Question

Every time I give my daughter whole milk to drink, she ends up having diarrhea for a week. At first I thought it was a coincidence, but it has happened repeatedly. Is she lactose intolerant, and if so, what other types of milk can she drink to still get the same amount of calcium?

Answer

Lactose intolerance can happen to anyone, although it is most common in people of African, Asian, and Native American descent. You do not mention how old your child is, but this tends to occur by about age 3 or 4, although it can appear at any time. Often there is a family history of difficulty digesting milk. Symptoms may be mild or severe. Cramping, bloating, gas, and diarrhea appear within two hours of drinking milk. Some people who are lactose intolerant can eat dairy products such as yogurt and cheese because the lactose has been broken down in processing. Others have symptoms with any small amount of dairy. If your child can tolerate other dairy products, the issue is easier to deal with. You can buy lactase enzyme preparations and milk with reduced lactose. Soy milk may not be the answer because many children who cannot tolerate lactose are also sensitive to soy. Rice milk with added calcium and calcium-fortified orange juice as well as canned fish with bones (salmon, sardines), tofu, broccoli, garbanzo beans (chickpeas), and dark green, leafy vegetables are alternative sources of calcium. Calcium requirements vary with age. Children age 1 to 3 need 500 milligrams a day, those 4 to 8 years old need 800 mg, and children age 9 to 18 need 1300 mg. It is relatively easy to meet those requirements if you pay attention to the calcium content of the other foods you offer.