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Pediatricians Say Dairy OK for Lactose-Intolerant Kids

New guidelines stress the need for proper calcium intake for bone health

TUESDAY, Sept. 5, 2006 (HealthDay News) -- The American Academy of Pediatrics has a new attitude about consumption of milk and milk products by children with lactose intolerance: Hey, give it a try.

New guidelines say the academy "supports use of dairy foods as an important source of calcium for bone mineral health and of other nutrients that facilitate growth in children and adolescents." Specifically, it does not recommend eliminating dairy products to treat lactose intolerance.

In practical terms, said Dr. Melvin B. Heyman, a member of the committee that wrote the guidelines, the new advice is for parents of children with lactose intolerance, in collaboration with pediatricians, to "test the system and see how much milk, cheese and ice cream they can tolerate."

One reason for the new advice, said Heyman, who is a professor of pediatrics at the University of California, San Francisco, is that "we have more information about what people will tolerate. We know that children who have lactose intolerance have a tendency to tolerate some dairy products."

At least an equally important factor is the need for the calcium in dairy products, he said. "Young people have to get as much calcium as they can to lower the risk of problems with bones as they get older," Heyman said.

The new guidelines were published in the September issue of the academy's journal, Pediatrics.

An estimated 30 million to 50 million Americans have some degree of intolerance to lactose, the main sugar found in milk and other dairy products. They have a shortage of the enzyme lactase, which breaks down the sugar, and can experience unpleasant symptoms, including nausea, cramps, bloating, gas and diarrhea if they ingest too much lactose.

The condition is relatively rare in whites, but as many as 75 percent of blacks, 90 percent of Asian-Americans and nearly 100 percent of Native Americans suffer from it. Symptoms generally start appearing after the age of 2.

When symptoms do appear, the first step should be to make sure that they are not caused by another condition, such as irritable bowel syndrome, celiac disease, an infection or parasites, Heyman said.

If lactose intolerance is the problem, it's important to remember that the condition does not do bodily damage, however unpleasant the symptoms might be, he said. Careful testing can help determine which products affect an individual and which are a lesser problem. "Some people might tolerate yogurt but have problems with milk," Heyman said.

The important point is that young people get an adequate amount of calcium, he said. The guidelines note that the National Medical Association, an organization of black physicians, "recently recommended that black people consume three to four servings a day of low-fat milk, cheese and/or yogurt."

"If lactose-free diets are used for treatment of lactose intolerance, the diets should include a good source of calcium and/or calcium supplementation to meet daily recommended intake levels," the guidelines state.

More information

Visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases for more on lactose intolerance.

SOURCES: Melvin B. Heyman, professor, pediatrics, University of California, San Francisco; September 2006 Pediatrics
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