Q. My daughter is 2 years old. When she was 8 months we found out that she is severely lactose intolerant. I am mildly lactose intolerant. Is this a coincidence or is it genetic? What are the chances that my future children will be the same way? Is there a test that can be performed on newborns to check for lactose intolerance before they even leave the hospital?

A. Lactose is the main type of sugar found in milk and milk products. The presence of an enzyme (lactase) in the small intestine allows the lactose to be broken down into smaller molecules and absorbed into the body. The deficiency of the lactase enzyme causes an inability for this part of the digestion to proceed normally. The result is usually some combination of abdominal cramps, gas, and diarrhea.

Lactose intolerance to some degree is a very common condition. It is estimated that more that half of African-Americans, and the majority of Asians have the condition. Since milk is a vital source of calcium and other nutrients, this presents a significant challenge. Most people with the enzyme deficiency find that they can tolerate some dairy intake. "Trial and error" experimentation will determine how much milk or other dairy can be consumed, especially as your child matures and grows.

Some older children and adults find they tolerate cheese or yogurt more than milk. In addition, most supermarkets now carry lactose-free milk that is nutritionally equivalent to regular milk. If this is not readily available, a commercial product can be purchased allowing you to treat milk yourself to reduce the lactose before consumption. Your pediatrician can advise you if these measures are suitable when your child is older.

http://www.niddk.nih.gov/health/digest/pubs/lactose/lactose.htm

http://www.nlm.nih.gov/medlineplus/lactoseintolerance.html

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