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Ask Dr. Marla: Lactose Intolerance, Eczema and Asthma

I read your article in the August/September issue about lactose intolerance vs. milk allergy. My son also has had issues with yogurt and whole milk, including vomiting. As soon as we stopped feeding him dairy products he was fine. He now drinks lactose-free milk. He also suffers from eczema and asthma. Could this be linked to a milk intolerance or allergy?

A. If the symptoms have stopped by using lactose-free milk then likely this is not an allergy but rather a lactose intolerance. Lactose intolerance is actually quite common. The symptoms typically are abdominal pain, bloating, gas, diarrhea and on some occasions vomiting. It may be that the spitting up is unrelated to lactose intolerance. However, since you have noted an improvement, you might want to continue using lactose-free products. Products to consider include lactose-free milk, aged cheddar, swiss and mozzarella cheeses, as well as cultured yogurt. These are all low in lactose. The other option would be to offer lactase tablets with any meal that includes dairy products as the child gets older.

Related to eczema and asthma?
These two conditions might mean that he is allergic to some foods but it is unlikely that a lactose-free diet would improve the symptoms. There is some medical literature that looks at diet and asthma. Studies are not entirely consistent but some literature points to the use of a Mediterranean diet that is high in fish, fruits and vegetables as having a decreased risk of asthma in childhood. It may be that foods such as fish that are rich in omega-3-polyunsaturated fatty acid have anti-inflammatory properties and can balance allergic activity. Fruits and vegetables are high in antioxidants which in adults have been shown to be inversely related to asthma. Fast food is high in hydrogenated vegetable fats and trans fatty acids which are possibly associated with both asthma and atopy (allergic sensitivity). This remains unproven. Experts in pediatric allergy and immunology have noted that while the data is interesting, there is not enough evidence to warrant deliberately changing someone’s diet. Eczema or atopic dermatitis is a common allergic reaction. While certain foods might aggravate the condition it is often difficult to prove which ones are to blame. Other triggers include other allergens, overheating or sweating, emotional stress and contact with irritants such as wool, pets and soaps. It might be reasonable to ask your physician to refer your child to an allergist for a complete assessment.

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Published in November 2010.

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