may have to show your child to a gastroenterologist.

Treatment of lactose intolerance

  • Create a food log

Keep track of the milk products that aggravate your baby’s lactose sensitivity when the symptoms arise and what foods are frequently included in your diet. Keeping a food log will help your pediatrician determine which foods cause your child’s symptoms to flare up, in particular, and which do not. For instance, because it is not fermented into lactic acid for easier digestion, yogurt (curd) is more challenging to digest than milk.

  • Regrade

It is the process of getting your baby back to its regular feeding habits. The cycle takes 5 or 7 days, but your doctor can help you carry it out in a shorter period.

Your baby could try the lactose-free formula for 1 to 4 weeks and then, after there have been no signs for a week and the bottom has healed, progressively return to breast milk or typical infant formula.

  • Regarding guide

You can replace one bottle of lactose-free formula with one breastfeed or usual infant formula for 5 days. It would be best if you carried out the cycle until you have replaced all the lactose-free bottles. Eventually, your baby will be back to the normal feeding cycle. If your baby develops diarrhea, you should give them the lactose-free bottle according to your process. For example, if on day four, the infant took one lactose-free formula and four breastfeeds our usual formula.  But on day five, when he feeds on five breastfeeds, the infant starts to have diarrhea. Go back to day four’s plan four breastfeeds and one lactose-free formula.

As a result, the baby will get back to its normal feeding cycle. However, for infants with congenital lactase deficiency, a lifelong condition, you will have to continue using lactose-free formula.


When it comes to tackling lactose intolerance, a lactose-free formula can provide the necessary nutrients to your infant. In other cases, it takes time for the digestive system to start the production of lactase enzymes. Hence, the formula would help during the process, ensuring your baby is safe and healthy. It is also advisable to keep in touch with your pediatrician to help you find the best lactose-free formula for your baby.


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