Lactose Intolerance Pediatric Care Plan

By David Shafran, MD
Medically reviewed
January 19, 2021

What is Lactose Intolerance?

Lactose is a carbohydrate found in dairy products that, when ingested, is processed and absorbed in the gastrointestinal tract. Lactose intolerance occurs when a person’s digestive tract is unable to digest and absorb lactose. This is usually due to a low level of the enzyme lactase in the body, which is responsible for breaking down the lactose.

Typically, dairy products like cheese and milk cause the most problems for lactose intolerant people.

It is important to note that lactose intolerance is not an allergy.

Lactose that is not absorbed by the digestive system causes the symptoms of lactose intolerance, which usually include:

  • Gassiness
  • Stomach cramping
  • Diarrhea
  • Vomiting 
  • Bloating

How is Lactose Intolerance Diagnosed?

Usually, formal testing isn’t needed to diagnose lactose intolerance. In order to diagnose lactose intolerance, look for a pattern in your child’s food consumption and gastrointestinal symptoms.

There are tests that can help you know for certain. These include:

  • Hydrogen breath test: your child ingests lactose and the amount of hydrogen in their breath is measured. An increased hydrogen level suggests lactose intolerance.
  • Lactose tolerance test: your child ingests lactose and a blood test is done to see if there’s an increase in your child’s blood sugar. If the blood sugar doesn’t go up as it should, this suggests lactose intolerance.

Lactose Intolerance Treatment

The main treatment for lactose intolerance is to reduce dairy intake. Make sure that your child is getting enough calcium and vitamin D, vitamins that you typically get from dairy products. Children between 3 and 18 need 600 international units of vitamin D per day. 

Non-dairy foods that contain calcium include: 

  • Oranges and orange juice
  • Almonds 
  • Beans 
  • Dark/leafy vegetables
  • Tofu
  • Soy milk

You can also give your child enzyme supplementation/replacement. This will help break down lactose in dairy products. There are many forms of this treatment. Examples include Lactaid, Lactrase, and Lactrol. Give your child the supplement just before they eat dairy. 

Calcium Requirements by Age

AgeCalcium (mg/day)
1-3700
4-81000
9-131300
14-181300

Check in with K If…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care

See a Doctor in Person If….

  • Stomach ache persists even after elimination of lactose
  • Stomach ache becomes severe
  • Your child develops nausea and vomiting
  • Your child had excessive or bloody diarrhea
  • Your child is not able to keep down liquids
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.