Lactose Intolerance ?

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I'm looking for a little advice here, our baby is 7 months. When she was born she had a bad stomach infection & was home for one day then back in hospital for a week, nill by mouth fluids from a drip & draining off green stuff from her stomach through a nose tube.

When she came home she wasn't putting on weight being breast fed, watery stools - so we were given nutramigen and she thrived.

At 6 months we were sent to hospital for a forced milk test to see whether she had a milk allergy. Throughout the day she was given a 50/50 mix of milk water in increasing amounts and she was fine. This finished with a full feed of normal formulae milk - she drank all this & 20 minutes later was violently sick, lots then failed to hold anything down, including water. Astonishingly they sent us home and we ended up back down the a&e later as she was getting dehydrated, so we gave her water & dyralites solution via oral syringe 5ml every five minutes until she perked up & home we went.

There was no conclusive diagnosis & they deduced she had no allergy - but was possibly intolerant to mailk/lactose. They advised us not to worry about a bit of milk whatever in food & continue with nutramigen wean normally & they would review at the next appointment.

At seven months now she takes any mashed up veg/fruit we give her - we have just started some finger food & mashed up more adventurous food, all went fine.
So we tried her with a bit of a pouch breakfast mix of mango/yoghurt rice & we had the same reaction, violently sick - so we did the oral water/salts mix via oral syringe to keep her hydrated & we skipped a milk feed & she was fine for the next one. Seems happy as normal this morning & back to milk/mashed food routine.

So apart from avoiding dairy products we are none the wiser, the hospitals a bit crap to be honest & we are thinking of seeing a paediatric dietician privately. But if anyone has any advise or similar experiences I'd love to hear them.

Thanks a lot, I know its a long post.

Concerned dad..

Hi Concerned Dad,

This must be horrible and worrying for you.

i'm a biomedical scientist and was, early in my career, someone who tested samples from patients for lactose intolerance. Without getting too technical and wasting your time while you're obviously worries, what I can tell you is that if your daughter has been tested for intolerance to lactose, this simply involved detecting antibodies to lactose which basically are either there or not. Although they should have also tested for coeliac disease (gluten intolerance) which is just standard and was probably done.

So, if the antibodies are not present then thats pretty black and white but there are further tests that should be done. I'm quite disappointed your medical professionals are not making more of an effort!

Bacteria in the stomach metabolise lactose. The fermentation that follows produces LOTS of gases which can cause some symptoms possibly including vomiting.

However has she received any antibiotic treatments? For stomach parasites or viruses such as Giardia lamblia or a rotavirus.

At this age your daughter could just be suffering when there is a lactose overdose BUT good news is - this is temporary. She would grow out of this.

If all else is eliminated then the only other thing could be a genetic disorder but again, your doctors should be onto this if they really can't find any other diagnosis and testing for it.

Best of luck with this, please post back and let me know how she's doing!

Claire, mum of two (16 and 10)

www.clairecrawshaw.co.uk

Thanks for your reply Claire - I think our paediatrician basically skipped any testing & said just go for the forced milk test "That'll tell us one way or the other", which it didn't.
The doctor on the ward was a bit surprised as normally they wait till they are a year old before trying that.

I guess we'll just keep on with the nutramigen - get her on solids keep her away from dairy products for the time being.

When she has a reaction to dairy it just knocks the stuffing out of her - which is pitiful to see. As you say it's not a crisis, she is not allergic & it isn't that hard to keep dairy out of the diet for a while.

At the next outpatient appointment I'll ask for a referral to a paediatric dietician & tell the consultant what I thought of his forced milk test.

That forced milk test is so prehistoric! Making a child suffer so they save a few pounds just doing an ELISA test....if that! hundreds of samples go on the analysers in a hospital lab every day, I think they're being unbelievably lazy or cheap!

Fingers crossed it's a temporary reaction and good luck with your referral!

Claire

www.clairecrawshaw.co.uk

yep absolutely nottirednow when I said temporary I should have mentioned I didn't mean a week or two! Apologies for not being clear. Just to clarify my sources though I do actually specialise in immunology and genetics but will make a concerted effort to not use terminology and explain myself better!

I agree with nottirednow, severe vomiting can be a sign of a milk allergy as well as lactose intolerance. I'm very confused as to why your hospital would deduce 'no allergy' following severe vomiting. As soon as my son vomited during a wheat challenge last year, they stopped the test as this was sufficient to confirm he was still allergic (within 5 minutes he had further more severe symptoms but they'd already decided to stop). I think you should avoid all dairy, stay on the Nutramigen and try to get a referral to a paediatrician who specialises in allergies. I know that there are very few 'true' allergy specialists in the UK but there are quite a few who have developed a specialism in this area through necessity. We see a paediatrician who is in fact a chest specialist (mainly asthma) but now deals with all types of allergic children and is very good.