My Twin Girls Were Tested for Lactose and Fructose Intolerances :: What to Expect

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My husband and I knew we had a long road ahead of us when our twin girls, Elle and June, didn’t tolerate switching to whole milk at age one. After continuing to see mild diarrhea and otherwise soft stools, our pediatrician referred us to a GI doctor at Children’s of Alabama. Among other things, the GI doctor ordered a lactose and fructose test. My husband and I had no idea what to expect.

I am writing this in the hope that those in a similar situation will have an idea of what will happen to them or their child during the testing process!

Before the Tests

We had to do a little prep work prior to their tests. For example, there was a small list of foods they could eat for dinner the night before the test. In short, they had to have something bland for dinner, then fast until the test was over the following morning.

To clarify, Elle and June were 18 months old at the time of the tests. We didn’t do any prep work with them in terms of explaining what was going to happen. We certainly would have if they could comprehend what was going on!

The Tests Themselves

The tests were scheduled to begin at 7:30 a.m. The tests themselves–hydrogen breath tests–weren’t that bad. They had to blow into a small bag to get a baseline number.

Then they had to drink special drinks (lactose for the lactose test, and fructose for the fructose test). Moving forward, they had to blow into a bag every half hour for three hours and were not allowed to eat or drink during the tests. 

The lactose and fructose tests are literally the same tests, just different drinks. We had them done approximately two weeks apart.

Elle and June had their lactose tests done first. They didn’t understand the concept of blowing into the bag, so the nurses fitted the bags with masks and forced them to blow into the bags. This made for some very angry little girls every half hour!

Navigating food allergies and food intolerances in children
Elle blowing into the mask for her lactose test.

Life Hacks to Make Life Easier

After the mask fiasco with the lactose test, I had an idea to use party blowers for the next test. Elle and June love their party blowers, and I figured that bringing some might put them in the right mindset. How right I was! They were actually excited to blow into the bags the second time around. They didn’t have to use the masks at all!

Navigating food allergies and food intolerances in children
Elle blowing into the bag for the fructose test. No mask!

We were also allowed to bring some of their favorite toys to keep everyone entertained for the duration. In our case, we bought some of their favorite toys of that particular moment as well as some books. This kept everyone happy between times!

At least in our case, Elle and June didn’t seem too upset about not having food for more than 12 hours. My husband and I tried to keep them distracted with their toys for the three hours. We did bring a small lunch box with some food they could have before leaving Children’s, though. Everyone’s mileage will vary.

The Result

To make a long story short, Elle and June both have fructose intolerance and June additionally has mild lactose intolerance.

Lactose intolerance is a little easier to work with. We have to watch for milk in things we give June. Most manufactured products say on the label that it contains milk or dairy products in an obvious place. We simply try to avoid those products.

Fructose intolerance is a little more tricky. The biggest culprit they told us to avoid is high fructose corn syrup. This is in many fruit juices and some snacks. At the time, our biggest offender was in some of the jellies we used to make Elle and June’s beloved PB&Js they have at lunch.

Moving Forward

At least in our case, we’re still at the point of gauging Elle and June’s intolerances. We were given a list of various fruits that have different levels of fructose in them. For example, a banana has a low amount of fructose, so they can have more bananas in a sitting than apples, which have a higher amount of fructose. 

One thing we were surprised to hear contains fructose was wheat. This means that we need to limit their intake of white and wheat breads. Even though Elle and June don’t have a gluten intolerance, we were told gluten-free products would be something to consider.

We are still finding what works for us. Whenever we give Elle and June something we know has fructose, we are watching for reactions and moving forward as needed. It will for sure be a long road ahead trying to work out all the kinks, but my husband and I are looking forward to figuring out our new normal!

How about you? Has your family dealt with lactose and/or fructose intolerances? I’d love to hear your experience and tips in the comments below!

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Kristina is an Alabama native who came to Birmingham in 2005 for college (has it really been 15 years?!). She had lived in Muscle Shoals her whole life up until that point. After graduating from UAB in 2009 with a degree in journalism and a minor in music, she married Paul in 2011. Paul has worked in the tech industry since 2009. Kristina has had several jobs in the area - everything from banking, veterinary medicine and receptionist. She most recently worked from home as low-level tech support. Kristina and Paul had the biggest surprise of their lives when they went in for the first 8-week ultrasound and found out that they were expecting "spontaneous" twins! Everything was going to change already, but they had to multiply it by two! Two girls, Elle and June, were born in July 2019 and nothing has been the same since. Kristina is now a stay-at-home mom to Elle and June and it has been the most rewarding job of all! Kristina, Paul, Elle and June make home in Alabaster, where you can usually find them on the weekends. They like going around to the things in the area, such as shopping and going on walks in the park. The babies are famous - neither Kristina or Paul can go anywhere alone without people asking about the twins!