Lactose intolerance

Pregnant women are commonly told to drink milk. But this advice doesn't sit well with those who avoid milk and milk products because of lactose intolerance. People with lactose intolerance have trouble digesting lactose, the sugar in milk, because they have low levels of the enzyme lactase.

Lactose intolerance is a common condition, affecting about 15 percent of the adult white population in the United States and 75 percent or more of the adult black, American Indian and Asian-American populations.

Signs and symptoms of lactose intolerance include loose stools, diarrhea, abdominal bloating and pain, gas, nausea, and rumbling or gurgling in the stomach and bowels. The signs and symptoms occur after you consume milk or other dairy products.

For many women, the ability to digest lactose improves during pregnancy, especially as the pregnancy progresses. So even if you're normally lactose intolerant, you may find that while you're pregnant you can consume milk and other dairy products without any bothersome signs and symptoms.

Because people with lactose intolerance often avoid milk products, they may not get enough calcium in their diet. The Institute of Medicine recommends a daily calcium intake of 1,000 milligrams (mg) for women age 19 and older, including pregnant women, and 1,300 mg for pregnant teens under age 19. It can be hard to meet this requirement if you don't consume milk and other dairy products, which are the best sources of calcium.

■ Prevention and self-care for lactose intolerance

If you have lactose intolerance or dislike milk or other dairy products, it's important to make sure you're getting enough calcium in your diet. Consider the following suggestions:

• Most people who are lactose intolerant can drink up to a cup of milk with meals without causing symptoms. If that amount bothers you, try reducing the portion to half a cup, twice a day.

• Try using lactose-free or lactose-reduced products, including milk, cheese and yogurt.

• Yogurt and fermented products such as cheeses are often better tolerated than regular milk. The lactose in yogurt is already partially digested by the active bacteria cultures in yogurt.

• Try using lactase enzyme tablets such as Lactaid and Lactrase, which help with lactose digestion. They're not effective for everyone.

• Choose a variety of other calcium-rich foods, such as sardines or salmon with bones, tofu, broccoli, spinach and calcium-fortified juices and foods.

■ Medical care for lactose intolerance

No medical treatment is necessary for lactose intolerance. But if you're concerned about not getting enough calcium in your diet, talk with your health care provider. Many calcium supplements are available to choose from.

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