Breaking down lactose intolerance & lactose-free milk

Written by our Horizon Organic Dietitian, Alysse Ritter, MS, RD

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What is lactose?

Dairy is made up of water, fats, carbohydrates, proteins, and a variety of vitamins and minerals. The predominant carbohydrate, or “sugar” in dairy is called lactose. Lactose is found in varying amounts of milk, cheese, yogurt, cottage cheese, ice cream, and other dairy products.

When is there an issue breaking down lactose?

Normally, when lactose is consumed, our bodies make an enzyme called lactase. Lactase is released in our small intestines and helps to break down lactose so it can be taken up by our bodies and used for energy.

Some people’s bodies are not able to breakdown or digest lactose as their bodies only make a small amount of lactase or may not make any lactase at all. For these individuals, when lactose is consumed but not broken down and absorbed properly, it continues through the intestines where bacteria are able to use it for a source of energy. As the bacteria digest the lactose, individuals may experience symptoms including gas, nausea, vomiting, bloating, “rumbling” belly sounds, belly pain, and diarrhea. The symptoms vary from person to person, ranging from mild to severe. Severity of symptoms may also be dependent on the amount of lactose consumed. While some people may be able to consume small amounts of lactose and may only have mild symptoms, others may not and can experience more severe symptoms. The occurrence of these symptoms and the inability to break down lactose is called lactose maldigestion or lactose intolerance.

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Who is affected by having a lactose sensitivity?

Babies typically make high amounts of lactase, but this enzyme can decline or even become fully absent later in life. A lactase deficiency likely doesn’t develop until later in childhood, typically after the first 10 years of life. Different populations are also more affected than others, varying across racial and ethnic groups. Issues with breaking down lactose is lowest in those from European countries and higher in those of African, Asian and Native American descent.

How is lactose intolerance diagnosed? And how is it treated?

If you suspect you or your child has an issue with digesting lactose, always consult your medical professional. Diagnosis and treatments should always be overseen by a doctor. There are certain diagnostic tests your doctor may use to help determine if you have lactose maldigestion or intolerance. They may also look at other conditions that have similar symptoms as lactose intolerance to help rule out other issues.

If your doctor determines you are lactose intolerant, they will likely recommend you avoid lactose containing foods and drinks. They may recommend that you take a lactase enzyme pill if you plan to consume products with lactose. They may also recommend you only consume lactose-free dairy products to help reduce and avoid unwanted symptoms. Many lactose-free dairy products have already had the lactase enzyme added to help break down the lactose. Because dairy is a readily available source of other very important vitamins and minerals, like vitamin D and calcium, it is important to make sure these are still being consumed in adequate amounts.

Are lactose free products the same as dairy free products?

No, lactose free products are not the same as dairy free products. Lactose free products, especially lactose free milk, may still contain dairy proteins. Someone who has a dairy allergy, which is different than lactose intolerance, should not consume lactose free milks as they still contain dairy proteins that cause an immune response and can be life threatening. Dairy allergies often appear within the first year of life while lactose intolerance generally occurs later in life, causing the uncomfortable symptoms discussed above.

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When should my child start
drinking
whole milk?

Written by our Horizon Organic Dietitian, Alysse Ritter, MS, RD

<   Parent Resources

After 12 months, nutrition continues to play an important role in your child’s growth and development. By their first birthday, they have likely already tried many foods and according to the American Academy of Pediatrics (AAP), can now be introduced to whole cow’s milk. Whole milk, sometimes referred to as 4% fat milk, offers your little one a wide range of nutrients including high-quality protein, vitamin D, and calcium and also fat that can serve as an energy source important for rapidly growing brains. Developed with pediatricians, Growing Years® Organic Whole Milk contains all the nutrients of whole milk plus it is fortified with choline, DHA Omega-3, prebiotics, and is high in vitamin D.

Transitioning to Whole Milk.

Sometimes, the first introduction to whole cow’s milk may not go as planned and your child may not like its taste initially. Here are some tips and tricks to ease the transition to your child drinking whole milk:

  • Whole cow’s milk can be combined with breastmilk or infant formula to help your little one adjust to its taste. If using cow’s milk combined with infant formula, prepare the formula correctly with water according to package instructions prior to mixing with whole milk*.
  • Whole milk can also be added to cereals or mixed with gravies and sauces in place of breastmilk or infant formula.
  • Whole milk can be a part of a snack or meal but should not be consumed in place of a snack or meal, as it could displace other nutrients.

Children younger than 24 months should not consume any other dairy milk other than whole milk because whole milk has a higher fat content, which is important for young children.

The AAP recommends 16 ounces of whole milk per day, and no more than 24 ounces per day, so milk is not displacing iron-rich food.

Switching to a cup.

Around the time your child is transitioning to cow’s milk, their dexterity skills are advancing. They are now able to grab, hold, and release objects, such as cups and toys, making this a great time to introduce a cup. Here are some tips to help ease the transition:

  • The AAP recommends transitioning from the bottle beginning at around one year of age.
  • The AAP recommends children be completely weaned off the bottle between 18 and 24 months. However, temporary transition to a sippy cup is acceptable as your child makes this switch.

You may need to try multiple cups while your child is weaning off the bottle to an open cup or straw cup.

Continued and prolonged use of a bottle or sippy cup have been associated with a higher risk of excessive weight gain, tooth decay, and the potential to displace iron-rich foods in the diet which could lead to deficiency.

Regardless of how you serve milk, consuming it when laying down to sleep can increase the risk of choking, tooth decay, and ear infection.

Transitioning to reduced-fat milk after 24 months.

After the second year of life, your child has likely mastered steadily holding and drinking from an open cup. At this point, some children might be ready to start drinking a dairy milk containing a lower fat content like Growing Years Reduced Fat Milk. Please consult your child’s health care provider for specific recommendations.

Here are some facts to know as you transition:

  • Though not necessary, a slow transition may be considered, particularly if your child notices a taste or texture difference that is not well-accepted. In doing so, whole milk can be switched out to 2%, then to 1%, and to skim, if desired.
  • Some parents may opt to continue providing their child with whole milk which is also acceptable and can be consumed as part of a balanced diet. Research suggests continued consumption of whole dairy milk during childhood is not associated with an increased risk of becoming overweight or obese.
  • At two years, the Dietary Guidelines for Americans recommends consumption of 2 to 2.5 servings of dairy per day, which can include fluid milk.
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*It is important to note that if using in combination with infant formula, the infant formula must be prepared correctly with water according to package instructions prior to mixing with whole milk.

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A closer
look at DHA,
choline, and
prebiotics

Written by our Horizon Organic Dietitian, Alysse Ritter, MS, RD

<  Parent Resources

We know how important proper nutrition is during childhood. Offering a wide variety of nutrients, dairy products are an easy way to help young children get high-quality protein, vitamin D, calcium, and as pediatricians note, a fat that can serve as an energy source including for rapidly growing brains.

Developed with pediatricians, Growing Years® Organic Milk and Lowfat Yogurt offer the goodness of dairy, along with a special bundle of added key nutrients: DHA Omega-3, choline, and prebiotics. Let’s take a look at why these nutrients are so important.

DHA Omega-3 helps support brain health.

While our bodies can make a small amount of the fatty acid DHA, the process is not very efficient. DHA is best consumed through foods and dietary supplements. Common food sources of DHA include seafoods, such as salmon, mackerel, and tuna, as well as certain types of algae.

Currently, the FDA has not established a daily recommended amount of DHA. However, some important agencies have suggested minimum daily amounts for different ages. According to the Food and Agriculture Organization (FAO) of the United Nations, the following recommendations have been made:

  • Children 2 to 4 years: 100-150mg of EPA (another type of Omega-3 fatty acid) and DHA per day
  • Children 4 to 6 years: 150-200mg of EPA and DHA per day
  • Children 6 to 10 years: 200-250mg of EPA and DHA per day

According to What We Eat in America, NHANES 2015-2016 data, children aged 2 to 5 years consume an average of 20mg of DHA per day and children aged 6 to 11 years consume 30mg of DHA per day.

DHA is important to help support brain health but can be hard to get into kids’ everyday diets. A one-cup serving of Growing Years milk contains 50mg of DHA, as does a serving of Growing Years lowfat yogurt.

How does DHA get to the brain? That’s why Growing Years products also contain choline.

Choline helps transport DHA.

Sometimes categorized as one of the B-complex vitamins, choline is involved in many processes in the body. Much like a delivery truck, choline plays a role in helping to bring DHA to the brain, so this important fatty acid can then be incorporated into brain cell membranes.

Our bodies can make choline, but not in adequate amounts, which means it must be consumed in food or supplements. Both animal and plant food sources contain choline, including eggs, beef, chicken, and soybeans, among many others. According to the Institute of Medicine, the daily adequate intake for choline in young children is:

  • Children 1 to 3 years: 200mg per day
  • Children 4 to 8 years: 250mg per day

Every serving of Growing Years milk and lowfat yogurt contains a good source of choline.

Preibiotics: good for little bellies.

According to the International Scientific Association for Probiotics and Prebiotics (ISAPP), a prebiotic is defined as “a substrate that is selectively utilized by host microorganisms conferring a health benefit.”

This is a fancy way of saying certain compounds act as food to “feed” the good bacteria in the gut to promote their growth. Increasing the growth of the beneficial gut bacteria can then lead to a health benefit to us (their host). A prebiotic substrate can include certain types of dietary fibers, as well as other non-carbohydrate compounds.

A prebiotic is different than a probiotic, which is defined by ISAPP as a live and specific microorganism that leads to a benefit in the host when given in adequate amounts.

Derived from chicory root, the prebiotics used in Growing Years® products come from inulin, which is a type of dietary fiber. As dietary fiber, the inulin counts toward total fiber intake for the day. From the Institute of Medicine, the daily adequate intake for fiber in young children is:

  • Children 1 to 3 years: 19g per day
  • Children ages 4 to 8 years: 25g per day

However, according to data from What We Eat in America, NHANES 2015-2016, many young children on average consume just above half of these recommendations. The data reports that the average daily fiber consumption is 12.1g per day for boys 2-5 years and 11g per day for girls 2-5 years. For slightly older children, the average fiber intake is 14.7g per day for boys 6-11 and 14g per day for girls 6-11 years.

Growing Years whole and reduced fat milk each contain 1g of prebiotics per one-cup serving, while a serving of Growing Years lowfat yogurt delivers 2g of prebiotics.

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