It is commonly seen in infants and young children who are not able to tolerate milk properly. It relates to insufficiency of enzyme lactase. The degree of lactase deficiency may vary in individuals. Lack of lactase does not break down the sugar present in milk as a result it passes unchanged into the large intestine where it gets converted to lactic acid by bacteria which causes diarrhea, discomfort, distension and abdominal pain. The problem is genetically and often seen in infants and young children, but may be present in adults also.


  1. Anorexia and nausea

  2. Intestinal distension

  3. Abdominal cramps

  4. Gas and flatulence

  5. Severe diarrhea

  6. Under-nutrition and loss of weight

Dietary management

It depends in the level of lactase activity. Various diagnostic tests are available to determine that level. Depending on the level of activity (very low level, moderate level), the dietary treatment could be planned.

Very low level of lactase activity –

  1. All milk products must be eliminated, substitutes of milk like soya milk, groundnut milk and their preparations could be given.

  2. Enzymes such as lactaid, maxilact are available in the market. Addition of these in milk or its products could digest 90% of lactose in milk and minimizing symptoms of lactose intolerance.

Moderate level of lactase activity

  1. Intake of milk is restricted depending on the tolerance

  2. Fermented and cooked form of milk should be preferred.

  3. Buttermilk, curds, custards, porridges and cottage cheese (paneer) can be used.

Some tips

  1. Milk can be substituted with tofu, soymilk, soy curd, and groundnut milk.

  2. Take a well balanced diet.

  3. Small amounts of milk in moderate lactose activity can be tolerated if taken with other foods like after a meal, or a snack.

  4. Curd is better tolerated than milk.

  5. Some commercially available foods with low lactose content are also available like ice-creams, cottage cheese etc. Try them.

  6. Lactose enzymes are also available. These can be added in the milk.

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