Breastfeeding (GV) 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 absorb breast milk or artificial mixtures. In this case, they speak of lactose deficiency. It is useful for all parents to know its main symptoms and methods of treatment.
What is lactose deficiency?
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 assimilation of trace elements. In the gastrointestinal tract, lactose breaks down, forming glucose and galactose. The first provides about 40% of the energy needs of the newborn. Galactose is involved in the formation of retinal tissues and the development of the central nervous system.
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 processed. In its original form, lactose reaches the large intestine, where it serves as a breeding ground for bifidobacteria and lactobacilli. They form a beneficial intestinal microflora. After a spirit of years, lactase activity naturally decreases.
It turns out that the lactose contained in the mother’s breast milk is always enough for the baby. And lactase can be a problem if, for whatever 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 deficiency, we have already figured out.
It is primary and secondary. Primary, in turn, is divided into the following varieties:
- Congenital Due to a genetic defect, inherited from parents. The enzyme is completely absent in the intestines. 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 10-12 weeks of fetal development. From the 24th week, an increase in its activity begins, which reaches a maximum by the time the baby is born. This condition disappears over time, and the enzyme activity normalizes.
- Adult type. Many older children and adults do not tolerate lactose. This is manifested by rumbling in the abdomen, increased gas formation, diarrhea. Such people are recommended a lifelong lactose-free diet.
The secondary form, or hypolactasia, is most common. She is an acquired pathology. It can occur against the background of gastrointestinal diseases, with infectious or inflammatory lesions of the intestine (rotavirus, enteritis, giardiasis, etc.).
In medical practice, the opposite state of lactose deficiency is often found. A lactating woman accumulates a large amount of milk. As a result, the child asks for food much less frequently. First of all, he receives a portion of nonfat front milk 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.
First symptoms
Determine lactose deficiency in infants, as a rule, is not difficult. Its first signs appear a few weeks after birth:
- Breastfeeding shortly after the start of feeding. At first, the baby actively sucks a breast with a good appetite. But after a few minutes she becomes tearful and restless, refuses food.
- Abdominal pain, colic. This symptom may appear during feeding or immediately after it. At the same time, the baby cries and knocks with legs.
- Frequent spitting up to vomiting.
- Bloating.
- Change in smell, color and stool consistency. In children, breastfeeding is usually observed diarrhea, and artificial - constipation.
- Increased gas formation.
- With diarrhea, the stool has a foamy consistency, a greenish color, a sour smell. The frequency of bowel movements can reach 12 times a day.
- Atopic dermatitis.
- Weight gain is not observed. In especially serious cases, malnutrition is detected - weight deficiency.
The presence of one or several symptoms from the list above is an occasion for parents to be wary. It is necessary to consult a doctor as soon as possible for an accurate diagnosis, treatment appointment.
Diagnostic Methods
A pediatrician or pediatric gastroenterologist is involved in the study of symptoms and treatment of lactose deficiency. To make sure that there is a pathology in the child, doctors use many diagnostic methods. With their help, you can determine the causes and type of disorder. First, the doctor examines the child, examines his anamnesis, feeding schedule.
The next stage is the so-called lactose-free diet. Milk sugar is removed from the diet. If the symptoms disappear within a few days when the child is transferred to a lactose-free diet or the addition of an enzyme to each feeding, this indicates the presence of pathology. When you try to give milk again, diarrhea and colic come back. All results are recorded in a special diary.
Mandatory is a blood test for lactose deficiency, which determines the growth of 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 normal operation of the enzymatic system, it lacks carbohydrates. In the first months of life, their insignificant presence is allowed. If the body refuses to absorb lactose, feces will contain a large percentage of carbohydrates. Simultaneously with this study, a pH study is being conducted. Normal acidity of feces is neutral or slightly alkaline (indicators from 6.5 to 7). With lactose deficiency, it is sharply acidic (less than 5.5).
A comprehensive examination of the child's body is necessary to eliminate inaccuracies in the diagnosis. Many inexperienced parents do not know what lactose deficiency is. Therefore, its manifestations are mistaken for other diseases.
Danger disorder
For children in their 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, there is a lesion of the upper layer of the intestine, a slowdown in the formation of enterocytes.
In undigested form, milk sugar provokes dysbiosis, contributes to the violation of the natural microflora of the gastrointestinal tract. As a result, a characteristic rash appears on the baby's body. With lactose deficiency, this is one of the initial symptoms that should be paid attention to. Penetrating into the stomach, lactose causes increased gas formation and is the cause of fermentation. As a result, the child becomes tearful and restless.
Refusal of a diet entails weight loss. A weakened body becomes vulnerable to pathogenic microflora. Against the background of the inability of the stomach to fully digest heavy food for him, there are attacks of diarrhea. Such a disorder unbalances any adult. For a newborn, it can be fatal, since dehydration occurs simultaneously with diarrhea.
Therapy Features
How to treat lactose deficiency depends on its shape. For example, with a congenital pathology, the child is immediately transferred to a lactose-free milk mixture. Throughout his life, he will be forced to adhere to a low-lactose diet. Secondary therapy is determined by the type of feeding the newborn. Let us dwell on this issue in more detail.
Natural feeding treatment
Therapy with the natural version of feeding is carried out in two stages:
- Natural (regulation of lactose intake).
- Artificial (use of drugs and specialized mixtures).
Symptoms of lactose deficiency in hepatitis B are quite common in completely healthy children. They are not associated with poor enzyme activity, but are due to improperly organized breastfeeding. The child predominantly feeds on “front” milk. The back, which is rich in fat, remains in the chest.
At the initial stage of therapy, doctors give the following recommendations for organizing HB:
- Even with an excess of milk, it is better to abandon regular expressions.
- You need to feed with one breast until it is completely emptied.
- Monitor the correct grip in the child.
- To stimulate milk production, nocturnal feedings should not be neglected.
- In the first 3-4 months, it is undesirable to tear the baby from the breast until the end of sucking.
In some cases, experts recommend for a while a woman to review her diet. In case of lactose deficiency in a child, it will be necessary to exclude foods with a high protein content of cow's milk. This substance is considered a strong allergen. When these products are abused, protein can pass into breast milk, causing an allergy. In its manifestations, it is similar to signs of lactose deficiency.
If the listed recommendations do not bring the proper result, it is necessary to consult a doctor for a second consultation.
The use of lactase preparations and specialized mixtures
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 so much milk sugar, which does not cause digestion. In severe condition (severe diarrhea, dehydration, abdominal pain) for some time it is necessary to exclude it from the diet. However, this is a temporary measure.
The most popular drug-enzyme is considered "Lactase Baby." This product is manufactured in the United States and is available in capsule form. For its use, it is necessary to express 15-20 ml of breast milk, introduce one such capsule into it and leave for several minutes for fermentation. First, the child needs to be given milk with the drug, and then breastfeed. If such therapy is ineffective and only by agreement with the doctor, the dosage can be increased to 2-5 capsules. Analogs of the drug are Lactazar, Lactase Enzyme.
Treatment with enzymes 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 independently and in the required amount produce the enzyme.
Lactose-free infant formula is another treatment option. They are used before HB 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.
Artificial feeding treatment
What is lactose deficiency, even the parents of children who are breastfed 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 monitor the condition of the child, his analyzes. Some doctors prescribe drugs for dysbiosis in parallel with treatment.
Features of the introduction of complementary foods
Feeding dishes are prepared on lactose-free mixtures or goat milk. In case of lactose deficiency, it is better to start acquaintance with new products with fruit puree for industrial production. After 5 months, you can introduce cereals (rice, corn, buckwheat), vegetable purees with a light fiber (zucchini, carrots, pumpkin). With good tolerance, after about 2 weeks you can try mashed meat.
Pediatricians recommend giving fruit juices after 6 months, after diluting them with water in a ratio of 1: 1. With 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.
Opinion Komarovsky
According to the famous pediatrician Komarovsky, adult lactose deficiency, allergy to cow's milk protein is not a problem. Nothing terrible will happen if a person refuses to use 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 the parents did not like in childhood or do not tolerate milk, the probability of its appearance in the child is quite high. These are really sick children who are poorly gaining weight and suffering from gastrointestinal problems.
In all other cases, Komarovsky talks about the influence of pharmaceutical companies. They need to sell lactose-free mixtures, which are much more expensive than regular ones. However, parents, trying to understand the question of how to treat lactose deficiency, take various steps if only the child fully develops.
In premature babies, pathology is usually associated with the immaturity of the body. It passes independently and as organs systems mature. Another reason is banal overfeeding. Moms and dads give the child a large amount of the mixture, which exceeds the permissible norms. As a result, the diagnosis of milk sugar intolerance is confirmed only because an immature organism cannot fully break it down in large volumes.
Breastfed babies are a little harder. If the baby is crying, inexperienced parents at first cannot understand the cause of the concern. He is constantly given breasts. As a result, overfeeding and problems with the breakdown of lactose are observed.
According to the pediatrician, throwing a hepatitis B and transferring the child to a lactose-free mixture is not worth it. You just need to review the feeding regimen, listen to the baby. As for children who are breast-fed, initially you need to change the nipple to the option with a small hole. The harder the baby will suck, the sooner he will feel full. The higher the likelihood that he will not overeat and subsequently experience gastrointestinal problems.
Prevention Methods
What is lactose deficiency in infants, every parent should know in order to recognize the symptoms in a timely manner and seek medical help. Is it possible to prevent the occurrence of pathology?
The issue of prevention should begin to be interested in from the moment of pregnancy and conception. A woman should be responsible for her position, visit a gynecologist in a timely manner and take the necessary tests. A child should be born full-term and with normal weight.
For a newborn, the prevention of lactose deficiency is reduced to the exclusion of infectious lesions and gastrointestinal diseases. Unfortunately, it is not possible to prevent the hereditary form. The main thing is in such a situation to find out in time about cases of pathology in the family.