Answers to Questions from Readers, Part 18a

Q. Can lactose intolerance in children cause behavioral problems in children if left undetected?

A. Only two small possible problems. Truly undetected LI may result in your child's having what is politely called "anal leakage." Once you know about LI, however, you should be able to avoid this by either keeping your child away from large amounts of milk or by making sure you keep lactase pills available at all times. If children do stay away from milk, there is always the "different child" syndrome, in which they dislike not being like everybody else. This is usually not a major problem; children with milk allergies, who must be many times more cautious about milk than anyone with LI, soon learn how to cope.

Q. It seems that I can't digest anything high in carbohydrates without extreme LI symptoms. Is there lactose in spaghetti? potatoes? biscuits? bread? cake?

A. There can be - and most likely is - lactose in biscuits, breads, and cake, (although definitely not in spaghetti and potatoes unless it's added in cooking) but that's probably totally besides the point. Lactose and most other carbohydrates share one trait in common: they must be broken down into simpler sugars by digestive enzymes. Usually the lactase enzyme that digests lactose is the only one missing, but that does not have to be the case. And in fact the inability to digest carbohydrates may be an indication of a more serious underlying problem. I would advise you to talk to your doctor about this and see if testing needs to be done.

Q. The packaging of Kraft's Cracker Barrel Cheese states that it's lactose free (or no lactose). Your listing didn't include this cheese. What do you know about this?

A. I know that you're reading it wrong, exactly what Kraft wants you to do. It does not in fact say lactose free. It says 0 grams of lactose per serving, a very different thing. All aged cheeses are low in lactose. If you choose your serving size carefully enough, you can always get the lactose content down below 0.5 grams in a serving, at which point the government will legally allow you to say 0 grams. So the lactose content is undoubtedly less than 0.5 grams per ounce, which is the size of their serving. But if there are 0.4 grams per serving, that is a full 1.5% lactose. (There are 28 grams in an ounce: 0.4 divided by 28 is just about 1.5 percent.) It may be much lower, but there is no way to tell. In the meantime it is a clever marketing gimmick, but the cheese is probably not lactose free, even though it is almost certainly tolerable by almost anybody with LI.