Lactose intolerance is a very common condition. Sometimes it is congenital, most often the body loses its ability to digest milk sugar over time. What are the symptoms of the disease in infants, what diet to use after diagnosis?
Lactose intolerance in infants
What is the difference between lactose and lactase
Lactose is a milk disaccharide composed of glucose and galactose molecules. Cow's milk contains up to 4.8-4.9 g of lactose per 100 g of the product, but in breast milk it is even more - 6.8 g per 100 g.
Lactose is found in milk
To break down milk sugar in the human digestive system, an enzyme is produced - lactase, with a shortage of which, lactase deficiency is diagnosed.
Causes of lactase deficiency
Lactose intolerance is caused by a malabsorption of milk sugar in the intestines. This is due to the low concentrations of lactase produced in the small intestine. Consequently, the enzyme is unable to break down all of the lactose. It enters the colon where it is attacked by bacteria, producing fluids and gases that cause symptoms of lactose intolerance.
Causes contributing to low lactase production and impaired lactose absorption in infants:
- Small intestine injury. Infections, illnesses, medication, and surgery that damage the small intestine can reduce lactase production.
- Premature birth. In premature babies, the small intestine may not produce enough lactase in the first months after birth. As the child grows, enzyme production often returns to normal.
- Congenital lactase deficiency. It is often caused by a genetic factor. However, the small intestine produces very little or no enzyme for the breakdown of milk sugar.
Symptoms
When lactose intolerance occurs in infants, the symptoms are often confused with cow's milk protein allergy. However, these two anomalies have different causes and slightly different symptoms.
The most common sign of an allergic reaction is a skin rash. To recognize the symptoms of lactose intolerance in infants, you need to look for the following:
- bloating;
- colic;
- flatulence;
- nausea and vomiting;
- diarrhea;
- frequent regurgitation;
- foam, mucus appear in the stool, it can turn green and often irritate the anus and intimate areas;
- children using adapted formulas may be constipated.
The child has abdominal pain
Varieties of pathological condition
There are several types of lactose intolerance in babies:
- Alactasia. This is a congenital lactase deficiency, in which it is not produced in the body. It can appear already at the first feeding and be transmitted sequentially to the offspring.
- Secondary intolerance. It is provoked by diseases or factors that cause the destruction of the intestinal epithelium and villi responsible for the production of lactase. Among them stand out:
- Crohn's disease;
- celiac disease (gluten intolerance);
- gastrointestinal parasites;
- cystic fibrosis;
- food allergy to cow's milk;
- gastrointestinal infections manifesting as acute diarrhea (rotavirus).
- Relative intolerance. With sufficient production of the lactase enzyme, it may not be enough for the complete breakdown of milk sugar due to its excessive intake in the digestive tract. As a result, lactose intolerance appears in infants, the symptoms of which are identical, since undigested lactose enters the large intestine and provokes the same processes as in the absence or insufficient production of the enzyme.
Important! If you often change breasts when feeding a newborn, then she will receive an excess amount of milk sugar, since there is more of it in the first milk.
Diagnostic methods
According to statistics, about 1% of children suffer from congenital lactose intolerance and up to 10% acquire it later. It is important to diagnose the disease in time and choose an appropriate diet.
Diagnostic specialists use the following methods:
- Stool analysis for coprogram. Allows you to determine the pH (acidity) of feces. Undigested lactose causes acidification of stool.
- Hydrogen breath test. This involves administering an oral dose of lactose to a newborn, then measuring the concentration of hydrogen in the breath. Exceeding it helps to understand the presence of lactose intolerance, which is fermented in the large intestine with the release of a large amount of hydrogen, which is removed by breathing.
Hydrogen breath test
- Elimination test. The baby should adhere to a lactose-free diet for 2 weeks. It is observed whether the symptoms disappear during this period, and whether they reappear after consuming milk sugar.
- Endoscopy. During an endoscopic examination, the doctor takes a sample of the small intestine to determine the lactase content. This method is used very rarely in infants due to its trauma.
How to help a baby
If a child is diagnosed with lactose intolerance, then the main treatment is to beware of foods that contain it. The doctor will tell you which foods should not be consumed and what can be substituted for them. This is especially true for babies whose diet is based on milk.
Note. In the case of serious diseases, due to which a lack of the lactase enzyme develops, the baby will need specialized treatment.
Catering
Based on the fact that alactasia, that is, the congenital absence of an enzyme that breaks down milk sugar, is extremely rare, Dr. Komarovsky advises: you should not rush to abandon HS and switch to lactose-free mixtures. The production of lactase is often restored with proper organization of nutrition for the baby:
- So that the baby does not receive an excess amount of lactose, which his body is unable to cope with, while breastfeeding, you should not change the breast often, let the baby suck it out to the end.
Important! You can express the first milk a little, then give the breast to the baby.
- It is necessary to ensure that the baby does not overeat. For children using adapted formulas, a hole in the nipple should be made in such a way that the milk does not pour out too freely.
- If lactase intolerance is diagnosed, breastfeeding remains, but it is necessary to use the drug "Lactase Baby" or "Lactazar". It is added to expressed milk and given to the baby first. Then you can breastfeed him.
The drug "Lactase Baby"
Important! The level of lactose in human milk is not affected by any foods consumed by the mother.
Switching to lactose-free mixtures
With mixed and artificial feeding, doctors advise switching to lactose-free milk formulas. For babies with a congenital lack of lactase, they must be used constantly.
Children with a temporary impairment of enzyme production, for example, after an infectious bowel disease, usually have a few weeks of feeding lactose-free formulas. Then, on the recommendation of a specialist, there is a transition to feeding with fermented milk mixtures, where there is much less lactose, or alternation of normal products with lactose-free ones. When enzyme production is restored, you can feed your baby again with a regular formula.
Lactose-free mixtures
You cannot switch to lactose-free mixtures abruptly, since the child is likely to have allergies, a general deterioration in the condition, and constipation. It is recommended to do this in stages:
- The first day - one-time feeding in the amount of 30 ml;
- The second day - two meals a day, 60 ml;
- Third to fourth day - two full feeds;
- The fifth day - using only lactose-free mixture.
Important! During the transition period, you need to constantly monitor the condition of the baby. In case of negative symptoms, it is recommended to change the brand of the lactose-free mixture.
Lactase deficiency is most often temporary and reversible, its treatment is prescribed for each child individually, depending on the causes of the disease.
