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Lactose-free baby formula is a cow’s milk-based formula that is free of lactose, made for infants who have trouble digesting lactose, which is the sugar found in milk. Examples of lactose-free formulas include Similac Sensitive, Similac Alimentum, Enfamil NeuroPro Sensitive and Enfamil A+ Lactose Free.
What Is Lactose-Free Baby Formula?
Lactose-free baby formula is a cow’s milk-based formula that is specially processed to remove lactose, the sugar found in milk. Manufacturers then replace the lactose with another type of carbohydrate, such as corn syrup, to make it easier for babies with lactose intolerance to digest.
Lactose-free baby formula options include these:
Enfamil A+ Lactose Free
Enfamil NeuroPro Sensitive
Enfamil Simply Plant-Based
Gerber Good Start Gentle Soy
Similac Sensitive
Similac Alimentum
Because most lactose-free formula is still made with cow’s milk, these formulas are not suited for babies with cow’s milk allergy, or CMA. Lactose intolerance and CMA are two different issues, though they may share similar symptoms that can include diarrhea, tender bellies, gas and fussiness.
CMA is an immune reaction, while lactose intolerance is a digestive issue from inadequate levels of lactase (the enzyme needed to break down lactose), according to Nestlé Health Science. Babies with CMA may do better with a soy-based or hypoallergenic baby formula.
There are several varieties of lactose-free formula, low-lactose formulas and nondairy alternatives available in the U.S. Parents and caregivers should speak to their pediatrician to make sure a particular brand of lactose-free formula is right for their baby, especially if their baby requires preemie formula or has a metabolic condition called galactosemia.
Similac
Similac baby formulas are some of the most popular in the U.S. Two of their lactose-free formulas are Similac Sensitive and Similac Alimentum. These are milk-based formulas that are processed for lactose-intolerant infants.
However, Abbott Laboratories — the makers of Similac — issued a recall on baby formula in February 2022 for some lots of Similac made in its Sturgis, Michigan, factory because of potential bacterial contamination. If you purchased or plan to purchase Similac baby formula, make sure you check the recalled formula list.
Enfamil
Enfamil brand baby formula made by Mead Johnson is another popular brand of formula. Its lactose-free brands include Enfamil NeuroPro Sensitive and Enfamil A+ Lactose Free. Enfamil NeuroPro uses corn syrup as a replacement carbohydrate.
Unlike Similac, Enfamil brands haven’t been recalled recently.
Lactose-Free Dairy Alternatives
Some parents and caregivers may opt for lactose-free dairy alternatives, which are naturally free of lactose and aren’t made with cow’s milk. They are more suitable for babies with lactose intolerance and cow’s milk allergies.
These formulas are made with soy, rice or other types of plant-based protein. Formulas sold in the U.S are regulated by the U.S. Food and Drug Administration and have the same nutrition as cow’s milk-based formulas. Examples include Gerber Good Start Gentle Soy or Enfamil Simply Plant-Based.
Low-Lactose Formulas
Low-lactose formula has reduced levels of lactose but may have higher levels than lactose-free brands. Many popular formulas fall in the low-lactose category.
Examples include Similac 360 Total Care Sensitive, which has 98% less lactose than Similac Total Care, and Enfamil A+ Gentlease which is advertised as a low-lactose brand, not lactose-free.
“Low-lactose formulas such as Enfamil Gentlease is a good choice to reduce fussiness, gas, and spit up related to formula, however it is important to remember that it is not fully lactose-free.” - Steven Powell, MSN, APRN, NP-C (Board-Certified Family Nurse Practitioner)
Babies Who Might Use Lactose-Free Formula
Only babies diagnosed with lactose intolerance should use lactose-free formulas. Most babies will tolerate regular cow’s milk formula well, and this is the type of formula many pediatricians recommend for balanced nutrition.
Babies with diagnosed cow’s milk allergies shouldn’t use lactose-free formulas since they still contain milk and milk protein, which are the causes of allergic reactions in babies with CMA. Mothers with babies who are lactose intolerant can still breastfeed, though mothers of babies who are sensitive to cow’s milk should refrain from consuming dairy while breastfeeding.
Parents and caregivers shouldn’t assume a fussy baby has lactose intolerance without consulting their baby’s doctor. Lactose intolerance is uncommon in children younger than 5 years of age.
Potential Side Effects of Lactose-Free Baby Formula
The potential side effects of lactose-free baby formula are similar to those of regular baby formula and are usually related to digestion or formula contamination. Symptoms include bloated bellies, loose stools and colic.
Symptoms of bacterial infection from contaminated formula include crying, fatigue, fever and poor feeding.
If a baby with a severe cow’s milk allergy or rare genetic disorder called galactosemia consumes a lactose-free formula that still contains cow’s milk or traces of lactose, the side effects can be life-threatening. The safest formula for these babies is one derived from plants and naturally lactose-free.
Formulas made with cow’s milk, including lactose-free brands, may cause a higher risk of necrotizing enterocolitis, or NEC, especially in premature babies. NEC is a rare but potentially deadly disease that causes intestinal tissue to die. Some parents have filed Similac and Enfamil baby formula lawsuits after their babies developed NEC and died.
Possible Benefits of Lactose-Free Baby Formula
Possible benefits of lactose-free baby formula include better weight gain, less fussiness and less discomfort for the baby. Babies may be less likely to have reflux or spit-ups.
Because lactose intolerance can cause diarrhea, switching to lactose-free baby formula could relieve diarrhea and stop babies from becoming dehydrated.
Some babies see an improvement in symptoms in a few days, and in others, it may take weeks.
“Infants have specific nutritional requirements and different formulas are designed to meet specific needs. If you elect to feed with formula, discuss with your child’s pediatrician to ensure you are selecting the best formula for your child.” - Jennie Stanford, M.D., FAAFP, DipABOM (Family Physician & Obesity Medicine Specialist)
Switching to Lactose-Free Baby Formula
If you think your baby may be lactose intolerant, don’t switch to lactose-free baby formula without first consulting with your child’s pediatrician. It’s important to get an actual diagnosis before switching formulas because your baby may have a genetic disorder or cow’s milk allergy.
Once your child’s doctor has confirmed lactose intolerance, they will help you choose a formula that will work for your baby. Sometimes pediatricians have samples of formula for parents to try before committing to buying an entire container. If you have a formula you would like to try, let your baby’s doctor know so they can check the nutrients and ingredients.
Babies with digestive issues may initially have more challenges transitioning to another type of formula or from breastfeeding. Formula has a thicker consistency and is harder to digest than breastmilk. Highly processed formulas also have a more bitter taste.
A pediatrician may recommend slowly introducing the new formula and weening babies off the old formula or breast milk. After transitioning, make sure you monitor your baby for any signs of discomfort or symptoms and keep your pediatrician informed.
Author: Jennie Stanford, M.D., FAAFP, DipABOM (Drugwatch)
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