Lactose intolerance in breastfed babies?

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I EBF my three-month-old son. From birth he has been colicky (first two months), then we had a few weeks of silent reflux which cleared up by itself, and now for the past eight days we've dealt with green poops/diarrhea/terrible gas pain. He has no fever, so our ped doesn't think it's a virus.

My son did have his first set of shots eight days ago, so I don't know if that's behind the new digestive issue, but I've been mulling over the idea that he's lactose intolerant. Both my husband and I have severe lactose intolerance, and as such neither of us have eaten cow's milk for about twenty years.

How does lactose intolerance manifest in babies? My son is gaining weight well, meeting milestones etc. but rarely does a feeding/bowel movement go by where he isn't in some state of discomfort.

Genuine primary lactose intolerance is really rare, as you will know better than anyone here. If there's a genetic component (I don't know) then of course he may well be. Some of the symptoms that you describe would certainly suit, atlhough they could be due to other conditions as well.

As you will very well know, all milk including breastmilk has lactose in it. Can you approach your doctor to discuss a lactase supplement?

The only other option if it IS LI is a milk-free formula but this would not be a choice I'd make until I'd established whether it was transitory or permanent LI, and whether treatment would work to allow you to keep BFing. Milk-free formula tastes horrible, and has its own risks like any formula and while your baby would be fine on it it wouldn't of course have all the other important components other than just being a food.

Kellymom has quite a bit of info on lactose intolerance in bf babies.

Human milk has human lactose rather than bovine lactose which is what humans react to as it's a foreign food to us, bovine lactose doesn't pass through to breastmilk. I've never heard of a baby being intollerant to human lactose.

It could be one of those things that bfed babies get. All of my babies have had runny smelly green stools at some point and only one of them has had an allergy, dd3 has a milk protein intollerance which she is thankfully outgrowing atm aged 18 months. Baby shots can definately have an impact on babys tummy, most babies get ill in some way afterwards.

Most of the time with a food allergy it will involve vomiting as well as stomach pains, runny poo, excess gas, they can also develop a rash, swelling, welts on the skin. With dd4 she developed a rash at about 4 days old, then a few days later she started posseting alot which over a week or two turned into reflux, that developed into acid refux and she was in pain and vomiting most of the time, when there was no milk left in her stomach she was bringing up clear stomach acid. She wasn't gaining any real weight, maybe an oz or two a week. I went dairy free so I could carry on feeding her until she was 8 months, then we switched her to soya formula.

It doesn't sound like your son has an allergy to me, he sounds very windy (my dd1 was a windy colicy baby who did gassy explosive poo's). Has he been checked for tongue-tie? It can cause a shallow latch and make baby swallow more air than they should while feeding (this will be more likely if you had problems bfing early on with sore crack nipples despite a seemingly good latch). When a baby has alot of wind in thier gut it can make thier poo green.

rika lactose is a sugar which is in all milk. It is possible to be intolerant of it but it's very, very rare in infants because, of course, they are designed to drink milk. You may be thinking about the protein in milk. It's much more common for human babies to be cow's milk protein intolerant.

It is more likely to be a reaction to the shots as you suggest, however as the OP has a strong family history of genuine LI then I wouldn't discount it as I don't know if it's something that can be passed down.

This is a medical issue OP, but we can offer information on milk options if you find you need it.

My 3 month old is on Enfamil O-Lac as he was exactly the way you explain your baby to be BUT I was not BF him. I was up until he was 2 months but had to stop. I put him on Apatamil, horrible green pop and smelly gas. Then tried SMA, same thing. My HV then suggested lactose free formula and I could see the difference immediately.

The only way you can find out for sure is to go to a dietician. But from what I've been told your baby can be allergic to your breast milk. It may be something which your eating.

My youngest daughter is milk protein intollerant (she is growing out of it atm). I can't find the article that I read ages ago but it said that the lactose in cows milk and the lactose in human milk is slightly different, was this article wrong?

bella "allergic to your breastmilk" is a phrase that doctors can come out with which means nothing. A baby may be intolerant of a component in milk, eg lactose, or of something like cow's milk protein which may be able to be passed through a mother's milk. This is someone different to being "allergic to your breastmilk". :)

rika I don't know without reading the article :)

My ped is extremely supportive of breastfeeding (militant, you might say--but in a good way!) so I'm going to discuss this with him next week. I imagine he'll try to find ways to improve the situation, rather than suggest formula, though of course I'll always do what's best for my son. This article seems to suggest that LI has a genetic component, and it also talks about transient LI. I wonder if the shots have hampered his ability to produce lactase?

www.babycenter.com/0_lactose-intolerance_1201464.bc

My son does have spit-up, some of which is clear, some of which is thicker and flies out, but not in any huge quantities. His gas is horrendous, though.

If he's bringing up clear fluid is could be reflux which can be caused by an allergy but also is common in babies under 8 months because the little valve at the top of the stomach doesn't close properly, it tends to get worse between 4-6 months. Reflux babies tend to be windy too because they gulp and swallow alot to try and get the acid back down. Doctors don't tend to do much about reflux unless it's affecting weight gain unfortunately.

Does the clear fluid/sick smell acidic? My daughters was so strong it would make your eyes water if you we near her.

It may be that he had a virus (even without a fever..not all viruses produce fever) that has damaged the gut slightly and he is now recovering from that (it takes as much as 4-6 weeks) and possibly has a slight lactose intolerance temporarily while the gut recovers. this page is quite good particularly this section may be of interest:
A diarrhea illness can often persist for a few weeks. Intestines heal slowly after the initial illness. The loose stools from temporary lactose intolerance can continue to be a nuisance for 3 ? 4 weeks as the intestines recover. As long as baby is generally well and has no fever, abdominal pain, your child is in the recovery stage. During the one-to-six-week recovery period from an intestinal infection your doctor may advise using a nonlactose soy formula, since the healing intestines may not tolerate lactose.
We have something very similar with DD (6 mo and ebf). She had a nasty tummy bug, but without fever..lots of diarrheoa and quite a lot of possetting...about 4 weeks ago, but is still suffereing with painful wind and runny poo. We've been using a probiotic sachet syringed in with cooled boiled water and, because she may have temporary LI we're also using lactose enzyme drops (colief in the UK) before each feed to help her digest the breastmilk better. My paed (we're in Spain) suggested a LF formula but DD won't take a bottle or the drink the formula and I didn't want to go down the formula route anyway. She seems a little better since starting the drops.
HTH