Please could someone explain lactose intolerance/CMP intolerance?

[Flowerface]

My 6.5 mo EBF DS had a month's worth of green diarrhoea after a virus. He was otherwise well. I gave up dairy and it went within 24 hours. I assumed this was a cows milk protein sensitivity and that I had to strictly eradicate all dairy. But the HV said that CMP sensititivity usually involves rashes, etc, and that it sounded more like lactose intolerance. But (and I realise that this may be a truly dunderheaded question...) surely breast milk contains lactose?!

The HV said that butter and cheese contain very little lactose so it should be OK to eat them. But I am fundamentally confused about the whole thing. I know I could just try eating things and seeing what the results are, but I have become used to life without 30 green nappies a day, and I don't want to go back!! Can anyone offer any clues or experiences?

TIA

You are fundamentally confused? Your HV definitely is. Breastmilk is totally full of lactose, made by your very own body, and so even if you cut out all traces of dairy your baby still wouldn't thrive if he had an ongoing problem with lactose :)

Sometimes after a stomach bug, people can develop secondary temporary lactose intolerance which can present with diarrhea among other things. This rights itself after a while usually, as the gut gets better. It could be that your son had this temp lactose intolerance and was going to get better anyway and that it was just coincidence that it happened when you cut out dairy.

On the other hand..... CMPI is not always associated with rash. DS had fairly severe CMPI with associated feed refusal and all sorts, but was never rashy. Peachy skin. So your HV is wrong about that, too.

I think it would be unusual for CMPI to appear for the first time at 6 months of age unless you had also at that point just started weaning him on things like fromage frais and cheese.

I think it is quite easy to be tested for lactose intolerance. My dh was explaining this to me last night (is a dr) did mention cmp but only in relation to a baby being formula fed. I would go and see your gp rather than talkin o a health visitor I I were you.

breastfed babies can have cow's milk protein allergy swimbikerun although not many GPs know about that

GP is way to go. I think there's a residual stool test or some such for lactose intolerance in babies, or hydrogen breath test for older ones.

CMPI is far harder to test for unless it's a proper immune-mediated allergy (e.g., the hives and anaphylaxis sort).

We found that even the paediatric allergy doctor didn't believe our daughter's symptoms were signs of non ige cows milk protein allergy. Reflux, conjunctivitis,snot, chesty cough, chest and ear infections, mouth breathing.

He believed there was a strong case for keeping her off dairy but that it was more likely a chemical in the milk causing it . NICE guidelines were quite helpful.

Good lord, salamanger..... the mind boggles.

Thanks everyone, though I am still quite confused! I am convinced that the change in diet made him better, but suppose I will jst have to experiment. The dr was very uninterested in the whole thing. DS is massive, so I think they are unconvinced that there could be anything much wrong.

DS is not at all interested in solid food at the moment. He may have ingested a microscopic amount of avocado, but nothing dairy - everything is coming from me...

When this was us, I slowly introduced the bits of dairy I was finding hard to replace (butter on toast first, then chocolate!), both of which he was fine with. Eating cheese on toast had some undesirable effects, so I stopped with that for another few months, and then increased things again.

temporary lactose intolerance is possible, lactose intolerance from birth would have resulted in a failure to thrive, which it doesn't sound like. CMP sensitivity sounds possible, but strange to have picked it up now?

BM (and all milks) are stuffed full of lactose, BM can contain traces of CMP if Mum ingests it.

He definitely wasn't failing to thrive - he is 99th centile! He was fine until he had this horrid cough and then he had a month's worth of hideous diarrhoea afterwards and was otherwise well...

Flowerface - did it really change within 24 hours?
My 4mo ds has been going through the green nappies thing for the past 3 weeks. GP advised it was a virus and to just bf through it, also cutting out dairy, but this hasn't made any difference for ds. GP said it could take 6-8 weeks to return to normal, but wondering what happens if it doesn't change, will I have to be dairy free forever?