Breastfeeding (HF) is a natural and necessary process for every newborn. The longer it lasts, the more complete the development of the child will be. However, not all children can fully assimilate mother's milk or artificial mixtures. In this case, they speak of lactose deficiency. Knowing its main symptoms and methods of treatment is useful for all parents.
What is lactose intolerance?
To answer this question, you first need to understand the terminology.
Lactose (milk sugar) is a carbohydrate that tastes sweet. In breast milk, its content is up to 85%. It is necessary for the formation of immunity and intestinal microflora, the proper absorption of trace elements. In the gastrointestinal tract, lactose breaks down to form glucose and galactose. The first provides about 40% of the energy needs of the newborn. Galactose is involved in the formation of retinal tissue andCNS development.
Lactase is an enzyme that is synthesized in the small intestine. It is he who is responsible for the breakdown of lactose that comes with mother's milk. A small part of it is not recycled. In its original form, lactose reaches the large intestine, where it serves as a nutrient medium for bifidus and lactobacilli. They form a beneficial intestinal microflora. After a couple of years, lactase activity naturally decreases.
It turns out that the lactose contained in mother's breast milk is always enough for the baby. And there can be problems with lactase if for some reason the enzyme is not produced by the body. In this case, they talk about lactose intolerance or lactase deficiency. The term "lactose deficiency" is considered erroneous, but is also widely used in practice.
Types and causes of pathology
What is lactose intolerance, we have already figured it out.
It is primary and secondary. Primary, in turn, is divided into the following varieties:
- Innate. It is caused by a genetic defect, inherited from parents. The enzyme is completely absent in the intestine. This form of the disease is rare, and is manifested by severe diarrhea and dehydration.
- Transient. It occurs in premature or immature children. In the fetus, lactase is first detected at the 10-12th week of intrauterine development. From the 24th week, an increase in her activity begins, which reaches a maximum by the time the baby is born. Suchthe condition resolves over time, and enzyme activity returns to normal.
- Adult type. Many older children and adults are lactose intolerant. This is manifested by rumbling in the abdomen, increased gas formation, diarrhea. For such people, a lifelong lactose-free diet is recommended.
The secondary form, or hypolactasia, is the most common. It is an acquired disease. May occur against the background of diseases of the gastrointestinal tract, with infectious or inflammatory lesions of the intestine (rotavirus, enteritis, giardiasis, etc.).
In medical practice, the opposite state of lactose deficiency is often encountered. A lactating woman accumulates a large amount of milk. As a result, the child asks for food much less often. First of all, he receives a portion of low-fat foremilk, supersaturated with lactose. The enzyme begins to be produced in excess. However, in this case, specific therapy is not required. It is enough to adjust the diet.
As a rule, it is not difficult to determine lactose deficiency in infants. Its first signs appear a few weeks after birth:
- Rejection of the breast shortly after the start of feeding. At first, the baby actively sucks at the breast with a good appetite. But after a few minutes he becomes whiny and restless, refuses to eat.
- Pain in the abdomen, colic. This symptom may appear during feeding or immediately after it. At the same time, the baby cries and knocks with his legs.
- Frequent regurgitation to the point of vomiting.
- Change in odor, color and consistency of feces. Breastfed babies tend to have diarrhea, formula-fed babies tend to get constipated.
- Increased gas formation.
- When diarrhea occurs, stools are frothy, greenish in color, and smell sour. The frequency of bowel movements can reach 12 times a day.
- Atopic dermatitis.
- No weight gain observed. In especially serious cases, malnutrition is detected - a lack of weight.
The presence of one or more of the symptoms from the list above is a reason for parents to be wary. It is necessary to see a doctor as soon as possible to make an accurate diagnosis and prescribe treatment.
A pediatrician or pediatric gastroenterologist studies the symptoms and treats lactose intolerance. To make sure the child has a pathology, doctors use many diagnostic methods. With their help, you can determine the causes and type of disorder. First, the doctor examines the child, studies his anamnesis, feeding pattern.
The next step is the so-called lactose-free diet. Milk sugar is removed from the diet. If, when transferring a child to a lactose-free diet or adding an enzyme to each feeding, the symptoms disappear within a few days, this indicates the presence of a pathology. When trying to give milk again, diarrhea and colic return. All results are recorded in a special diary.
A blood test for lactose is mandatoryinsufficiency, which determines the increase in sugar. After it, a sample of exhaled air is taken from the child for several hours to assess the concentration of hydrogen.
Another informative diagnostic method is fecal analysis. During the normal operation of the enzymatic system, it does not contain carbohydrates. In the first months of life, their slight presence is allowed. If the body refuses to digest lactose, the feces will contain a high percentage of carbohydrates. Simultaneously with this study, a study of pH is carried out. Normally, the acidity of feces is neutral or slightly alkaline (indicators from 6.5 to 7). With lactose deficiency, it is sharply sour (less than 5.5).
A comprehensive examination of the child's body is necessary to exclude inaccuracies in the diagnosis. Many inexperienced parents do not know what lactose deficiency is. Therefore, its manifestations are mistaken for other diseases.
For children of the first year of life, this pathology can be extremely dangerous. It negatively affects the functioning of the main systems of internal organs. At the same time, the upper layer of the intestine is damaged, and the formation of enterocytes is slowed down.
Undigested milk sugar provokes dysbacteriosis, contributes to the disruption of the natural microflora of the gastrointestinal tract. As a result, a characteristic rash appears on the baby's body. With lactose intolerance, this is one of the initial symptoms that you should pay attention to. Penetrating into the stomach, lactose causesincreased gas formation is the cause of fermentation. As a result, the child becomes whiny and restless.
Getting off the diet leads to weight loss. A weakened body becomes vulnerable to pathogenic microflora. Against the background of the inability of the stomach to fully digest food that is heavy for it, attacks of diarrhea occur. Such a disorder unbalances any adult. For a newborn, it can be fatal, as dehydration occurs simultaneously with diarrhea.
Features of therapy
How to treat lactose intolerance depends on its form. For example, with a congenital pathology, the child is immediately transferred to a lactose-free milk formula. Throughout his life, he will be forced to adhere to a low-lactose diet. Therapy of the secondary form is determined by the type of feeding of the newborn. Let's dwell on this issue in more detail.
Treatment while breastfeeding
Therapy with natural feeding is carried out in two stages:
- Natural (regulation of lactose intake).
- Artificial (use of drugs and specialized mixtures).
Symptoms of lactose deficiency on breastfeeding are quite common in perfectly he althy children. They are not associated with poor enzyme activity, but are due to improperly organized breastfeeding. The child mainly eats "forward" milk. The "back", which is rich in fat, remains in the breast.
At the initial stage of therapy, doctors give the followingrecommendations for organizing breastfeeding:
- Even with an excess of milk, it is better to refuse regular pumping.
- You need to feed with one breast until it is completely empty.
- Maintain proper grip on baby.
- Night feeds should not be neglected to stimulate milk production.
- In the first 3-4 months, it is undesirable to take the baby off the breast until the end of suckling.
In some cases, experts recommend that a woman reconsider her diet for a while. If a child is lactose intolerant, it will be necessary to exclude foods high in cow's milk protein. This substance is considered a strong allergen. With the abuse of such products, the protein can penetrate into breast milk, causing allergies. In its manifestations, it is similar to the signs of lactose deficiency.
If the above recommendations do not bring the desired result, you should seek a second consultation with your doctor.
Use of lactase preparations and specialized formulas
If the rash with lactose deficiency and other signs of the disorder are severe, the doctor prescribes therapeutic nutrition for the child. It is selected with such an amount of milk sugar that does not cause indigestion. In a serious condition (severe diarrhea, dehydration, abdominal pain), it is necessary to exclude it from the diet for a while. However, this is a temporary measure.
The most popular drug-enzyme is "Lactase Baby". This remedy is producedin the US and is available in capsule form. To use it, it is necessary to express 15-20 ml of breast milk, introduce one such capsule into it and leave for a few minutes for fermentation. First, the child needs to be given milk with the drug, and then breastfeed. With the ineffectiveness of such therapy and only by agreement with the doctor, the dosage can be increased to 2-5 capsules. The analogues of the drug are "Lactazar", "Lactase Enzyme".
Enzyme treatment is carried out in short courses. It is stopped when the child is 3-4 months old. At this age, the body, as a rule, can already produce the enzyme on its own and in the required amount.
Another treatment option is lactose-free formula milk. They are used before breastfeeding in the amount of 1/3 of the volume of milk that the child eats at a time. The introduction of the mixture begins gradually, adjusting the volume depending on the severity of the symptoms of the disorder.
Treatment with artificial feeding
What is lactose deficiency, even the parents of children who are bottle-fed know. To eliminate its manifestations, the doctor prescribes a low-lactose mixture. At the same time, the content of milk sugar in it should be comfortable for digestion. The mixture is introduced gradually, replacing the previous one in full or in part.
In case of remission within 1-3 months, such therapy is stopped. Parents also gradually introduce the usual mixture and at the same time control the condition of the child, his tests. Some doctorsalong with treatment, drugs are prescribed for dysbacteriosis.
Features of the introduction of complementary foods
Complementary foods are prepared with lactose-free mixtures or goat's milk. In case of lactose deficiency, it is better to start acquaintance with new products with fruit puree of industrial production. After 5 months, you can enter cereals (rice, corn, buckwheat), vegetable purees with coarse fiber (zucchini, carrots, pumpkin). If well tolerated, mashed meat can be tried after about 2 weeks.
Fruit juices pediatricians recommend giving after 6 months, after diluting them with water in a ratio of 1:1. Dairy products with lactose deficiency should also be introduced in the second half of the year. It is better to start with cottage cheese, hard cheeses, butter.
According to the famous pediatrician Komarovsky, for adults, lactose deficiency, allergy to cow's milk protein is not a problem. Nothing bad will happen if a person refuses to eat certain foods. With children, the situation is somewhat more complicated, because milk for them is the basis of nutrition in the first year of life.
Genetically determined pathology is extremely rare (no more than 0.1%). If parents did not love in childhood or do not tolerate milk, the likelihood of its occurrence in a child is quite high. These are really sick children who do not gain weight well and suffer from problems with the gastrointestinal tract.
In all other cases, Komarovsky talks about the influence of pharmaceuticalcompanies. They need to sell lactose-free formulas, which are much more expensive than conventional formulas. However, parents, trying to figure out how to treat lactose intolerance, take various steps to ensure that the child develops fully.
In premature babies, pathology is usually associated with the immaturity of the body. It passes independently and as the organ systems mature. Another reason is banal overfeeding. Moms and dads give the child a large amount of the mixture, which exceeds the allowable norms. As a result, the diagnosis of lactose intolerance is confirmed only because the immature body cannot fully break down it in large volumes.
Breastfed babies have a slightly harder time. If a child cries, inexperienced parents at first cannot understand the cause of the anxiety. He is constantly breastfed. As a result, there is overfeeding and problems with the breakdown of lactose.
According to the pediatrician, giving up breastfeeding and transferring the child to lactose-free formulas is not worth it. You just need to reconsider the feeding regimen, listen to the child. For formula-fed babies, the nipple should initially be changed to a small hole version. The harder it is for the baby to suckle, the sooner he will feel full. The higher the likelihood that he will not overeat and subsequently experience problems with the gastrointestinal tract.
What is lactose deficiency in a baby, every parent should know in order to timelyrecognize symptoms and seek medical attention. Is it possible to prevent the occurrence of pathology?
The issue of prevention should begin to be interested from the moment of pregnancy and conception. A woman should be responsible for her situation, visit a gynecologist in a timely manner and take the necessary tests. The baby should be born full-term and at a normal weight.
For a newborn, the prevention of lactose deficiency is reduced to the exclusion of infectious lesions and diseases of the gastrointestinal tract. Unfortunately, it is not possible to prevent the hereditary form. The main thing in such a situation is to find out in time about cases of pathology in the family.