Lactose in nature is found only in the breast milk of mammals. That is, only during breast-feeding milk sugar enters the child's body. Not all children equally well perceive mother's milk, and the reason for this can be lactase deficiency.
Lactase insufficiency - what is it?
Lactose intolerance is a deficiency or complete absence in the child of an enzyme that breaks down lactose, which manifests itself in intolerance to dairy products. If we consider the role of lactase in more detail, then its function is the splitting of lactose into two simple sugars: glucose and galactose, which are absorbed through the walls of the intestine. If this splitting is not possible, excess fluid accumulates in the intestine, which is accompanied by diarrhea .
Lactase deficiency - causes
The reasons for which there is lactase deficiency in infants, there may be several, but it is worth knowing that the predisposition is higher in those infants who were born prematurely. Beginning with the 24th week of fetal development in the intestine begins the production of lactase and in babies who were born before the term, this process is not started at full strength. Lactase insufficiency can be of two types: primary and secondary.
Primary lactase insufficiency
This species is due to heredity, that is, it is the genetic intolerance of lactose, due to the innate mutation of the genes. This kind of lactase intolerance occurs in five to six newborns out of a hundred. No matter how far science has gone far in development, the causes of such a breakdown of genes have not yet been found. There is a hypothesis that lactase congenital insufficiency is a symptom of a genetic disease that is not yet discovered by scientists.
Secondary lactase insufficiency
The reasons for which lactase deficiency occurs in children may be several, and after their elimination, the ability of the intestine to produce lactase is completely restored. The main causes of secondary LN:
- intestinal infections ;
- celiac disease ;
- an allergy to milk protein.
From here it is possible to draw corresponding conclusions: secondary lactase deficiency is not an independent disease, but manifests itself due to the presence of other diseases. It is important for parents to know that after setting such a diagnosis, the next step should be the search for the root cause and its further elimination. This applies to cases if the diagnosis is made to a child up to 3 years of age.
Lactose intolerance - symptoms
There are some signs of lactose intolerance, in the presence of which there may be a suspicion that there is a lactase deficiency in the infant, the symptoms of which are similar in the primary and secondary form. Information, as manifested lactose intolerance, will be very useful for every mother:
- colic and / or bloating;
- after breastfeeding or afterwards, the child shows undue anxiety;
- a very frequent liquid stool of yellowish color with an acidic odor and a foamy consistency (upon settling the stool is divided into dense and liquid fractions);
- there are problems with the weight of the child - it is either poorly recruited or goes down.
Lactase insufficiency - diagnosis
The question of how to determine lactose intolerance is of interest to young and inexperienced mothers who have not previously encountered such a situation. Since this disease can occur not only in infants, but also in adults, we offer all kinds of diagnostics, with the exception of dietary diagnostics, when the products are removed from the ration with lactose and the symptoms disappear.
In order to confirm LN, the following tests are carried out:
- respiratory (the level of methane and hydrogen in the exhaled air is above the norm);
- absorption of D-xylose;
- the determination of carbohydrates in the stool by the method of Benedict;
- glycemic profile, after carrying out lactase load.
Lactose intolerance assay
The most common method of diagnosis is the determination or disproval of lactose intolerance by clinical studies of stool by the method of Benedict. This method is designed to reflect the body's overall ability to metabolize carbohydrates. Taken stool for lactase deficiency or its suspicion is subjected to studies that help to identify the presence of sugars that have the ability to restore copper from the state of Cu2 + to Cu +, that is, having a reducing activity.
Lactase insufficiency - treatment
If lactase insufficiency in newborns is detected and it is secondary, then it is first of all necessary to consult a doctor with the purpose of diagnosing the underlying causes that provoked lactose intolerance. Previously mentioned the fact that LN is not an independent disease, but a consequence of the presence of other diseases and disorders in the body. To ease the condition and eliminate symptoms, some groups of medicines may be used, but one must pay attention to how much and whether it is possible to give them to children!
Containing lactase:
- Tilactase;
- Lactraza;
- Lactase and Lactase Baby.
Preparations for the restoration of intestinal microflora:
- Enterol;
- Bifilysis;
- Acipol;
- Bibiform.
Medications to eliminate bloating:
- Babi Kalm;
- Espumizan.
Used for diarrhea:
- Diosmectit.
When does lactase insufficiency occur?
The question of when lactose intolerance can pass in infants, implies the case of acquired lactose insufficiency, because if a child has a congenital mutation of genes, then with age, she will not go anywhere. With secondary LN, the symptoms will pass if the cause is eliminated-to find a disease or infection that provokes lactose intolerance. If the cause is prematurity, many pediatricians promise to restore lactase production by 2-3 years, due to the fact that the intestine will form finally and begin to cope with the splitting of lactose.
Lactase insufficiency - clinical recommendations
If the baby has transient lactase deficiency, then besides these ways to get rid of it, it is worthwhile to listen to the recommendation of experts on the organization of breastfeeding, on which very much depends. The thing is that the composition of mother's milk at the beginning and end of feeding varies - fat content in the end rises, and in the beginning milk is more watery. Watery milk comes from the baby's stomach into the intestines faster than fatty, so lactose can not be split in full and provoke fermentation, swelling and frequent sour stool.
Here's what the doctors advise:
- Do not decant after feeding, so there will be less fatty milk with a high content of lactose.
- Breast change is not recommended until complete devastation for the same reason.
- It is more preferable to often feed one breast, because this will run less watery milk.
- Night feeding is shown because of the production of more fatty milk.
- Experts recommend not to stop feeding until the baby is fully saturated.
- Proper application plays an important role. So, painful sensations at feeding can speak about not correct application. The use of gaskets should be avoided because they contribute to the incorrect formation of abnormal breast engagement and ineffective sucking.
Lactase insufficiency - diet
Many are interested in the question of what diet is recommended for lactose intolerance to mothers. The baby may have an allergy to whole milk protein, so it is recommended that mom not consume whole milk. Its protein can be absorbed from the intestine and into the blood and from there into the breast milk, which will cause the symptoms of LN. In rare cases, nurses are recommended to remove from the diet not only whole cow milk, but also other products:
- butter and products containing it;
- cottage cheese and cheese;
- sometimes all dairy products;
- beef.
The issue of feeding the mother, whose child is suffering from lactose intolerance, must also be considered from the side of permitted and prohibited products. If we consider foodstuffs that are best to refuse, then their list is not that big and it will not be difficult to adhere to the diet:
- dishes with spices, spicy and salty;
- products with preservatives, stabilizers, emulsifiers and dyes.
- Coffee, coffee-based drinks and alcohol;
- red vegetables;
- fruit of exotic origin;
It is recommended to reduce the use of such products:
- sugar;
- black bread;
- grapes;
- sweet kinds of baking.
What is allowed to include in the diet of a mother during the GW:
- dried fruits compote;
- in small amounts of jelly and pastille;
- vegetables in any form, but not fried;
- berries;
- cereals, ideally - sprouted.
Mixture for lactase deficiency
What can mother advise, who are forced to abandon breastfeeding, and are wondering what to replace milk with lactose intolerance, so it is wise to approach the choice of the mixture. It is recommended to use special mixtures that do not contain lactose or have a low content, which are produced using membrane filtration technology. It is better, if the choice of a mixture will take a child's doctor.
Lactose-free mixtures:
- Frisoosa. A mixture of Dutch made, produced and a special soy isolate.
- NAN (without lactose). The Swiss mixture of highly adaptable milk is applicable for primary and secondary LN.
- MD mil Soy. A mixture of soybean beans, which is further enriched with selenium, methionine and L-carnitine.
- Mamex (lactose-free). Mixture on vegetable lipids with maltodextrin, taurine and carnitine.
- Nutrilac (lactose-free). A popular lactose-free mixture of Russian origin.
Mixtures with a low lactose content:
- Nutrilon is low-lactose. Russian product, applicable for artificial nutrition or mixed version.
- Nutrilac is low in lactose. The Dutch mixture, which is allowed from birth. Contains corn syrup and taurine.