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 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. Symptoms may include loose and frequent stools, increased (explosive) wind and abdominal bloating.
How long does my baby need a lactose-free diet?
Lactose should only be avoided if the symptoms cause significant distress to the baby (e.g. crying, pain, nappy rash etc.) Most babies grow out of lactose intolerance once their gut has recovered.
If your baby is distressed, remove lactose for 2 days [use a lactose free formula/milk and follow a lactose free diet]. If the symptoms improve then continue with the lactose free formula/milk and diet for up to 8 weeks to allow resolution of symptoms. To test if the gut has recovered, try giving small amounts of standard formula/milk or dairy products e.g. ordinary yogurt or food made from cow’s milk. If your baby continues to have loose nappies and is unsettled, stop the lactose-containing food, and try again in 1 - 2 weeks. It will take a bit of time for your baby to regain their ability to digest lactose, so increase the amount gradually. If the symptoms do noy improve after following a lactose free diet, please contact your GP
Lactose-free infant formulas such as SMA LF or Aptamil Lactose Free taste similar to ordinary formulas and can be bought in a pharmacy or supermarket, they are not available on prescription. Until the age of 1, it is important that your baby drinks at least 600ml (20 ounces) a day of a lactose-free formula to receive sufficient nutrients, especially calcium. If your baby is over 1 year, then a supermarket alternative such as Arla lactofree whole milk drink or Alpro Growing Up soya drink can be used.
Can I give other drinks?
The main drink for a baby under 1 year 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. 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
Lactose free formula and Arla Lactofree milk as well as calcium enriched soya, oat, hemp or nut milks can be used in cooking (but should not be used as a main drink until 1 year of age). Rice milk is not recommended for babies and children under 5 years.
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.
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 |
| |
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 (check label for milk) and flour
Potatoes, sweet potatoes
Pasta, rice
Breakfast cereals (check label for milk) |
Milk breads, brioche
Pasta 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 |
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.
