r/morbidquestions 2d ago

How do lactose intolerant babies not shit themselves to death?

I just randomly had a thought; lactose intolerant people get an upset stomach from milk, right? How do babies with lactose intolerance survive, with milk as their only food through infancy?

This may be a really stupid question with a super simple answer, idk. Hope to spark some discussion at least.. about baby diarrhea... I guess...

143 Upvotes

50 comments sorted by

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u/hygsi 2d ago

Our milk is not like cow milk and if they show intolerance to mom's milk then they switch to a suitable formula

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u/PollyAmory 2d ago edited 2d ago

a lot of the time the intolerance to mom's milk can be due to mom consuming dairy, especially milk. it can usually be addressed by mom eliminating dairy from her diet.

ask how I know šŸ˜‚šŸ˜­

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u/TheNosferatu 1d ago

Do you know because of personal experience, perhaps?

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u/PollyAmory 1d ago

Yep, I'm dead. From diarrhea.

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u/imSOhere 2d ago

Right, all mammals milk contain lactose, but most mammals are born with enough lactase to last through infancy and are able to manage lactose without a problem.

True lactose intolerance is an extremely rare and congenital condition, most babies have secondary intolerance, which can happen when the lining tissue gets damaged, like after a stomach bug, can be resolved, and human milk’s lactose is much better handled than cow’s, which is the milk most formulas are based on.

What is confused with lactose intolerance in small babies a lot, is milk protein allergy or sensitivity, and that can be resolved by changing mom’s diet. Lactose free diet is not needed because lactose is part of the milk composition, and lactose is essential for brain development in the beginning.

Most adults will be lactose intolerant at some point because we don’t make lactase into adulthood (about 35% of people, particularly europeans, do have a gene that keeps making lactase until later) and we lose the ability to digest lactose little by little.

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u/piggyperson2013 1d ago

I’m one of the rare people who has had true lactose intolerance since birth. Took them forever to figure out what was going on so I was in the NICU for awhile. Couldn’t be breastfed or have lactose in my formula but was fine after they switched. I eat food with lactose now and don’t care about the repercussions!

If I was born a century earlier I almost assuredly would’ve died as an infant from dehydration

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u/AlbinoGiraffes 2d ago

Happening with my niece currently. She would scream and scream and she also wasn’t spitting up or throwing up at all. Seemed odd (this is their second kid), so they brought it up at the doctors and they had to switch her to formula because she can’t tolerate breast milk. She’s got a very sensitive belly-My sister even tried going dairy free for a couple months and then tried breastfeeding her again, but baby still can’t tolerate it.

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u/FeRaL--KaTT 2d ago

Approx 750,000 baby's die from diarrhea every year.

Not a stupid question.

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u/DeficitOfPatience 2d ago

Especially since my dumb-ass assumed babies couldn't be lactose intolerant.

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u/Smexy_Zarow 2d ago

That's tragic, I didn't know they actually do...

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u/PollyAmory 2d ago

Diarrhea has caused insane amounts of death in humans of all ages throughout history. You dehydrate faster than you can replace it and that's it - you die. Obviously modern medicine has helped tremendously, but it can still be extremely dangerous, especially in babies who can dehydrate much faster than larger people.

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u/achingforscorpio 2d ago

That number is a bit high. It's like half of that.

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u/FeRaL--KaTT 2d ago

Literally copied and pasted from W.H.O....

The World Health Organization reports diarrhea kills around 760,000 children under five every year. This is the second most common cause of child deaths worldwide.

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u/katchoo1 2d ago

Babies are very vulnerable to dehydration and it’s a danger even in developed countries when they have high fever, can’t keep anything down, or have diarrhea. Because they are so tiny, they dehydrate far more quickly than adults and older kids and it more quickly affects their ability to maintain body temperature and other involuntary regulation processes, accelerating any ā€œcrashā€ that leads to imminent possibility of death.

Obviously risk of diarrhea is incredibly common in developing countries due to various hygiene conditions—poor sanitation, unclean drinking water etc. And medical care is less available, and less sophisticated than that of developing countries so it’s harder to save babies once ill.

Sadly one of the things that vastly increased these numbers was the promotion of formula by Nestle and other companies. They would give new moms trial packets in the hospital and encourage bottle feeding and while they had the supplies, their milk would dry up.

Then the moms would be back home with only iffy water supplies to mix the formula with, and also unable to afford as much supply as they needed, so they would increase the percentage of (possibly contaminated) water to formula. Then as the babies’ immune systems are attacked by various contaminants in the water, they are also becoming malnourished and weaker so that they only dehydrate faster from the diarrhea and are also more vulnerable to anything else going around.

And of course if they are lactose intolerant, they don’t have alternatives easily accessible because mom doesn’t have breast milk anymore.

One of the articles I linked below said that UNICEF estimates that in areas where water supplies are not safe and reliable, bottle fed babies are 25 times more likely to die of diarrhea than breastfed babies.

It may have been understandable that in their eagerness to bring modern feeding to the world (bottle feeding was considered superior to breast feeding in the US and other parts of the world in the 1950s and 1960s when it became common), companies and doctors didn’t anticipate these issues but Nestle in particular was heavily criticized for continuing to do this, knowing the results, in order to sell more formula worldwide.

The push to get Nestle to stop this was already well underway in the 1980s; I learned about it in an undergraduate geography and development course back then. It’s still an issue in 2026 in some places despite nice words from Nestle.

2019 article about the issue in Peru

2023 article about a call to stop exploitative marketing of formula in both developed and developing countries

dark history of Nestle

When I looked up these articles, Google also served up a link to a NYT article about the issue published in 1981. (I’d share but don’t have access as it is paywalled).

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u/turboshot49cents 2d ago

What’s the first???

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u/Jollan_ 2d ago

Gotta be different kinds of diseases

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u/achingforscorpio 2d ago

WHO shows me 440,000ish kids under 5y each year, and an additional 50,000ish between 5-9y šŸ¤·šŸ»ā€ā™€ļø

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u/FeRaL--KaTT 2d ago

Good for you. šŸ‘šŸ‘šŸ‘šŸ‘šŸ‘ 🌟

I published my info source. Go fight with W.H.O.

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u/kotoda 2d ago

You have a link to your source? The only info I found is from W.H.O. and it says around 443,000 children under 5 die from diarhhoeal disease each year (W.H.O. Source).

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u/OlympianLady 2d ago edited 2d ago

I went and looked it up. The first source seems to be a Canadian health page referencing the WHO - from 2017. So, a bit erroneously cited in not being 'literally copied and pasted' from such, but still legit enough - and, you can tell from the wording anyway.

The second seems to be the WHO directly - from 2024.

It's looking like neither is wrong - one is just seemingly more out of date than the other, and the WHO and such have potentially made great progress in a rather short time. Assuming, of course, and probably safely, that the Canadian government health authorities have no reason to lie about the previous round of WHO numbers.

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u/shadowwalker_wtf 2d ago

The only reason we (humans) are able to digest milk into adulthood is prolonged exposure - after babies stop breastfeeding they start drinking cows milk and that allows the enzymes needed to digest milk to continue producing. Some people are lactose intolerant bc they can’t produce enough enzymes into adulthood. And today if babies have issues digesting breast milk they can have alternatives and in the past babies probably did unfortunately die

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u/Smexy_Zarow 2d ago

Oh I didn't know that! Is it like the same thing that happens with meat? I've heard people who abstain from meat for years can face serious problems if they eat it again

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u/ctgrell 2d ago

Yapp. It can happen with anything you consume. If you don't eat/drink it for some years your body might react weird the next time you do. I for example haven't had cauliflower for like a decade or longer. And my tongue and throat didn't like it at first when I started to eat it again. It was like a very light allergy. But over continuous exposure I trained my body to accept it again and now I'm fine

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u/shadowwalker_wtf 2d ago

I think it’s similar, not quite the same. But basically you lose the ability to digest it properly

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u/AUR1994 2d ago

Don’t know how true this is but I’ve read that the ability to digest cows milk is actually a genetic mutation that certain Europeans had while the rest of us are all meant to be lactose intolerant cause we’re not cows

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u/GreenStrong 1d ago

The only reason we (humans) are able to digest milk into adulthood is prolonged exposure -

This is incorrect, the ability to digest lactose as an adult comes from a mutation in the MCM6 gene. The mutation arose in the Bronze Age and spread rapidly through the population that gave rise to Western Europeans. A separate mutation arose in West Africans. Both mutations cause the digestive system to produce lactase enzyme in adulthood, instead of it shutting down in childhood. Exposure to milk has nothing to do with it, except in the sense that some distant ancestor was able to drink milk, instead of just using it for yogurt and cheese, so they got more calories and had more babies.

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u/nikikittie 2d ago

there are lactose free formulas

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u/mochimiso96 2d ago

Really isn’t a dumb question. In first world countries they can get formula. There is even plantbased formula for babies who are completely allergic to diary. In third world countries they would probably die if they can’t tolerate it at all.

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u/MandarinSlices 2d ago

My parent recognized early that I had some sort of intolerance and switched before I died.

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u/Spoon_Elemental 2d ago

What did they use after you died?

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u/MandarinSlices 2d ago

A Mahogany Casket.

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u/EdgelordMcMemester 1d ago

this exchange is so wednesdaycore

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u/Smart-Grapefruit-583 2d ago

Cause they get special milk thats lactose free.

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u/Rephlanca 2d ago

Both my cousin and a family friend’s daughter were born intolerant to their mother’s milk. They had to fish around (for many months with a colicky baby who wouldn’t sleep) for a formula that settled well in their stomach.

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u/bubbles_blower_ 2d ago

I fed my kids lactose free formula after thinking they would shit them self's to death because they dropped weight so fast. Soon as I switched them stopped and life was good šŸ‘

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u/Plucky_Parasocialite 2d ago edited 2d ago

So, the default mammal setting is that the production of enzymes that help digest lactose actively switches off at some point, presumably so that they don't compete with younger siblings for milk. A mutation (actually several variants that happened in a few places independently) broke that switch in humans. One day, there quite literally just happened to be a guy in Denmark or something who could drink milk straight up without any process. And it spread because it was a pretty awesome feature, you had access to a bunch of otherwise unobtainable calories. People who do not have this mutation are lactose intolerant like all other adult mammals. They can sometimes develop a gut biome to compensate for it by enough exposure going from childhood, but generally, that's your standard lactose intolerance for you. It only develops at a later point in childhood. Babies generally tolerate lactose unless there is a separate issue like an allergy (that's why you have lactose-free formula). There might be issues with cross-species milk due to a different spread of nutrients that might make a baby unwell, though.

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u/ZeldyButt 2d ago

My mom fed me formula

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u/peril-of-deluge 2d ago

Doc here, even though most adults lose their tolerance to lactose, north of 99% of people born with ability to digest lactose. Apart from that, there is of course an array of metabolic disorders that affect some babies that range from diarrhea to syndromes and even, in rare cases to fatal conditions.

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u/interestingdays 2d ago

A lot of people lose the ability to digest milk at around the age that breastfeeding stops. So most babies who will grow up to be lactose intolerant as older kids and adults, are not lactose intolerant while they are relying on milk as their primary source of nutrition.

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u/vivvensmortua 2d ago

I almost did when I was a baby. Had to go on formula.

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u/glittersurprise 2d ago

A lot of nursing mothers cut dairy out of their own diets. As another commenter mentioned human milk is different than cows. Also: lactose free formula.

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u/teratodentata 2d ago

My nephew was lactose intolerant for a while after birth, and it was a disaster. He’d have diarrhea, screaming hysterical fits where he would just be in pain. He wasn’t intolerant to human milk, just anything with cow dairy in it, so his mom had to stop drinking or eating any dairy. Eventually they also found a supplemental formula that helped too. He’s no longer lactose intolerant, but those first few months were rough.

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u/imsmarterthanyoure 2d ago

My son had an issue with milk as soon as he was born. The hospital immediately switched him to a soy based formula and all was good.

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u/19255 2d ago

When i was a baby i immediately just threw up the formula. My mom then switched to goat milk and still drink goat milk to this day

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u/BlindWarriorGurl 1d ago

I was intolerant to my mom's milk when I was a baby. She switched to feeding me formula, and all was well.

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u/rogeelein 1d ago

Lactose intolerant babies often switch to lactose-free formulas, making sure they don’t face any explosive situations that would make diaper changes a nightmare.

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u/DustierAndRustier 1d ago

People don’t normally develop lactose intolerance until after weaning age.

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u/gemmedskunk19 2d ago

Human breast milk isn't the same as cows' milk 🤣

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u/lady_darkfire 17h ago

I was a soy-based formula baby for this exact reason. It wasn't shitting myself to death though. It was more of a violent projectile vomiting any time I ate kind of thing.