Caring for a lactose-intolerant child can present a few challenges and demand some changes in your typical childcare routine, specifically regarding dietary and nutritional concerns. Lactose intolerance is a condition caused by a deficiency of lactase, an enzyme that’s produced by the cells that line the small intestine and assist in the breaking down of lactose into glucose and galactose, which are easily absorbed into the bloodstream after being broken down.

Symptoms of Lactose Intolerance

When dairy products pass through a body with normal levels of lactase, lactose is broken down into manageable compounds that the body digests easily. When lactase-deficient children ingest foods and drinks containing lactose the missing enzymes cause the lactose to pass through the small intestine into the large intestine without being broken down. Once there, the native intestinal bacteria cause it to ferment into acids and gases. The result of that process leaves your charge with cramps, diarrhea, gas and abdominal pain for anywhere from 30 minutes to two hours after consuming foods containing lactose. For some children, the severity of the symptoms are such that lactose and dairy products must be eliminated from their diet altogether. Others, whose symptoms are milder, may be able to manage their diet by limiting the amount of dairy products they consume to avoid discomfort. It’s important for caregivers to know which camp their lactose-intolerant charges fall into.

Who Suffers From Lactose Intolerance

While all people have the potential to develop a lactase deficiency that leaves them lactose intolerant, the condition is more common among those of Asian, African, Native American and Hispanic lineage. Those that develop lactose intolerance generally struggle with the condition for the rest of their lives, though some children may recover after ending a course of certain antibiotics or recovering from a gastrointestinal infection.

Lactose Intolerance in Infants

Although some parents believe that their babies and toddlers are lactose intolerant, the truth almost always lies in an allergy to cow’s milk. The vast majority of infants are capable of processing lactose since it’s found in both breast milk and most infant formulas. According to the Children’s Hospital in Boston, lactose intolerance almost never develops before two years of age. Most children that do develop low lactase levels do so between five and seven years of age, though many do maintain a tolerance to lactose throughout their lives.

Dietary Restrictions and Physician’s Supervision

One of the primary methods of diagnosing lactose intolerance in adults is to strictly avoid lactose and follow up to determine symptom resolution, however, children should not be placed on any restricted diets without the recommendation and supervision of a physician or registered dietitian. Proper growth and development during the childhood years relies heavily upon a nutritious diet comprised of various vitamins, minerals, fats and proteins. If your charge’s pediatrician recommends a lactose-restricted diet, she’ll also identify alternative sources of nutrition to replace those lost nutrients.

Vitamin D and the Lactose Intolerant Child

A primary concern of parents and pediatricians in regard to children with a lactase deficiency is the development of a vitamin D deficiency, which can cause rickets and other health problems. Because most commercially-available milk is fortified with vitamin D, it is one of the more common sources of the nutrient in children’s diets. Inadequate vitamin D and calcium absorption can be avoided in the lactose intolerant child with consumption of a daily multivitamin and foods that are rich in calcium, including broccoli, kale and kelp. Because so many children are reluctant to eat these foods, fish and some fortified cereals can be a good source to help to prevent deficiencies as well.

How Childcare Providers Can Help Children Manage Lactose Intolerance

The most important thing that a childcare provider can do for a lactose intolerant charge is to listen carefully to his parents, noting what does and does not work for their child in terms of dietary habits. While lactose intolerance is not life-threatening, like milk allergies can be, the discomfort and pain that a lactase-deficient child suffers after ingestion of dairy products can be quite severe. Rather than experimenting with the child’s diet yourself to find a solution, work closely with your employers and their pediatrician in order to find what works best for him and his body. There are some digestive aids and lactose-free milk products on the market, including drops and tablets that contain the lactase enzyme. These digestive aids can be very effective in controlling symptoms for some children, but you should always consult with your employers or your charge’s pediatrician to ensure that they’re recommended for use. It’s also important to help younger children learn how to manage their own diet as they get older, so that they’re well-informed about which foods are safe and which ones could cause a flare-up of symptoms.

http://www.nannyjobs.org/blog/important-information-for-nannies-to-know-about-lactose-intolerance/