lactose intolerance - constant problems with kindergarten

[ErnesttheBavarian]

Just before Christmas dd was dx with lactose intolerance. (She's 3.5) (I know it's not an allergy as such, but not much more!)

Over the holidays her poo was best ever - she's had varying degrees of runny poo since she was out of nappies. Since we had dx, we've obi. dropped normal milk and got lactose free, avoided dairy and her poos have been proper little sausages much to our relief. (and hers I bet)

1st day back at kindergarten she came home and had a horrible totally liquid poo (looked like vomit) and stank, and she said her tummy hurt. Must have been something she ate at Kindergarten. I spoke to them, explained her dx, she had been given quark, with I guess is like fromage frais/petit filous type cheesy yoghurt. She seems to be ok with yoghurt but the quark caused a bad reaction. Have tried to google, but no luck. Is quark different to yoghurt in terms of lactose content?

Anyway, last Thursday they accidentally gave her vanilla pudding, and it may be coincidence, but when we woke her on Friday morning she had vomitted in her sleep and had dried puke all over her face, bed etc.

Today she's come home and done really horrid poo again.

So I think she ate something bad again.

Apart from repeating everything, what else can/should I do?

How do I educate them and us better?

well, what have you done to instruct them?
do you check the menu before hand to give them the go-ahead to give it to your daughter?

and if they keep making mistakes, provide your own food.

sounds like your baby has a nasty food intolerence, they should be working harder to keep your child's diet milk free at kindergarten.

quark is a soft cheese

i would be livid!

they have a duty of care to her and they are not meeting it. would they be this careless if it was an allergy and she might die from it? I suspect not, so if they can keep allergic children safe then they ought to be able to keep an intolerant child safe.

I would ask for a meeting with them, stress just how angry you are at them compromising her health, ask to go through the menu and work out substitutes for all the dairy items they have.
I have found it's easiest to have a blanket "no dairy" rule for DS2's nursery becasue with so many chldren with varying needs it's really hard for them to keep track of things like "no dairy, but can have yoghurt and this brand of cheese"... easiest to say no to it all.

if they continue to feed her things tht make her ill then i would be putting a complaint into the LEA or whoever is in charge of things where you are (am assuming not UK as mention of kindergarten and quark!!)

are you in germany?
I would not just talk to staff but print a couple of large print notices saying something like
bitte amy keine milchprodukte geben (milch, joghurt, quark)

give one to staff in the morning, pin one to the notice board.

can you go to the paed to give you an Attest?

I feel for you, my own DD is also lactose intolerant & it can make her very ill, even now at 9 we have still occasionally had problems - for example new School cook giving her a cheese roll as they didn't have a veggie optionfor her - at 9 DD does know better, but trusted as it was School it was safe :(

How intolerant is she?? if she can safely eat yoghurt then that sounds the same as my own DD in that she does produce some lactase enzyme, just not enough - so she can tolerate the small amounts of lactose you might get in say chocolate, can safely eat mature cheeses, but not mild, can eat cooked cheese & hot milk, but not drink cold milk unless its lactofree.

I agree with above thast it IS the Nurseries "duty of care" not to make your DD ill by being careless, but having hit similar problems when my own DD was at nursery I know they are not so strictly regulated as far as food goes as Schools & quite often the staff giving out the food really don't have a clue, so as annoying as it is, if you can't get them to understand Lactose a reduced diet, you might actually be better off just insisting on no dairy at all, that way theres no room for this type of mistake -

annoying though as said above, if it were nuts etcf, they would no doubt be VERY careful but for your DDs sake it might be best to go the no dairy at all route at Nursery - no room for this type of error that way

good luck :)

Thanks to all of you for replies. Yes, we are in Germany. I only recently got the dx, and have received v. little info so am feeling my way somewhat.

Spoke to Kiga staff this morning, glad I went in calmlyand not all guns blazing, as they assured me she didn't get the desert (chocolate pudding, poor dd) they gave her an apple instead, The main course was all ok in theory. They assure d me they have informed the kitchen and they are being careful. The vanilla pudding incident they told me they realised and took it off her so she only had a bit (hope she wasn't too traumatised!). So maybe there's something else going on, some other allergy or intolerance. Anyway, as a result, I've made another appt at the docs and go 1st thing in the morning, so hopefully will get more help & info.

rockinhippy, thatnks for the details, this is all the stuff I don't know and am trying to work out, so you may have saved me and dd some trouble, so mild cheese not good, mature ok, I didn't know cooked cheese is ok.

I'm going to ask for some tests, more info, poss an appt with a dietician and if things don't improve, she'll have to try having packed lunches.

Thanks. if any of you experts who are further along the learning curve than me wants to share some tips/info i'd be glad. e.g.. ice cream?

it really depends on the child.

some cannot have any dairy at all, others like rockinhippy's dd find that there are some products that they can tolerate, so you may have to just experiment.

we're slightly different in that it's actually a cow's milk protein intolerance that my 2 have, so all dairy is out

how well is stuff labelled over there? here pretty much all food has an "allergy advice" section after the ingredients which will let you know if there is any milk products in it becasue it isn't always listed as milk

ok, well, we are v. much trial and error. Thank goodness she can tolerate chocolate!

Unfortunately Germany not so forward as UK re allergy advice (or veggie products , but we#ll see what we're dealing with.

How did you find out it's cow milk protein not lactose intolerance? Is there a blood test or was it trial and error?

thisisyesterday diary/dairy protein allergy & lactose intolerance aren;t the same thing,

Lactose intolerance is where the body isn't producing enough of the enzyme that is needed to break down the Lactose, which is the sugar in milk, some Lactose Intolerants might not produce any Lactase Enzyme(aka LPH) at all, but from what I was told most do, just not enough to cope with a big load of Lactose - ErnesttheBavarians if your DD can eat yoghurt without problems then it suggests that she does have some of the Enzyme or that too would make her ill

my own DD (now 9) is diagnosed lactose intolerant & it was the hospital dietician that told me that Maturing of Cows Milk Cheeses & boiling Milk, cooking cheese, bacteria in yogurt etc helps break down the Lactose & therefore are fine for her - which they are - I have noticed though, that my own DD does become diary intolerant & also wheat intolerant after a bad bout of her IBS triggered by Lactose or in her case also chemical food additives - Azo Dyes, Benzoate Preservatives & Artificial Sweeteners or stress -

Wheat & Diary along with meat are hard to digest foods, so it makes sense that if her intestines have taken a bit of a battering for any of the above reasons, then she needs a rest from hard to digest foods & also needs a more bulking diet - so less veg, more things like white rice, potato, none wheat flour white bread etc - we use white spelt, which is fine for most things - my DD was very ill recently - a virus seems to have triggered a bad IBS reaction which lasted for a couple of weeks :(

so currently instead of her usually healthy fruit, veg, pulse & grain packed diet, she has been living off fish, mash, white rice & spelt flour pasties etc - & gradually reintroducing more veg & pulses - at the weekend we will try her on wheat & diary again - after about 5 years of dealing with it, this is what we;ve found works best - we also give her Manuka Honey, which amongst other things is a good digestive aid & we buy Childrens Viridian Stomach Flora powder, which I mix with the honey for her to take

Non cows milk cheese are also okay for her to eat - things like sheep & goat feta - which is the best & Almond milk or plenty of almonds or things like tinned sardines will help keep her calcium levels up :)

I'm just looking into it now, but you can apparently buy a Lactase enzyme supplement - not yet sure how it work with DCs as far as dosage etc goes

You might want to look into the additives I mention above as a possibility for her problems too - a friend of mine who works in alternative health care told me they are often linked, she said sometimes raw egg can be too - as in mouse, ice cream etc - also here in the UK they rule out the diary allergy, before diagnosing lactose intolerance

hope that helps

fell free to shout if I can help further

thanks, see how I get on tomorrow. Apart from asking to speak to dietician is there anything else you recommend asking/checking?

erm, i know they aren't the same thing, that's why i said in my case it's different because we're dealing with a slightly different issue

but it is still true that people with intolerances have varying degrees of it. some people with a lactose intolerance do need to cut ALL dairy out. others do not, as you have found with your daughter

trust me, i've read more on lactose/cmp intolerance than I ever, ever wanted to know

hi, update, went to doc and been referred to children's hospital gastroenterology dept and also got appt with dietician. Doc has suggested it could also be a fructose intolerance too, but she not specialist, hence referral. Appt 7. Feb, so not too long.

Know anything about fructose intolerance. Apparently eating an apple is fine, but apple juice not. Gah, yet more to learn.

@ thisisyesteryear yes you are right, I miss read it & re reading my post does sound a bit stroppy - it really wasn't meant too - in my defence I was typing in a big rush, with a stroppy, very stressed & VERY annoying DH & also DD breathing down my neck, both wanting the computer & our wonderful - not neighbours also hammering on the wall behind me - which they had been doing all day- so my apologies for my annoyance with that coming through in my post [note to self, don't post when wound up & unable to concentrate properly]

ErnestReally glad to see you got the referrals so easily, & hope they come through quickly

interesting your Dr thinks of it being a Fructose "intolerance" though here DDs dietician just said that fructose is a natural laxative & apple juice contains the most, so best to keep of it if theres any diareah & not drink too much as a rule it took us ages to finally see the Dietician & apple juice was the main thing we were doing wrong, as I'd also thought orange juice was the one to be careful with - but not according to DDs dietician - its apple juice & knowing that has made a difference

it's ok, i know the feeling! :)

The dietician phoned today and we had a bit of a chat. She basically said that apple juice is the work of the devil, so will ban that forthwith for all of them. She suggested we wait until we've had the appt with the gastroenterologist before we make an appointment so we know exactly what dd's got wrong with her and have an idea of what she can and can't eat.

She did say I can phone whenever I want before then though if I have any questions, but the few questions I did ask was 'well, it varies so much from person to person...' which I have learnt to be the case, but anyway, feels a bit sad that dd is a bit of a guinea pig. WIll keep a detailed food diary in the couple of weeks wait before the appt though. Glad don't have to wait.

I (stupidly) googled fructose intolerance, and there are 2 types, one hereditary which is serious stuff leading to liver & kidney damage etc but I'm sure that's not the case, there`s no history of anything like that in our family. The other type is not dangerous, but the list of what you should avoid was breathtaking, I'm praying she doesn't have fructose intolerance, cos goodness only knows what I#d be able to cook for the family, what with ds3 fussiness and ds1 vegetarian.. Think I'll just put everyone on a gluten free vegan diet (with no apple juice) to to cover my back. (joke)