Aoife Hearne: Baby’s intolerance to milk could be an allergy

As a dietitian, I have a great interest in nutrition for children, but when it comes to specialist areas such as food allergy or intolerance, it is critical to get advice from experts in the area. 

Let me introduce Caroline O’Connor, a registered paediatric dietitian, lactation consultant and mum of four. Caroline is the founder of Solid Start and has more than 20 years of experience working with babies, toddlers and children.

I put your question to Caroline, who gave the following advice:

The first step is to distinguish between an allergy and an intolerance. An allergy will generally involve the immune system, and you may see symptoms such as itchy skin, flare-up of existing eczema, and swelling of eyes, lips, and face with or without digestive symptoms. But, if it’s an intolerance, the most common symptoms are digestive such as bloating, tummy pain, wind, and very loose stool.

What your baby can drink at one year old will depend if she has been diagnosed with lactose intolerance (a sugar in breastmilk, formula and cow’s milk) or cow’s milk protein allergy (either an immediate or delayed allergy to the protein in regular infant formula and cow’s milk).

Babies with lactose intolerance are generally prescribed a lactose-free formula and when they hit their first birthday, they can start drinking lactose-free cow’s milk. Branded and own-brand varieties are available in all supermarkets.

Lactose-free milk is cow’s milk with the enzyme lactase added to make it easier to digest. It tastes the same as regular semi-skimmed milk and, just like regular milk, is an excellent source of protein and calcium.

Babies with a cow’s milk protein allergy usually drink a specialist hypoallergenic formula. A few choices are available when babies turn one, depending on their overall diet, growth and other medical conditions:

• 1. They can continue drinking their hypoallergenic formula;
• 2. They can switch to a well-fortified soya milk drink if soya is tolerated;
• 3. They can switch to a well-fortified oat-based milk drink if they are otherwise meeting the protein requirements in their diet.

All babies and young children following a milk-free diet should consult a registered dietitian for personalised advice to ensure they consume adequate protein and calcium.

If you have a question for dietitian Aoife Hearne, please send it to parenting@examiner.ie