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AAP Recommends Dairy for Children With Lactose Intolerance

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Dairy Foods and Children

A new American Academy of Pediatrics (AAP) report1 released today in Pediatrics recommends children with lactose intolerance include dairy foods as part of a healthy diet in order to get enough calcium, vitamin D, protein and other nutrients essential for bone health and overall growth. The report cautions that lactose intolerance should not require total avoidance of dairy foods.

In fact, the report cites research indicating that many children who are sensitive to lactose can drink small amounts of milk without discomfort, especially when consumed with other foods. Dairy foods that are often well tolerated include hard cheese, such as Cheddar or Swiss, yogurt containing live active cultures, and lactose-free or lactose-reduced milk.

"While calcium-fortified beverages and other foods can provide an alternative source of calcium, the report reinforces that they do not provide an equivalent nutrient package to dairy foods like milk, cheese and yogurt," said Ann Marie Krautheim, registered dietitian and senior vice president of nutrition and health promotion at the National Dairy Council. "We hope this report will further educate parents on how to continue to include dairy in the diets of children sensitive to lactose and also help improve their nutrient intake."

As confirmed by this report, patients who think they may be sensitive to lactose should talk with their doctors for a full evaluation, as dietary history alone is an unreliable tool for diagnosing the condition.

The AAP recommendation for children and adolescents with lactose intolerance to choose dairy foods first for overall diet quality and adequate intake of many nutrients is consistent with guidance found in the 2005 Dietary Guidelines for Americans2 and from the National Medical Association3, the largest African American physicians group in the country. For those who have trouble digesting lactose, the following tips can be used to help keep dairy in the diet:

  • Drink milk with food

  • Aged cheeses like Cheddar and Swiss are low in lactose

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  • Introduce dairy slowly. Gradually increase the amount

  • Reduce it. Enjoy lactose-free milk and milk products

  • Yogurt with live and active cultures helps digest lactose

Editor's notes on lactose intolerance:

  • Lactose intolerance is a clinical syndrome with one or more of the following symptoms: abdominal pain, diarrhea, nausea, flatulence, and/or bloating after the ingestion of lactose or lactose-containing substances. The extent of the occurrence of the above symptoms is dependent on the amount of lactose consumed, the degree of lactase deficiency and the types of lactose containing foods.

  • Lactase is an enzyme which enables people to digest lactose, the primary carbohydrate (sugar) naturally found in cow's milk. The inability to digest lactose often results from a deficiency of the lactase enzyme.

  • The report focuses on primary lactose intolerance, the most common type and genetically determined. Symptoms of primary lactose intolerance do not usually become apparent until late adolescence or early adulthood.