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Lactose Intolerance or Milk Allergy

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... in Practice - Nutrition. Available in every WIC agency and at www.brightfutures.org/nutrition/index.html ... Child Nutrition and WIC Reauthorization Act 2004 ... – PowerPoint PPT presentation

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Title: Lactose Intolerance or Milk Allergy


1
Lactose Intolerance or Milk Allergy?
  • WIC and Nutrition Services
  • Department of Health and Senior Services

2
What is Lactose Intolerance?
  • Inability to digest significant amounts of
    lactose, which is the predominant sugar in milk
  • A result of lactase insufficiency, the enzyme
    essential for the conversion of lactose into
    glucose and galactose

3
Types of Lactose Intolerance
  • Congenital
  • Very rare
  • Primary
  • Develops after 2 years of age
  • Secondary
  • Usually resolves in 1-2 weeks

4
Symptoms of lactose intolerance
  • Intolerance does not involve the immune system
  • Nausea, cramping, bloating, abdominal pain, gas,
    diarrhea
  • Symptoms may begin from 15 minutes to several
    hours after eating food with lactose

5
Prevalence of Lactose Intolerance
  • An estimated 30 to 50 million American adults are
    lactose intolerant
  • 90 of Asian Americans
  • 80 of African Americans
  • 62-100 of Native Americans
  • 53 of Mexican Americans
  • 15 of Caucasians

6
What is Milk Allergy?
  • An abnormal immune system reaction to proteins in
    the cows milk
  • Triggered by a combination of genetically
    inherited factors and early introduction of cows
    milk or soy protein into an infants diet
  • www.foodallergy.org

7
Symptoms of Milk Allergy
  • An immune system reaction
  • Swelling, sneezing, nausea, vomiting, hives,
    rash, itching, runny nose, coughing, difficulty
    breathing, gas, diarrhea
  • Anaphylactic reaction possible
  • Symptoms may begin within seconds or up to
    several hours after eating the food
  • See your Doctor

8
What are the options?
9
Review the Options
  • Breastfeeding is the best option for most infants.

10
Infants at risk for food allergy
  • Exclusive breastfeeding is recommended
  • Eliminate foods that cause infant allergies from
    the mothers diet while she is breastfeeding
  • Delay solid foods until 6 months of age
  • 1 year of age Introduce cows milk
  • 2 years of age Introduce eggs
  • 3 years of age Introduce peanuts, other nuts,
    fish, shellfish

11
Bright Futures in Practice - Nutrition
  • Available in every WIC agency and at
    www.brightfutures.org/nutrition/index.html

12
Infants with milk allergy
  • Breastfeeding
  • Alternatives to breastfeeding
  • Soy formula
  • Hypoallergenic formula
  • Avoid milk products or foods with milk

13
Children and Women with milk allergy
  • Eliminate milk
  • Casein or caseinate
  • Casein hydrolysate
  • Dried milk solids
  • Lactolbumin
  • Lactate solids
  • Sweetened condensed milk
  • Whey or whey solids

14
Children and Women with milk allergy
  • Substitute other foods to provide missing
    nutrients
  • Cook with alternative foods
  • Alter recipes and meals
  • Avoid cross-contamination
  • Learn strategies for coping with restaurant meals
    and special occasions
  • Conduct food challenges (with medical support)

15
Infants with lactose intolerance
  • Breastfeed
  • Alternatives to breastfeeding
  • Soy formula
  • Lactose free formula

16
Children and Women with Lactose Intolerance
  • Eat or drink small servings
  • Know your personal tolerance level
  • Eliminating milk and other dairy foods may pose
    nutritional risks

17
Tips for Tolerance
  • Experiment with gradually larger amounts
  • Drink milk with a meal rather than alone
  • Eat smaller, more frequent portions
  • Choose aged cheeses lower in lactose
  • Try dairy foods with active cultures
  • Read labels
  • Kosher foods that say parev or parve are
    milk-free

18
Some lactobacillus or sweet acidophilus milks are
no lower in lactose and may not be tolerated any
better than other forms of milk.
19
Special food products
  • Lactose-reduced or lactose-free milk and other
    dairy foods
  • Add lactase enzyme to fluid milk
  • LactaidTM
  • CactraseTM
  • DairyEaseTM
  • Chew or swallow a lactase supplement before
    eating lactose rich foods

20
Lactose-free foods
  • Broth-based soups
  • Plain meat, fish and poultry
  • Plain fruits and vegetables
  • Tofu
  • Breads, cereal and crackers made without milk,
    dry milk, or whey

21
Alternative Sources of Calcium
  • Vegetables cooked/raw broccoli, turnip and
    collard greens, kale, Chinese cabbage
  • Fish/Seafood canned sardines and salmon with
    edible bones, raw oysters
  • Calcium-fortified orange juice
  • Calcium-fortified soymilk
  • Tofu processed with calcium salts
  • Almonds

22
Calcium 1 cup milk
  • 8 cups spinach, raw
  • 1 ½ cups turnip greens, cooked
  • 2 ¼ broccoli, raw
  • 5 cups red beans, cooked
  • 3 oz. sardines, canned with edible bones
  • 1 ½ cups orange juice, calcium fortified
  • 2 ¼ cups soy beverage, calcium fortified

23
Calcium education
  • power point presentations,
  • calcium intake requirements,
  • functions of calcium, and
  • information regarding risks of inadequate intake
    of calcium are available at
  • www.dhss.mo.gov/Calcium/education

24
Calcium-Related Health Problems
  • Osteoporosis
  • Colon and Rectal Cancer
  • Hypertension and Stroke
  • Overweight and Obesity

25
WIC Policy
  • Non-contract and exempt formulas for infants or
    WIC-eligible medical foods for women and children
    require a prescription.

26
For children and women with lactose intolerance
documented by the CPA, cheese may be issued as a
substitute for milk.
27
USDA encourages programs to offer alternative
types of milk for children who are lactose
intolerant.

28
In schools and childcare settings
  • Schools and childcare providers must make
    substitutions for severe food allergy.
  • Schools and childcare providers may provide
    substitutions for food intolerances.
  • Services funded through IDEA include
  • Purchase of special foods
  • Purchase of feeding equipment
  • Consultation with a registered dietitian
  • www.fns.usda.gov/cnd/guidance

29
Child Nutrition and WIC Reauthorization Act 2004
  • Schools and childcares must offer a variety of
    fluid milk with different fat contents.
  • Schools and childcares may offer flavored and
    unflavored milk and lactose-free milk.
  • Schools and childcares may substitute a non-dairy
    beverage that is nutritionally equivalent to
    fluid milk and fortified with calcium, protein,
    vitamin A and D to levels found in cows milk.

30
For More Information…
  • STTM 2
  • Calcium pg 26-27
  • Food Allergies pg 113
  • Calcium and Osteoporosis pg 127-130

31
For more information…
  • Rita Arni, RD, LD
  • WICNS Child Nutrition Team Leader
  • 573-751-6183
  • arnir_at_dhss.mo.gov
  • Jean Trae, PhD, RD, LD
  • WICNS Child Nutrition Coordinator
  • 573-751-6183
  • traej_at_dhss.mo.gov
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