Milk and Medications: The Tale of a GI Virus

We were forced to take a small break from Free Snacking this week since we were recovering for a GI virus. This virus took out my poor two-year-old for 48 hours and introduced me to the world of hidden dairy in medications and supplements.

After a full night of throwing up, I went to the grocery store to look for some Pedialyte. The Pedialyte section, just like most things, seemed to be suffering from a two year pandemic supply chain problem (though it was right beside the infant formula so that put complaints into perspective), and the only kind they had was Pedialyte Advanced Care. Ok, that’s fine, I thought. I read through the list (because that is what I have been trained to do); water, sugar, some long words… seemed fine. Then I saw there was a contains statement- milk! I reread the ingredients.

Water, Dextrose. Less than 1.0% of: Galactooligosaccharides, Citric Acid, Potassium Citrate, Salt, Sodium Citrate, Natural & Artificial Flavor, Sucralose, Acesulfame Potassium, Zinc Gluconate, Blue 1, and Red 40.

Contains milk ingredients?!?!? Why, Pedialyte, why?!

Galactooligosaccharides have got to be the offending party here. But what are they? According to the internet, they are a prebiotic made up plant sugars that are found in dairy products, beans, and certain root vegetables. Prebiotics are things that the bacteria in your gut like to eat, so I guess the “advanced care” here is trying to make your gut bacteria happy again after diarrhea has destroyed their precious biome. People who are allergic (IgE mediated, actually ALLERGIC not intolerant) to milk are allergic to milk protein. Galactooligosaccharides, by themselves, should be fine for my kid to eat. But when I see "milk" I'm not bringing that near my kid.

I guess my bigger question is if these prebiotics are found in beans and root vegetables, why did Pedialyte decide to go the dairy route? Cow’s milk protein allergy affects 2-6% of children! And lord knows how many people think they are lactose intolerant. And vegan. Anyways, I guess I’ll just be giving my kid only the normal amount of care in the future.

Which brings me to the next realization of hidden diary. After throwing up for over 24 hours, we headed out to our pediatrician and got some much needed Zofran (anti-nausea medication) so that my kid could at least drink something without vomiting immediately. We got our script for it and headed on our way. At the pharmacy, when we were picking it up, the pharmacist mentioned “Oh hey, noticed she’s allergic to milk, this has milk in it, but it’s probably fine because it’s just lactose, just try a little bit, make sure she doesn’t die, and then she can have her full dose. Have a good night!”

I’m sorry, that can't be your professional advice for somebody with severe food allergies? I’m going to give that advice 0/5 stars, would not trust you to feed my baby, and how did you get this job?

After talking to my pharmacist sister-in-law, my kid’s pediatrician, and looking at Go Diary Free, I’ve learned some things. Lactose is a fairly common ingredient in medications, especially tablets. It apparently makes things taste better- creamy and slightly sweet to offset whatever the active medication tastes like (milk: why you so delicious?). Lactose, just like our prebiotic friend above, shouldn’t be a problem in people with IgE mediated milk protein allergies, however again, it is definitely a milk product and there is always a risk of contamination. Liquid Zofran (that my kid had the doctor’s office and the kind that we picked up from the pharmacy) doesn’t have any milk products in it. I even checked the ingredient list on “package insert” and there was no mention of any milk products.

I’m not sure why the pharmacy where I picked up the liquid Zofran from had an alert that it contains milk (when it was easy enough to check that it does, indeed, not), but I did learn some things. I’ve got to continue to check ingredient lists on medications as well as food (even if there's no good reason for that food to have allergens in it. Seriously Pedialyte? Seriously?). And we need to be especially careful with dissolvable tablets, even over the counter. Milk! It’s everywhere!