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Lactose Intolerance (Formula Alternatives, Fat Intake)


Question

My 4 year old daughter weighs 16.5 lbs and is lactose intolerant. Do you know what kind of milk is as fattening as whole milk? Currently she is on an expensive formula called Nutramigen.

Answer of our experts

Unfortunately, no lactose-restricted milk is as calorically dense as whole milk. Lactaid and Dairy Ease do come with some fat, but not more than 2%. There are several ways to fix this. If weight gain and calcium are both critical things, then 1% fat 100% Lactaid milk can be supplemented with 1.5 to 2 cc of "Microlipids" per ounce. For a 6 oz bottle, this would be about 2 teaspoons. Microlipids is a commercial fat source available by prescription. It will mix in with milk, and should not be detectable by the child. It will add back the fat stripped away by skimming. Lactose is found only in the water phase, not the cream phase of milk (this is how cream can be "skimmed" of the top). Most lactose intolerant children can tolerate heavy cream. ½ to 1 tablespoon per bottle will add back tremendous calories, and is a lot cheaper than Microlipids

DP/TK 7-13-10

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Recommendation(s)

Feeding and Dental Difficulties

R12
In every CdLS individual with prolonged and marked feeding difficulties, the multidisciplinary assessment (from healthcare workers across many disciplines) should consider (temporary) placement of a gastrostomy (surgical opening through the abdomen into the stomach) as a supplement to oral feeding.
R13
In individuals with CdLS who have recurrent respiratory infections, reflux and/or aspiration (breathing foreign objects into airways) should be ruled out.
R14
The palate should be closely examined at diagnosis. In case of symptoms of a (submucous) cleft palate, referral for specialist assessment is indicated.
R15
Dental assessment and cleaning should take place regularly; a more thorough dental examination or treatment under anaesthesia may be necessary.

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