Prenatal Vitamins For Lactose-Intolerant Women

Do you know that about 68% of the world population has lactose malabsorption?¹ Are you also troubled by lactose intolerance and worried if this will affect your pregnancy? Here are some useful information and tips to help you navigate your concerns.

Introduction

For lactose-intolerant women seeking prenatal vitamins, choosing supplements tailored to their needs is essential. Considering lactose-free prenatal vitamins, carefully reading labels, and exploring alternative nutrient sources can ensure you receive enough nutrition for a healthy pregnancy without discomfort. Consulting healthcare professionals for personalised guidance is strongly advised to address individual needs and provide the well-being of both the mother and the developing baby.

The importance of efficient nutrition in supporting the well-being of both mother and baby cannot be overstated. In this guide, we aim to empower you with knowledge on lactose intolerance and provide a guide on how to make informed choices specifically for lactose-intolerant women. 

Key takeaways

What is lactose intolerance?

Lactose intolerance is when you get symptoms, such as stomach, bloating, diarrhoea and gas, after eating food containing lactose. Lactose is the primary source of calories in milk and can also be found in butter, cheese, cream, and yoghurt.

The body digests lactose using a substance called lactase. Lactose intolerance is when your body fails to produce enough lactase to digest and absorb lactose to transform the food into usable energy. When these excessive amounts of non-functioning lactose reach the last bit of the small intestine, they will start drawing water into the intestine, causing loose stools or watery diarrhoea. Unfortunately, the symptoms don’t end here. This undigested lactose will keep travelling down to the large intestine, where this lactose is finally being broken down. However, gas will also be produced during the process, where you might start having these embarrassing moments with feeling windy, bloating, abdominal pain, cramps, and nausea.²

Also, remember that lactose intolerance is not the same as having food allergies. Milk allergies are caused by your immune system’s response, not your lactase activities

What’s the difference between lactose malabsorption and lactose intolerance?

These ineffective lactase activities are called lactose malabsorption, where the lactose cannot absorb and utilise dairy products. When lactose malabsorption is combined with the earlier symptoms, it’s often referred to as lactose intolerance.³

How did I get lactose intolerance? 

Lactase activity is highest at birth and reduces after weaning.⁴ The age when this decline starts, and the proportion of the adult population with low lactase activity is strongly related to ethnicity.⁴ Therefore, both children and adults can develop lactose intolerance. 

Lactose intolerance could be temporary or permanent, depending on why the body isn’t producing enough lactase.

Here are some common causes of this condition:⁵

• Primary lactase deficiency (the most common cause worldwide)

An inherited genetic trait in certain ethnicities causes this type of lactase deficiency. In these cases, a person’s body may have less lactase activities over time. Symptoms may start during the teenage or adult years.

• Secondary lactase deficiency

It is a shortage of lactase caused by digestive system problems. It can occur at any age and may result from another condition, infections, surgery to the small intestine, or certain medications, such as gastroenteritis, coeliac disease, ulcerative colitis, or chemotherapy. 

Is lactose intolerance common? 

Lactose malabsorption is widespread in most parts of the world, with wide variation between different regions and a frequency of around two-thirds of the world's population.⁴ And most of them are related to primary lactase deficiency. Lactose intolerance is most commonly found in Asian Americans, African Americans, Mexican Americans, and Native Americans.⁴

Although a lot of people have this problem, not everyone is symptomatic.⁶ Individuals with lactose intolerance can have different thresholds for how much lactose they can take before experiencing symptoms. The severity of symptoms also varies among individuals. Some people may experience only mild discomfort or symptoms occasionally. 

Will lactose intolerance present differently during pregnancy?

The digestive condition varies in individuals during pregnancy. You might start hating/craving some foods without knowing or getting sick even just by thinking of it. And the unpleasant symptoms that you experienced before when having dairy products might still be the same. The symptoms might appear within a few hours after you have milk or milk products.⁷

However, research indicates that the ability to digest lactose improves during pregnancy, especially in the latter stages.⁸ So, don’t give up on trying. You can find the rough amount that you can comfortably take and might find your body starts having more tolerance towards dairy products. 

How will lactose intolerance during pregnancy impact me and my baby?

The symptoms, such as diarrhoea and bloating, would not harm your baby. However, apart from these discomforts, there are more nutrition-wise aspects you should be aware of. Lactose intolerance won’t seriously hurt you, but avoiding all dairy products may affect your health. 

Milk and dairy products are some of the best calcium and vitamin D sources.

• Calcium

Adult bones contain approximately 99% of the body's calcium content. Calcium is a mineral which our bodies cannot produce. It can only rely on our food and drink intake. Low calcium levels can increase the likelihood of breaking your bone, fracture or loss of a tooth, dry skin, brittle nails, muscle spasm, tremor, and slow development in children. If it continues over a long time, you might develop permanent loss of strength for your bone, leading to conditions such as rickets and osteoporosis.⁹

During pregnancy, your body will work harder and absorb more calcium to give you and your baby enough bone strength. During lactation, calcium in your body will be resorbed to provide calcium for milk. Therefore, inadequate calcium during pregnancy will impact both you and the baby. Research suggests that none or deficient dairy consumption is positively associated with slow baby growth and birth weight.¹⁰ Additionally, the great demand for calcium from the mother will also have an impact on the mother’s bone health along with other conditions, such as pregnancy-induced hypertension and preeclampsia.¹¹

• Vitamin D

Vitamin D is a fat-soluble vitamin derived from diet and sun exposure to the skin. Vitamin D is known mainly for maintaining normal calcium metabolism; its receptors are found in other tissues, such as the liver and kidneys. Without sufficient vitamin D, the body struggles to absorb enough calcium from the diet, even if the dietary calcium intake is high. Consequently, parathyroid hormone production increases and tries to reabsorb calcium in the kidneys to maintain normal calcium levels. This compensation will eventually lead to a condition called hyperparathyroidism with symptoms for example, depression, tiredness, muscle weakness, and bone fractures.¹²

Due to the close relationship between Vitamin D levels and Calcium, Vitamin D deficiency is also highly associated with baby growth restriction and conditions such as high blood pressure for the mother.

What should I do if I think I develop lactose intolerance in pregnancy?

If you already have lactose intolerance, you might be experiencing symptoms and a tolerance to dairy products. If you think you might develop lactose intolerance and want to manage the condition or have further concerns, please contact your GP. It is important that you are given a diagnosis before cutting off dairy products during pregnancy, as there are other conditions that might present with similar symptoms.

What can I do to prevent lactose intolerance?

No treatment can help your body make more lactase for people with primary lactase deficiency. In the past, lactose-intolerant people were advised to avoid dairy products. Today, as more options are available, it is preferable that you try different foods and see which ones cause fewer symptoms. That way, you can still get enough calcium and other essential nutrients. 

Here are some tips for you

Check nutrition labels and ingredient lists on food. Lactose is often added to processed foods, including soups, salad dressings, and snack foods. If you’re highly sensitive, a food diary might be helpful for easily pinpointing which foods are causing or aggravating your symptoms.

Of course, you can choose from some non-dairy sources of calcium, for example, plant-based milk or products, nuts, seeds, and dried fruit. 

However, supplements offer a convenient and practical way to ensure sufficient and consistent nutrient intake without the need for constant meal planning or searching for replacements.

The NHS suggests ten micrograms of vitamin D each day⁹ 

It's also recommended pregnant and breastfeeding women take a daily supplement containing this amount between September and March. Do not take more than 100 micrograms (4,000 IU) of vitamin D daily, as it could be harmful.⁹

The NHS suggests 700mg of calcium each day for adults⁹

The recommended dose for pregnancy varies in different countries. Ireland increases this daily requirement to 1,200 mg for pregnant and breastfeeding women,¹³ whilst the UK does not recommend a definitive amount but increases the daily intake. WHO recommends daily calcium supplementation (1,500 –2,000 mg) for pregnant women to reduce the risk of pre-eclampsia in populations with low dietary calcium intake.¹⁴

Consult your healthcare provider if you have trouble managing your symptoms or finding a suitable supplement. Please note supplements containing vitamin A (retinol) are not recommended when you're pregnant or considering having a baby. Always check with your pharmacist for supplements during pregnancy and breastfeeding period.

Summary

Managing lactose intolerance during pregnancy involves informed choices, monitoring nutrient intake, and consulting healthcare professionals for personalised guidance. The guide encourages readers to explore dietary alternatives and highlights the importance of supplements in ensuring essential nutrients for a healthy pregnancy. Always consult with healthcare providers for individualised advice during this crucial period.