Lactose in baby formula: everything you need to know

Lactose is one of those things that most of us have heard of, but often, we don’t actually know much about it. 

Put simply, lactose is a carbohydrate (or sugar) that is in all natural animal milk – including cow, goat and breastmilk. It’s essential for energy and to fuel growth. 

This means that all formula (other than some specialist allergy formulas) will contain lactose. But not all formulas contain enough to give babies the energy they need, which means other carbs (such as starch or corn syrup) are sometimes added in. 

 

Does this matter? In this blog we’ll look at:

• The benefits of natural lactose

• Why some formulas add other carbs

• What lactose intolerance is and how common

• Which formula might be best for your baby

Natural lactose and why it’s important

 

Human breast milk contains a high level of lactose – more than cow’s milk and more than any other carbohydrate source. 

In fact, it makes up around 40% of the total calories in breast milk. That should tell you something about how important lactose is.

 

Lactose is vital because:

 

• It supports brain development. Lactose breaks down into glucose and galactose, both of which are vital for brain development. 

 

• It helps babies absorb more calcium. Calcium is important for strong bones and teeth, and is of course found in milk. Scientists have found that lactose helps babies absorb calcium much more easily (though the exact reasons why aren’t yet fully understood). 

 

• It promotes healthy gut bacteria. Lactose acts as a prebiotic, helping good bacteria to grow. This  leads to easier digestion now, and sets babies up for lifelong gut health. 

 

Simply put, babies are biologically programmed to need lactose. 

Lactose and other carbs in baby formula

Baby formulas usually provide around 40% of their calories from carbs. In some formulas, such as Kendamil, most of these carbs come from lactose – just as they would in breastmilk.

Other formulas top up their lactose content with extra carbs. These could be:

• Starch. Starch is a complex carb found naturally in foods like potatoes and rice, and can provide useful slow-release energy that helps babies stay fuller, longer.

• Maltodextrin. Maltodextrin is a starch-derived carb that is often used to stabilize formula and help make it more creamy. It can be easier to digest than starch.

• Corn syrup solids. Corn syrup solids are a highly processed form of corn starch. It helps provide extra energy, but can spike blood sugar. It’s banned in all EU formulas, but common outside of Europe. 

• Sucrose and glucose. These simple sugars aren’t used at all in European formula. They are found in some (usually cheaper) US formulas, and in some speciality formulas as a lactose alternative.
  
  

Lactose – the best option for your baby?

European regulations mean that all EU formulas (other than certain speciality formulas) must provide at least 30% of their carbs from lactose. 

Many EU formulas don’t contain any other added carbs, while others will add some starch or maltodextrin (often organic). However, lactose will always be the primary carb source. EU formulas don’t contain corn syrup, glucose or sucrose. 

Why are these regulations in place? The EU wants baby formula to be as close to breastmilk as it can be, which means lactose should be the primary carb, just as it is in breastmilk. 

EU regulations around lactose in formula mean that babies get all the potential benefits of natural lactose, however they’re fed. Including:

• Better gut health, thanks to lactose’ natural prebiotic qualities.

• Stronger bones, as lactose aids calcium absorption.

• More stable blood sugar, setting them up for a healthy life.

 

Of course, this doesn’t mean that formulas with lower levels of lactose are ‘bad’ or ‘unhealthy’ – but the research does clearly indicate that lactose is beneficial.

What about lactose intolerance?

 

You’ve probably heard of lactose intolerance, and with good reason. Lactose intolerance is incredibly common in adults – affecting around 70% of people worldwide to some degree.

However, lactose intolerance is almost unheard of in babies. We’re (nearly) all born with the ability to digest lactose, thanks to an enzyme in the gut called lactase. But as we get older, many of us lose the ability to produce lactase, and with it, the ability to digest lactose.  

Lactose intolerance in adults is most common in areas of the world where dairy products aren’t often eaten (such as most Asian countries). But it’s relatively uncommon in Europe and North America – where most people drink milk and eat dairy products into adulthood, and so their bodies keep making lactase.

 

What if you think your baby might have a lactose intolerance?

Parents often worry that fussiness, colic, or gas means their baby is lactose intolerant. But true lactose intolerance in newborns is extremely rare, since nearly all babies produce lactase without any problems. 

Issues like colic and reflux are usually caused by other sensitivities or formula ingredients, or simply the normal adjustment of a developing tummy.

Occasionally, babies develop a temporary lactose sensitivity after a stomach bug. If you’ve noticed your baby struggling to feed or keep down formula after a bug, speak to your pediatrician about temporarily using a lactose-free formula. 

As well as this, a very small number of babies may suffer from:

 

• Congenital lactase deficiency (rare), or
  
  

• Galactosaemia (a serious metabolic condition diagnosed at birth)
  
  

If your baby has either of these conditions, they’ll suffer from serious symptoms, and you’ll almost certainly already be receiving medical care and specialist formula. 

How to choose a lactose-only formula

If you want your baby to have a formula that only contains lactose and no starch or maltodextrin you’ll find there’s plenty of choice among European formulas. 

These include:

All Kendamil formulas. These are made with whole milk from Jersey cows, which is naturally high in lactose – so there’s no need for other carbs. 

Most goat’s milk formulas, since goat’s milk is naturally high in lactose. 

Most HiPP formulas, including all HiPP UK and all HiPP Dutch. 

Other European formulas do include starch or maltodextrin – but this doesn’t mean they’re a bad choice. A small amount of organic starch is added to formulas like Holle to provide extra energy, and help keep babies full. This can be really beneficial for many babies – and they’ll still get most of their carbs from lactose. 

There’s no hard-and-fast rule here. And the thing about European formulas is that you can be certain that whichever one you choose, it’ll be natural and closer to breastmilk, with a high lactose content.