Lactase deficiency

Lactase deficiency

For a long time now, everyone has known about the need for breastfeeding. Pregnant women are told about this in the antenatal clinic, postpartum women are told by obstetricians, young mothers are told by doctors in the children's clinic. All well-known baby food manufacturers write on every can of formula that breast milk is indispensable for babies. A mother experiences great happiness when breastfeeding her baby; the child grows self-confident, with a sense of security, sympathy for the world around him, his psyche is more stable than that of a baby who is bottle-fed.

However, circumstances may arise in which breastfeeding, no matter how desired, is not possible. There are certain diseases in which infants need special feeding, different from breastfeeding. One of them is lactase deficiency.

This pathology is also called alactasia (a milder form is hypolactasia) and is a deficiency of lactase, an enzyme that breaks down the main carbohydrate of mother's milk - lactose.

In order for milk to be absorbed by the child’s body, the nutrients it contains are broken down by special enzymes into simpler molecules. Enzymes are found in saliva, gastric juice, bile, and are 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 less well.

The main energy and structural part of breast milk is lactose - milk sugar, a carbohydrate that is the main one in the nutrition of infants. It is broken down 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 component parts, it remains in the intestines, causing loose stools, increased gas production, and creating an environment for microbes to multiply.

The diagnosis of lactase deficiency is made by a doctor based on the parents’ story, examination of the child’s stool for carbohydrates, lactic acid, pH, and a provocative test with lactose (increased hydrogen content in exhaled air).

Treatment of lactase deficiency is based on diet therapy with the limitation or complete exclusion of products containing lactose: breast milk, regular adapted and non-adapted milk formulas, fermented baked milk, sour cream, milk porridges and puddings, kefir, acidophilus. Of the mixtures currently sold, we can recommend lactose-free AL 110, low-lactose “Nutrilon with low lactose content”, soy mixtures: Alsoy, Enfamil-soy, Isomil, Nurse.

The transfer of children to recommended formulas is carried out within 2-3 days; for infants, it is enough to replace 1/3-1/2 of the feeding volume; for formula-fed infants, a complete replacement of the formula is necessary. On days 2-4 of treatment, the child becomes calm, vomiting, diarrhea, and gas disappear, and from 4-5 days the baby begins to gain weight.

It is advisable not to stop breast milk for as long as possible, since it contains a large amount of substances (for example, immunoglobulins) that the child cannot receive from 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's protein, less often mother's milk, improper introduction of any complementary foods (including .including juices and milk formulas), 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 treatment methods recommended by the doctor, keep a food diary, and create a calm, comfortable environment for the child in which recovery will be faster and the likelihood of relapse will be reduced.