Lactose intolerance (perhaps) in 2yo. Don't know what to do next.

[MuffinMclay]

I posted a few weeks ago about ds1's possible lactose intolerance. After weeks, if not months, of horrible nappies (that were getting worse), I decided to try him on a dairy free diet.

After 3 days dairy free he was doing normal solid poos (LOL can't believe my life now revolves around discussing poo ). He then continued to do solid poos once or twice a day for the next 10 days. Fantastic!

Unfortunately since Thursday he has had horrible nappies again. He doesn't seem unwell (although there is small a chance he could have caught mumps from playing with his cousin), and isn't teething.

I feel at a loss to know what to do for the best for him now. He did have some dairy stuff on Thursday (biscuits at mother and toddler group), but has had no other dairy products at all. Is it really likely that they could still be having an impact 5 days later?

I don't want to reintroduce dairy stuff if it is a problem, but wonder if it could be something else altogether.

I don't know where to turn for advice (apart from MN). GP is notoriously unsympathetic about food allergies etc, and will say it is a phase. I asked hv for advice, and she was utterly useless (and made me feel like the world's worst mother at the same time). It is really getting me down now.

Are there (reliable) people one can see privately for advice about this sort of thing?

Private allergy/intolerance testing is rife with quackery so I personally wouldn't advise it. I would press your GP for a referral to a specialist consultant.

FWIW I did a dairy and egg exclusion diet for DS's eczema (made no difference) and was told by the consultant that it should be carried out for two weeks minimum to reach any firm conclusion. Was it totally dairy-free, ie no whey etc?

Stupid question time - what would I find whey in? What is whey?

Just been checking all packets (and googling whey). I'm pretty sure he hasn't eaten any (apart from last Thursday's biscuits - no idea what was in them).

Sounds like you've already checked it out but whey is a dairy by-product found in lots of products including some biscuits.

For any exclusion diet to be accurate it needs to be followed 100%, so if you want to carry it on I would count Friday as his first dairy-free day, then stick to it religiously for two weeks and see if he still has symptoms.

I'll do that.

Another horrible nappy this morning.

my ds had symptoms like your dc and i took him off wheat and it made a difference straight away like you say... solid poos for the first time! its been less than 2 weeks and hes eating better (think the bloating was ruining his appetite). Unfortunately he now has a chest infection and i expect the antibiotic will affect his nappies now.......

That's the thing. I wonder if I've removed the wrong stuff from his diet.

I can't decide whether to remove wheat as well as dairy, or bring dairy back and remove wheat. Rhetorical questions really.

I feel a bit out of my depth with all this, but don't know where to get good professional help. I don't like treating him as a scientific experiment.

I feel sorry for him because all his favourite foods are dairy ones - cheese, yoghurts, filled pasta etc.

It does sound like your child is reacting to the dairy products. At this age it's more likely to be an intolerance to cow's milk proteins (including whey or casein) than lactose. I'm sure by googling you can find out more about the differences - and you can always try to get hold of a copy of my favourite book by Jonathan Brostoff and Linda Gamlin which is very comprehensive on reactions to food.

And although it is quite a delayed reaction he could be reacting to something in the biscuits. Unfortunately some kids react to milk and to wheat too. I know how much of a pain it might be, but if you are going to cut out wheat, keep him off dairy at the same time. If you make more than one change at a time it's hard to know for sure what is going on. Then reintroduce them one at a time, with at least a week in between, to check the reactions to each.

I agree that it's really hard to find someone private and trustworthy to help you through this. I know too many people who have been to see private nutritionists/nutritional therapists or alternative therapists and ended up with a huge list of foods to avoid. In my opinion they are avoiding most foods unnecessarily, and have awful diets as a result. Plus they seem to end up spending loads of money on supplements .

Unfortunately the NHS recognition of and treatment of food sensitivities is patchy to say the least. If your child shows a clear classical reaction i.e. an allergic reaction pretty soon after having a food, and a clear result from skin prick tests, they should be able to sort out what's going on. I'm not sure what (if anything) would be done on the NHS even if you could clearly show them that your child's loose stools were related to milk. My ds1 had a cow's milk and soya intolerance and I had varying responses from the various health professionals we saw about him. There was one good dietitian but she went off on maternity leave after only a couple of appointments and we never saw her again. The next dietitian we saw was more interested in telling me how to wean ds2 and gave me a booklet by the Dairy Council . In the end we just worked it out ourselves - we kept both boys off cow's milk and soya for quite a while and then decided when to try to reintroduce it.

I went to see Dr Gideon Lack privately about ds2, who had severe reflux and other GI problems, to check if he was having reactions to food. Luckily ds2 doesn't appear to have any. But Dr Lack is more of a classical allergy specialist than someone who deals with intolerances so once the skin prick tests were clear I'm not sure how much further he could have helped.

Thank you mummypig, that is really helpful. I do have that book, and it makes interesting reading.

Would you recommend Dr Lack? Just googled him, and he is within travelling distance of us.

I don't know. Dr Lack was a lovely man. If your dd had coeliac disease, or a classical allergy, I'm sure he would be very helpful. I'm just not sure how much help he would be with other intolerances. I expect he knows a lot more about them than most paediatricians, though. And he certainly wouldn't dismiss your concerns. I find it's always good to talk to a medical professional who doesn't treat me like an overconcerned parent.