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Thread: Sudden intolerance to lactose in breastmilk?

  1. #1
    Join Date
    Aug 2013
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    Default Sudden intolerance to lactose in breastmilk?

    Hi ladies -

    I am really struggling here and I thought I'd come to you (again) for your wisdom.

    I've been on the forum before mostly for issues having to do with my indifferent nursling. Since day one I've been through so many nursing strikes and plugged ducts and taken all sorts of measures to get her to nurse but we managed to nurse exclusively for one year and she arrived at her first birthday in the 100% percentile.

    She is now 13 months old.

    She started solids around 7 months, very slowly, with vegetables, fruits, rice and oats, and built up to yogurt, cheese, tofu and animal protein with no problems.

    Then, around one year old, she came down with a bad case of diarrhea. I thought it was a virus but a week went by and she was not getting better. She had no fever or vomiting or temperament change other than pickiness with solid food.

    Once major infection was ruled out, her pediatrician told me to cut out all dairy as she suspected lactose intolerance as a result of the diarrhea. But the diarrhea has persisted. So now the pedi is telling me it's the lactose in my breastmilk!

    My daughter had no difficulty with breastmilk as an infant, no colic, barely any spitting up, etc.

    Have any of you heard of toddlers suddenly becoming intolerant of their mother's milk after a year?

    I've fought so hard to nurse this baby so to be told that my milk is poisoning her is really difficult.

    But she's starting to lose weight so I feel like we need to do something.

    To make matters worse she seems to be starting ANOTHER nursing strike (or weaning? How will I EVER know?) as she is biting me when I offer the breast during wakeful periods and only suckling (i.e. not drawing milk) before bed and naps.

    So I've pulled out the pump which I SO happily put away a few weeks ago based on the advice here that I could finally RELAX nursing an older baby and now I'm pumping again to replace feedings as if she were a newborn.

    I don't want to give her cow's milk, almond milk, or soy as it could make things worse (or more confusing) so I am giving her sippy cups of pump milk after she rejects me (I didn't do this at first but I am worried she is dehydrated from the diarrhea and I'm concerned about the weight loss).

    I know there's a lot going on in this post but I am really desperate for advice and support. Everyone around me has been telling me to wean for months, and now the fact that her doctor is blaming my milk for her GI issues and my daughter herself doesn't seem to want to nurse, I feel like I'm fighting a losing battle.

    I'm doing a lot of crying these days and I feel really alone in trying to figure this out.

    Thanks in advance.

  2. #2
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    May 2006
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    Default Re: Sudden intolerance to lactose in breastmilk?

    It would be very unusual for such a young child to suddenly develop true lactose intolerance. Because babies and young children are designed to consume breastmilk, they are also designed to digest lactose. The production of lactase, the enzyme that breaks down lactose, peaks in infancy and early childhood. People who become lactose intolerant typically do so later in life, usually in adolescence or adulthood.

    Now, what could be happening- and what seems much more likely to me- is something called "secondary" lactose intolerance, which often follows a gastrointestinal illness. The illness results in a temporary decrease in the production of lactase, and therefore in a temporary difficulty with the digestion of lactose. As the gut heals from the gastrointestinal illness, the production of lactase will rebound and the person will be able to digest lactose again. Now, if this is the problem, then it's not like your milk is "poisoning" your child. It MIGHT give her some increased gastrointestinal distress (diarrhea, flatulence, tummy rumbling, bloating, abdominal discomfort, maybe even nausea and/or vomitting), but it's very unlikely to result in weight loss.

    So, let's talk about the diarrhea- how long has it lasted? Is baby getting dehydrated? Is it happening every single day? Is there any sign of improvement? What is baby eating, in terms of solids, at this point? Are you pushing the BRAT diet (bananas, rice, apples, toast) and avoiding the "P" fruits (prunes, plums, aPricots, peaches, pears)? Are you giving baby a daily probiotic? Is baby actually losing weight, and if so, how much?
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
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    Aug 2013
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    Default Re: Sudden intolerance to lactose in breastmilk?

    Diarrhea has lasted 4 weeks. She will have 2 bouts on a good day, 5 bouts on a bad day (seems in proportion to the amount of food she's consumed). It's always very copious and stinky and has loads of undigested food in it (sorry).

    She was on the BRAT-Y diet after the first week, then the BRAT diet (no dairy), then they told me to resume a "normal" diet just no diary. We've been trying this about 5 days.

    But her pickiness has remained and I can hardly get her to eat anything but cheerios and fruit.

    She is offered the breast but only nurses about 4 times a day and I have NO IDEA how much she's getting as sometimes she nurses 30 seconds and other times she nurses to sleep but it does not seem (to me) that any milk transfer is happening.

    I am giving her water to prevent dehydration and sometimes pumped breastmilk. I do not think she's dehydrated - she might only have 2 wet diapers/day but the diarrhea diapers could also be wet, it's just hard to tell because they're soaked with diarrhea.

    For some unexplained reason, on Monday last week she had 2 normal BM's out of the blue (while drinking breastmilk), then on Tuesday the diarrhea started again (they guessed it was because I put a wisp butter on her oatmeal) but now she's had NO dairy for 3 days and she's still having diarrhea.

    She tested positive for malabsorption which is a test for residual carbohydrate in the stool - of which lactose is apparently the most common. (Technically it could also be glucose or fructose or maltose, etc…)

    So that's why the pedi is blaming the lactose in my breastmilk. She said, "since she's one you're going to wean her anyway so let's just give her Lactaid." Um… nope.

    I am giving her a non-dairy probiotic in water. Sometimes she drinks it, sometimes not.

    She's lost just under a pound.

  4. #4
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    May 2006
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    Default Re: Sudden intolerance to lactose in breastmilk?

    Do you trust the pediatrician's scale? A big dip like that... Could be scale error.

    I still don't see any real reason to think that your child is lactose intolerant. AFAIK, the diagnostic test for lactose intolerance is a breath test that has nothing to do with the stool. But if the pediatrician is hellbent on this being lactose intolerance, then why not manage it instead of suggesting premature weaning? You can buy lactase pills and lactase powder, which you could add to your kid's breastmilk sippy cups. This might be an avenue to explore, just to try to eliminate the lactose variable.

    I would go back to the BRAT diet for now. It's not harmful and could be helpful.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  5. #5
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    Default Re: Sudden intolerance to lactose in breastmilk?

    I will ask for the breath test. That's a good idea.

    I can't believe she's embarking on yet another nursing strike in the midst of all this. She totally refused me most of the day and I only managed to pump once.

    I feel like I've been fighting her for months and now with all this other stuff going on I just want to give her something to make her feel better and - as a mom - I hoped it would be my breastmilk. But she wants nothing to do with it.

    Hooking back up to the pump 4-5 times a day feels so devastating. I've barely left the house in a year since she won't nurse in public and I was really looking forward to feeling a little human again!

    Without nursing I can't just give her water since her solid intake is so bad right now but if I offer her alternative non-animal milk, I feel like we're weaning.

    Is there something in-between that I'm just not grasping?

    So confusing.

  6. #6
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    Default Re: Sudden intolerance to lactose in breastmilk?

    And yes, I have a scale at home too so that weight drop is accurate.

  7. #7
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    Default Re: Sudden intolerance to lactose in breastmilk?

    Babies this age rarely self-wean. They're just too young and their intake of solid food is often too erratic to make up for shortfalls in nursing. But there are some babies who go on nursing strikes and self-wean early. The only thing you can do is to patiently and calmly offer the breast, and not feel hurt if the baby turns you down. Meanwhile, continue to offer baby plenty of solids and sippy cups. I think that if she is refusing to nurse, you should give her some dairy in her sippy cups- Lactaid or animal milk dosed with lactase (which is all that Lactaid is) or breastmilk are all fair choices. Almond, rice, or soy milk is probably less good, because the nutritional makeup is too different from human milk- talk to your pediatrician if you want to use one of those, instead.

    Offering a sippy full of milk is not the same as weaning nor is it all that likely to hasten weaning. Kids who are into nursing don't suddenly start turning up their noses at mom just because she gave them some cow's milk in a cup.

    What you do about pumping is very much a personal choice. If you're really dedicated to keeping your supply going and making sure your child gets some breastmilk even if she self-weans, then pumping is going to be part of your life, sucky as that is. But if you decide you're ready to let go, nursing if your child wants but not forcing your supply to keep going by employing the pump, that's okay, too.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  8. #8
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    Jun 2009
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    Default Re: Sudden intolerance to lactose in breastmilk?

    fwiw my child, at 13 months, had diarrhea for 3 weeks-21 days. Then very loose poops for ages after, many weeks-they have only started looking like they did ‘before’ a couple days ago. But it was no longer diarrhea (I assumed) because it was not as frequent. (When she had diarrhea she pooped at least 5 times a day)
    I was a wreck, but my daughter’s pediatrician was calm. He never even suggested or tested for lactose intolerance. To be fair, her weight seemed ok and she was certainly never dehydrated, because she nursed a lot.

    WHY would a child suddenly stop being able to tolerate breastmilk? It simply makes no sense. I would be much more likely to suspect that some other food or illness was/is the culprit.

    She said, "since she's one you're going to wean her anyway so let's just give her Lactaid." Um… nope.
    Unfortunately this indicates your pediatrician is not breastfeeding friendly. But of course you knew that.

    An excellent book for parents dealing with any eating or weight gain issues is My Child Won't Eat.

  9. #9

    Default Re: Sudden intolerance to lactose in breastmilk?

    I just want to say it sounds like you are doing and have done an amazing job at giving your child what you know to be the best, and you have fought a consistently uphill battle to do it. My daughter had a cow's milk protein intolerance, which is different from what it sounds like your baby has, and we also went through a 17 day nursing strike and loads of diarrhea and vomiting to figure out what was going on. I just want you to know that I'm standing and clapping for you from here for the job you are doing for your child.

  10. #10
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    Default Re: Sudden intolerance to lactose in breastmilk?

    Thank you so much, emmamama - that means the world to me. I know only other mothers understand how heartbreaking it is to finally get something IN your child only to see those hard-won calories exit one way or another too soon for any good to be done. How did you get through a 17 day nursing strike? How did you know it was a strike and not weaning?

    I know it's unusual for babies to self-wean before 2 but they must be out there - and knowing the difference between a strike and weaning continues to perplex me.

    I am so afraid I'll mistake her signs as weaning and then she'll decide to come back when she's feeling better and I'll have dried up. She's so much less interested when my supply is this low anyway it's hard to imagine she's going to put in the "work" to rebuild it. Especially when she can drain a full sippy cup in 1 minute flat.

    In the meantime, today she had so much diarrhea I couldn't even believe what I was seeing. I am insisting on more labs. I went to pick up more vials today.

    lllmeg - did they ever diagnose your daughter or make any suggestions as to why she was having GI distress for so long? We are on week 4.

    I did get My Child Won't Eat based on advice on this forum. It's a great read and I wish he was my pediatrician but I think he talks mostly about the weight curve slowing between 1-3 and not necessarily toddlers losing weight. I just think that can never be good!

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