lactase deficiency

Lactase deficiency is a congenital or acquired condition in which the body, due to a lack / absence of the lactase enzyme, is not able to break down milk sugar – lactose, that is, it cannot absorb milk.

Varieties of lactase deficiency

According to the severity, there are partial and complete lactose intolerance; by origin are distinguished:

  • Primary LN – it can be congenital (genetically determined, familial), transient (occurs in premature babies) and adult type.
  • Secondary LN develops as a result of intestinal infections, as well as any diseases of the gastrointestinal tract.

If the activity of the lactase enzyme is insufficient to break down all the milk sugar (lactose) that enters the small intestine, lactose in an unchanged state passes into the large intestine. There it becomes food for numerous microorganisms. Although a child will need a small amount of unsplit lactose in the colon (lactose is a nutrient medium for bifidobacteria), its excess leads to a quantitative and qualitative change in the composition of the microflora with the development of lactose intolerance.

The severity of LN depends on the level of the decrease in the enzyme and the individual characteristics of the intestine.

The main symptoms of lactase deficiency

  • diarrhea (diarrhea) after drinking milk. In babies, stools are frequent, liquid, frothy, with a sour smell, and the stomach may hurt
  • flatulence (increased gas formation in the intestines)
  • in small babies, dehydration of the body is likely, insufficient weight gain

Treatment of lactase deficiency

The method of treatment is selected depending on the age of the patient, the degree of lactase deficiency and the origin of the disease.

In primary LN, the basis of treatment is to reduce the amount of lactose in food, up to its complete elimination. In parallel, intestinal dysbacteriosis is corrected.

With secondary LN, the main attention is paid to the treatment of the underlying pathology, and the decrease in the amount of lactose in food is only temporary.

You can reduce your lactose intake by reducing or eliminating whole milk from your diet. At the same time, the presence in the menu of cheeses, sour-milk products, butter is allowed. This method is best for adults and older children. If the baby is breastfed, the best way out is not to reduce the amount of breast milk, but to use special products that break down lactose. The drug is added to expressed breast milk, and after mixing, it is recommended to set the milk aside for a few minutes for fermentation. The drug is given at each feeding.

Formula-fed babies will need to pick up a mixture with a sufficient amount of lactose. Complementary foods (cereals, vegetable purees) for children of the first year of life with LN are prepared not with milk, but with low- or lactose-free bases. Fruit juices are introduced into the diet of such babies later, in the second half of life.

In infants older than 1 year and adults with lactase deficiency, it is advisable to replace milk and dairy products with specialized low-lactose meals. Condensed milk and confectionery products with milk fillers are excluded from the menu. If low-lactose products are not available, lactase capsules are recommended.

Articles from the forum on the topic ” Lactase deficiency “

How does lactase deficiency manifest itself in children?

Answer #1

However, there may be circumstances in which breastfeeding, however desirable, is not possible. There are certain diseases in which infants need special, different from breastfeeding, feeding. One of them is lactase deficiency.

This pathology is also called alactasia (a milder form – hypolactasia) and is a lack of lactase, an enzyme that breaks down the main carbohydrate in breast milk – lactose.
The diagnosis of lactase deficiency is made by a doctor based on the story of the parents, the study of the child’s feces for carbohydrates, lactic acid, pH, a provocative test with lactose (an increase in the hydrogen content in the exhaled air).

Treatment of lactase deficiency is based on diet therapy with the restriction or complete exclusion of products containing lactose: mother’s milk, conventional adapted and non-adapted milk formulas, fermented baked milk, sour cream, milk porridges and puddings, kefir, acidophilus. Of the mixtures currently on sale, we can recommend lactose-free AL 110, low-lactose “Nutrilon with low lactose content”, soy mixtures: Alsoy, Enfamil-soy, isomil, Nursoy. Justified the use of mixtures containing lactase, such as Laktofidus company Danone. If desired, while maintaining breastfeeding, you need to give the baby the enzyme lactase.

The transfer of children to the recommended mixtures is carried out within 2-3 days, in infants it is enough to replace 1/3-1/2 of the volume of feeding, artificial people need a complete replacement of the mixture. On the 2-4th day of treatment, the child becomes calm, vomiting, diarrhea, gassiness disappear, from 4-5 days the baby begins to gain weight. Milk-free complementary foods for children with lactase deficiency are started earlier, following the diversity of the diet and the balance of key nutrients. From dairy products, yogurts containing live biocultures and cheeses can be introduced into the child’s diet, they are also digested with a lack of lactase. With a long dairy-free diet, calcium must be added to the baby’s diet. With secondary hypolactasia, complete clinical and laboratory remission is achieved in two to three months,

It is advisable not to cancel breast milk for as long as possible, since it contains a large amount of substances (for example, immunoglobulins) that a child cannot get anywhere other than breast milk.

In newborns and babies, the causes of abdominal pain, regurgitation, diarrhea can be not only lactase deficiency, but also intestinal infections, dysbacteriosis, non-sterile (with microbes) breast milk, intolerance to cow protein, less often mother’s milk, improper introduction of any complementary foods (including hours of juices and milk mixtures), so it is better to entrust the diagnosis and choice of treatment to a professional. It is necessary to strictly adhere to the diet and other methods of treatment recommended by the doctor, keep a food diary, create a calm, comfortable environment for the child in which recovery will go faster and the likelihood of relapses will decrease.

In order for milk to be absorbed by the child’s body, the nutrients contained in it are broken down by special enzymes into simpler molecules. Enzymes are found in saliva, gastric juice, bile, produced by the pancreas and villi of the intestinal wall. Enzyme activity in young children is normally low and increases as the child grows. With harmful effects on the baby’s body, enzyme systems are depleted, and milk is digested and absorbed worse.

The main energy and structural part of breast milk is lactose – milk sugar, carbohydrate, which is the main one in the nutrition of infants. It is cleaved by the enzyme lactase into a glucose residue and a galactose residue, which, due to their small size, can already be absorbed into the blood. If lactose is not broken down into its constituent parts,

Answer #2

Lactase deficiency is manifested by attacks of intestinal colic, diarrhea, regurgitation, vomiting, bloating, decreased appetite, anxiety, insufficient weight gain and, as a result, malnutrition. The stool is rapid, watery, frothy, with a large amount of gas, sometimes with greenery, with a sour smell. Symptoms are persistent and there is no significant effect from treatment with enzymes and probiotics.

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