Going to see a consultant about DS's lactose intolerance

[Sugarmagnolia]

So I'm taking DS to see a consultant tomorrow about DS's lactose intolerance. He's 3.5 now and clearly hasn't outgrown the problem as "everyone" said he would. He's never been properly tested for it, only really our own anectodal evidence and experience to go by but it's pretty clear. I don't really think she's going to tell us anything we don't already know and I'm not particularly concerned about his health but I want to know:

-Does it make a difference if it's a lactose intolerance or a milk protein intolerance?
-Is it worth having him tested to find out?
-Is there anything important he might be missing in his diet that could cause problems later?

Also on a related note, I want to talk to her about the relationship between his intolerance and his periodic trouble with toilet training/staying dry and is this something we need to investigate.

I'm just wondering if anyone else has done this and if you have any suggestions of other things I might want to ask about while I have the chance. Thanks!

ask if there is still a prospect of outgrowing it - they'll probably say yes. Then ask about when they suggest you try reintroducing dairy and how you do it. (cheese before milk, for example, because its less allergenic, do you do live yoghut before or after cheese).

If they think the problem is lactose ask if they think probiotics and/ or lactase may help. If they do can they prescribe a probiotic (they can't prescribe lactase).

If they think its cows milk protein ask if its worth trying goats milk or sheeps milk.
Assume you have calcium supplements but if not ask about those and if you also need to supplement magnesium or vitamin D.

It's not unusual for a 3 1/2 year old boy to have problems with being dry/ toilet training. Does no harm to ask but I doubt they'll say much of use.

Thanks tatt - he takes a children's multivitamin with calcium every day but I'll make sure to write down how much is in it and check if that's enough. There's some calcium in the Rice Dream as well which he has every day.

Will also ask about lactase enzyme. I remember seeing lactase tablets for children in the states but I don't know if they make them here.

Well, I think our appointment went very well today. I'll share just in case anyone else is thinking of doing the same thing.

She checked his height and weight and wants to check it again in 9 months to make sure his growth is ok but isn't overly concerned as we are not a "tall" family.

We will get an appontment with a dietician to discuss his diet.

The dietician will also give us detailed guidelines for doing a proper dairy trial with him if we want to. This will involved collecting stool samples to check for lactose sugar and blood to check for milk protein antigens (I think that's what she said). In any case it will clarify whether it's lactose, milk protein, both or neither that he has trouble with.

She also wants to do an ultrasound scan of his kidneys just to make sure there isn't another reason why he's wet a lot but doesn't expect to find anything. As it's not invasive I thought this was ok.

She said there are other tests that can be done such as a biopsy of his intestines but we both agreed that was totally unnecessary.

So that's it.

very helpful - I'll pass that on to a family I know who are not getting that type of help from their consultant.

Hope it's of some help. Can I just say, I think how much help you get partly depends on the age of the child. Up until he was 2 no one was interested and certainly didn't think it was worth testing for because the likelihood was he was going to outgrow it. Now that he's 3 1/2 and it's clear this is something that's going to be with us/him for a long time I wanted to make sure we were doing the right things for him and there was nothing to get in the way of his future growth/health.

I think it just depends.

dd1 was managed and tested from very young (under 18 months I think) without us really pushing for it, and is tested regularly to see if her dairy + egg allergy has improved.

We too haven't had any change come the age of 3, which is disappointing but were told there is still a good chance that by 5 they've gone.

good luck with kidney ultrasound.

May I ask you experts what symptoms of your children's lactose intolerance? Can these get worse over time rather than better?

Dh is lactose intolerant but we are just now exploring the possibility that ds2's runny bowels and foul farts are the result of the same thing. Trying to experiment with a lactose free week but symptoms don't seem to be conmsistently coming or going. Ds2 is 8 now so it seems quite late for us to discover this but his erm.. problems seem to be getting more explosive!

aDad - if it's a true allergy I would think you'd be more likely to get expert help than for an intolerance as the symptoms of an allergy can be more dangerous. The worst thing that's ever happened to us is we've had to do a few more loads of washing!

shimmy21 - DS's symptoms vary depending on what and how much he's had to eat. Most often it's diarhhoea and/or lots of wind and/or frequent bowel movements. Very occassionally he actually vomits but I think that's only happened once or twice. These symptoms can appear anywhere from 6-36 hours after he's eaten dairy.

The most recent, but very definite symptom, is trouble controlling his bladder. I KNOW he's only 3 1/2 and little boys his age sometimes are just like that but....take yesterday for example. After our visit with the consultant I took him out for lunch. I enquired about the scrambled eggs and they contained cream. So we opted for fish fingers - not the healthiest but usually a safe option for him. Excpet instead of chips they came with mashed potato. With butter. He was starving and I couldn't bear to take the plate out from under his nose. That afternoon he wet his pants twice. Although he is often a bit "damp" he almost never has a true accident unless he's eaten something he shouldn't.