Lactose Intolerance: An Overview

Accepting that these are very rough, wildly variable numbers, here are some sample lactose levels in common dairy foods (from that same Wikipedia entry):

Dairy product Lactose Content
Yogurt, plain, low-fat, 240 mL 5 g
Milk, reduced fat, 240 mL 11 g
Swiss cheese, 28 g 1 g
Ice cream, 120 mL 6 g
Cottage cheese, 120 mL 2–3 g

Here’s the deal:  Lactose is in dairy LIQUID.  Butter has nearly no lactose, skim milk has a ton (because, by volume, it’s ALL liquid.)  Make sense?  Whole milk has less lactose per cup than 2%, and 2% has less than non-fat.  (Does anyone know the difference between “skim” and “non-fat” milk?  Besides price?  Because I don’t.)

Lactose-intolerance is the absence of lactase enzymes in the small intestine.  Lactose is a disaccharide (made of two sugars, galactose and glucose.)  Put on your thinking caps and read this:

Disaccharides cannot be absorbed through the wall of the small intestine into the bloodstream, so in the absence of lactaselactose present in ingested dairy products remains uncleaved and passes intact into the colon. The operonsof enteric bacteria quickly switch over to lactose metabolism, and the resulting in-vivo fermentation produces copious amounts of gas (a mixture of hydrogencarbon dioxide, and methane). This, in turn, may cause a range of abdominal symptoms, including stomach crampsbloating, and flatulence. In addition, as with other unabsorbed sugars (such as sorbitolmannitol, and xylitol), the presence of lactose and its fermentation products raises the osmotic pressure of the colon contents.”

Nice, right?  Lactose can’t be processed, so can’t continue the normal path.  It shoots into the colon where it doesn’t belong, and creates “copious amount of gas.”  There are a few methods of testing for the lactose intolerance- the one used most commonly for infants, apparently, is stool acidity.  If you’ve had (or have) a lactose intolerant baby, you KNOW.  A blistered bottom is a very good indicator of stool acidity, and heart wrenching to try and help your baby with.  If I am 15 minutes late in noticing a dirty diaper, Mimi WILL have a diaper rash that will last for days.  If I miss 2, she will blister.

Very frequent bowel movements is another indicator.  See above for why this is VERY frustrating.  Frequent wakings at night (as in, wailing every 2 hours) is another of our indicators that the lactase has let us down again.

OK, so here’s what this means for us: I am going to start experimenting on my daughter.  Wow, that sounds rotten, but I promise it will be bad for me too if I mess up.

Things we will be trying:

1) Hard cheese.  Tillamook has a “Vintage White Special Reserve Cheddar” that is aged for TWO YEARS.  It has almost no lactose.  The last time I gave Mimi a slice of cheddar (9 month cheddar) she was sick a few hours later.  I’ll give her a slice of the vintage white and watch for a day.

2) Yogurt.  I had declared yogurt a failure, but I did it wrong.  I make yogurt at home with 2% milk and powdered skim milk added as a thickener.  I basically added powdered lactose.  Yay me!  I don’t think the “live cultures” could convert all the sugars I had put in.  SO, I am going to make whole milk yogurt (less lactose, and she needs the fat for neural development) and I am not going to add powdered milk.  When it has set, I will strain it so it’s “Greek style.”  The more liquid I can drain out, the less lactose it will have.  It will be nice and thick, and nothing but milk and cultures.  After it’s drained I can season it to be palatable, because we like our yogurt sweetened.

3)  If these don’t work, I will purchase “lactose free” milk at the grocery store and try her on that- I don’t believe she has a milk protein allergy, because she doesn’t show any of the listed symptoms.  But if she can’t eat the cheese or the yogurt, then I’m not going to rule it out.

If the first two things work (hard cheese and strained yogurt) then we will work on learning her “lactose daily limit.”  Obviously she’s getting lactose from nursing, so the question is how much more than she handle?

**Update: I gave her a slice of cheese Thursday for lunch.  I’m still watching.

10 Responses

  1. Really a great mother, experimenting on own daughter…Good luck…


    • Dear Oliver – How do you propose she figure out what her daughter can eat, exactly, if she doesn’t experiment? I’m curious…should she experiment on someone else’s daughter to see what her own daughter can eat? That doesn’t seem to make much sense…

  2. Keep us posted!! And make sure I have a CLEAR understanding when I get back – I don’t want to cause any problems!!!!

  3. We used to have such a lot of allergies/intolerances that our lives became miserable and very house-bound. What worked best for us was N.A.E.T.. It’s an allergy elimination protocol that uses a 25 hour avoidance after treatment. It was a lifesaver in our family. You can google it to find a practitioner in your area.

    Good luck! I certainly remember what all this was like!

  4. I forgot to mention before, that when I was making yoghurt, I’d add a package of Knox gelatin to thicken it up. I just liked it firmer than it was without the setting agent, and it worked very well. And no extra lactose!

  5. I was thinking of something else too, regarding the fats if you’re concerned about her dietary intake. Check out Udo’s Oil as a supplement that you can mix in with her food. My kids responded very well to it.

  6. Thanks for the rundown on this, DIYM! I’ve always wondered why I can eat yogurt/ice cream/butter (and boy, would I be sad if I couldn’t eat ice cream ;), but can’t for the life of me drink milk.

    Good luck figuring out the right line with Mimi!

  7. Hi… I am backlogged 8 posts on this site, so I am catching up!! About lactose intolerance, I used to be highly intolerant (most asians are), but have since built up my tolerance. I can now have milk or cream in my teas, but have trouble digesting more than 1/2 cup of milk.
    But yeah, started with yogurt and cheese and built it up from there. It’s slow progress, but it does work

  8. Hey Mama, how goes the lactose fight? Hoping you are finding her balance!

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