Lactase deficiency in children: causes, symptoms, treatment. Lactase deficiency in infants symptoms, causes and treatment Secondary lactose deficiency symptoms

Breast milk is the natural and most desirable food for a newborn. But sometimes the child's body refuses to absorb one of the most important elements in the composition of milk, called lactose. This disorder is called lactose insufficiency, the symptoms in children up to a year of which appear quite early. It will be useful for every parent to know the characteristic manifestations and methods of treatment.

Lactose is a milk sugar found in all mammalian milk. The main task of this element is to provide the body with energy for normal growth and development. It also favorably affects the work of the intestines, as it acts as the main element for the formation and development of beneficial lactobacilli. Lactose is an important micronutrient for brain development.

Another useful property milk sugar is to improve the body's ability to absorb calcium, which is important in the first months of life. Normal absorption of lactose, glucose and galactose in the baby's body prevents the occurrence of dysbacteriosis.

Varieties of the disorder and causes

Depending on how the symptoms of lactose deficiency in children manifest themselves, this disorder has several forms. Each of them may have their own causes.

lactose intolerance in infants

It exists in several forms, which differ in the cause of occurrence. Primary deficiency occurs when the enzyme is not absorbed well enough, or is completely absent from the body. But at the same time, the cells that form the surface of the intestine are not damaged. This type is the most common.

The congenital form is extremely rare and is very serious illness. It can lead to the most serious consequences - up to death, if the necessary medical care is not provided in a timely manner.

The disease develops due to genetic mutations in the body of the baby. The main symptoms of lactose deficiency in children under one year old are rapid dehydration, a noticeable shortage or a sharp loss of body weight.

In children born with underweight or premature babies, a transient form of insufficiency is sometimes diagnosed. This is due to the fact that the formation of the enzyme system occurs at week 12. Even after the same period, it is activated and begins to process lactase.

So when a child is born ahead of schedule, or has a much lower weight, the enzyme system does not have time to fully develop, which leads to an enzyme deficiency.

One of the most common forms of lactose deficiency is functional. It does not appear due to any disturbances in the system of digestion or bowel function. The main reason for its occurrence may be the usual overfeeding of the baby. The body simply does not have time to process all the material received, which, without being digested properly, then enters the intestines and causes characteristic symptoms.

The secondary version of this disorder involves damage to the cells that are responsible for the production of lactase. It can disrupt the normal functioning of the intestines and cause an inflammatory process. The functioning and production of enterocytes is suspended.

There is an opposite state of the body, which is characterized by an excess amount of lactase enzyme. This happens if a large amount of milk accumulates in the breast of a nursing mother. There is an overabundance in the child's body. Unlike cases with a lack of an enzyme, in this situation it is not necessary to start treatment. To normalize the amount of lactose in the body of a newborn, it is enough to correct the diet.

Sometimes babies are allergic to carbohydrates that the body needs. The reasons for it can be both congenital and acquired. Symptoms in this case do not differ from the main signs. The only thing that can give out an allergic reaction of the body is a skin rash.

The danger of this disease

For children under one year old, this disease can be extremely dangerous. First of all, the disorder can cause a disruption in the normal functioning of all organs. Also, the upper layer of the intestinal walls is damaged and the formation of enterocytes stops.

Milk sugar in an undigested form provokes the appearance and contributes to the violation of the natural microflora of the gastrointestinal tract. Getting into the baby's stomach, lactose provokes increased gas formation, and becomes the reason for the fermentation reaction. As a result, the child becomes restless and irritable, refusing favorite foods.

Refusal of a regular diet leads to a sharp weight loss. This factor is very harmful in such early age, as it leads to disruption of the normal functioning of all organs. A weakened body becomes vulnerable to many harmful trace elements. This also leads to complications in the form of dystrophy.

Due to the inability of the baby's stomach to cope with heavy food for him, the child has bouts of diarrhea. This disease can unbalance an adult, and for a newborn it can be fatal. Due to frequent bowel movements, rapid dehydration of the body occurs.

Characteristic symptoms of the disease

Depending on the cause, the symptoms of lactose intolerance in infants may vary. But regardless of the variety, there are several common signs of the disease. It is possible to determine the disorder of the enzyme system due to the following features:

regardless of the diet and the abundance of food, the child ceases to gain the necessary weight. This state remains until a certain moment. If no active measures have been taken, the baby begins to lose weight dramatically, which leads to undesirable consequences;
appears abnormally liquid stool, sometimes accompanied by abundant foam. Also, the feces may become greenish in color with a strong sour smell. This is because lactation intolerance provokes the occurrence of diarrhea in infants;
a visible violation of the functioning of the gastrointestinal tract, which manifests itself in swelling and characteristic uterine rumbling. Colic can also be a serious symptom. All this makes the newborn irritable and capricious, which should also attract attention;

sometimes the disorder manifests itself in seemingly unreasonable regurgitation in an infant.

In any case, the child is at an age when the occurrence of any deviation from the norm should cause decisive and active action. This is the only way to eliminate undesirable consequences in time.

Diagnostic laboratory procedures

To make sure that the baby is really lactose intolerant, doctors use many laboratory methods diagnostics. They are able to determine with high accuracy the causes of the occurrence and the type of disorder manifested in the baby. To do this, the doctor may resort to the following tests:

a special diagnostic power mode is applied. Milk sugar is excluded from the child's diet. If he was the cause of the disorder, then the condition of the infant immediately improves and the symptoms disappear;
a laboratory blood test can reflect an insufficient increase in sugar. In the body of a newborn, this occurs in the case of lactase indigestion;

after a blood test for several hours, a sample of exhaled air is taken from the baby to study the concentration of hydrogen. This is also a fairly effective procedure to determine the state;
stool analysis. During normal operation of the enzyme system, carbohydrates should be absent in the stool. In children in the first months of life, the presence of a small percentage of them in the stool is allowed. But if the body refuses to absorb lactose, the baby's feces will contain a large amount of carbohydrates;
the most informative method for determining the disorder is a biopsy to study the activity of enzymes and enterocytes. It is able to determine the disease with great accuracy, but is rarely used;
to determine the cause of occurrence and subsequent classification, genetic studies may be needed for congenital abnormalities.

All these procedures are carried out in order to exclude an error in the diagnosis. At an early age, there are a huge number of reasons that can cause diarrhea, indigestion and other manifestations of impaired bowel function. Similar symptoms make it difficult to determine the disease, therefore diagnostic procedures are extremely important.

Therapeutic procedures for lactase deficiency

To treat this disorder, doctors use drugs of various actions. The most important task is to influence the children's body as carefully as possible, excluding the use of strong drugs. Depending on the symptoms manifested, the doctor selects the necessary course of treatment, which includes medications aimed both at restorative actions and at eliminating symptoms and side effects like diarrhea.

Medical correction is most effective only in premature babies. But if the child's condition is critical, the doctor can still turn to the help of biocorrective drugs.

Now there is effective drugs, reviews and photos of which can be found on the Internet. But in no case should you use drugs without consulting a doctor, so as not to harm the health of the baby.

Recovery normal microflora intestines and removing the effect of dysbacteriosis, doctors actively use medicinal product called Bifidumbacterin. It has a beneficial effect on irritated intestinal cells and starts the recovery processes of the body. The drug is allowed to be used from birth.

Another proven therapy is feeding a mixture of already digested enzymes with pre-expressed mother's milk. However, in the case of a severe disorder, a complete rejection of breast milk is recommended. In this case, at the discretion of the doctor, its substitutes or specialized medical nutrition will be prescribed.

Medical intervention

The course of treatment may consist of a complex of corrective drugs, or it may be only a small addition to the main diet. Here are the most common and proven drugs.

To help the pancreas of an infant, preparations containing all the enzymes necessary for this are used. These include Festal, Mezim Forte, Pancreatin and other similar agents.

In addition to Bifidumbacterin, Hilak Forte and Linex probiotics are used to restore microflora and normal bowel function.

Treatments for bloating and indigestion and diarrhea medications may be used, depending on the need to address symptomatic problems.

It is important to understand that the entire necessary course of treatment should be selected by a doctor who can be contacted if necessary. But some verified videos on the Internet are also informative: Dr. Komarovsky is popular among young mothers. But the need to contact your doctor does not remove it.

Health food

In the case of a mild disorder of the baby, which occurs with not too pronounced symptoms, the attending physician may limit himself to recommending therapeutic nutrition. Such drugs are very careful about the fragile body of the newborn, and have practically no contraindications.

The diet is aimed at completely eliminating the cause of the disorder from the baby's body. Most drugs contain either an already split enzyme, which is absorbed directly, or its synthetic substitutes.

For special nutrition of newborns, the following drugs are used:

if doctors have prescribed the use of low-lactose drugs, then more often it is Nutrilak, Nutrilon or Humala;
lactose-free preparations include Mamex, Nutrilan lactose-free and Nan.

Sometimes, it can be extremely useful nutritional supplements which aid in the digestion of the child. They become an indispensable tool for a young mother if, due to an unpleasant disorder, the baby was forbidden to eat. breast milk, or he refuses it himself.

They have a different clinical purpose, allowable age and manufacturer. In order to choose a supplement, you should consult with your doctor. The most common of these are Lactase Enzyme, Lactase Baby and Lactazar.

Complementary foods can be just as beneficial, but they must be done with great care so as not to provoke even more irritation of the intestines. It is recommended to keep a food diary to prevent recurrence of symptoms.

It is advisable to start complementary foods with vegetables, giving one at a time over several days, gradually increasing the dosage to 150 g over 2 weeks. Then the baby begins to feed rice, corn or buckwheat porridge. The last product allowed for consumption by a newborn is meat.

After 9-10 months, children are allowed to give a small amount fermented milk products- natural yogurt or kefir. It is necessary to carefully monitor the reaction of the body to the foods consumed.

Some foods, unlike others, may not cause irritation in children, even though they contain milk sugar. Therefore, when feeding, pay attention to:

the absence of obvious signs of indigestion - a characteristic rumbling or bloating;
lack of increased gas formation;
unchanged feces during normal bowel movements;

Lactase deficiency in newborns is a serious disorder of the gastrointestinal tract, especially in the first years of a child's life. It leads to many of the most undesirable factors and complications, sometimes exposing an already defenseless organism to mortal danger.

And since the symptoms of a violation of the enzyme system are quite common, it can be confused with ordinary indigestion. Therefore, if any symptoms appear, the infant should be given immediate medical attention.

Lactase deficiency, or hypolactasia, is a very common phenomenon among both infants and adults. it pathological condition forces nursing mothers to stop breastfeeding ahead of schedule, transferring the child to artificial nutrition, which cannot but affect his health in the future. However, as practice shows, the “fashionable” diagnosis today “lactase deficiency” often has nothing to do with true milk intolerance, but is a common food allergy of a newborn to the mother’s diet or complementary foods. Knowing the causes, symptoms, tests, and treatment of true hypolactasia is important to avoid treating the underlying disease.

Lactose and lactase: why they should not be confused

Often on the Internet you can find the fundamentally wrong term "lactose deficiency". What is lactose and lactase?

Lactose, or milk sugar, is a carbohydrate from the group of disaccharides present in the milk of any animal.

Lactase is an enzyme produced by the cells of the mucous membrane of the small intestine and is involved in the breakdown of lactose.

Hypolactasia: its types and causes

Decreased lactase activity (and sometimes complete absence this enzyme) and is called hypolactasia or lactase deficiency (LN). This condition entails the inability to properly digest milk sugar, which serves as a breeding ground for the reproduction of various microorganisms. Bacteria provoke strong gas formation, stool disorders, colic and many other problems.

Lactase deficiency is divided into two types.

Primary lactase deficiency

It implies low activity of lactase or its complete absence without damage to enterocytes - epithelial cells intestines. Such hypolactasia happens:

congenital (genetic anomaly);
transient (temporary intolerance to breast milk, characteristic of premature babies);
hypolactasia of the adult type (about 18% of adult Russians suffer from LN).

Secondary lactase deficiency

In this case, lactase deficiency is caused by damage to enterocytes. It occurs much more often than primary hypolactasia and is provoked by diseases such as:

allergy to cow's milk protein;
intestinal infection;
intestinal inflammation;
atrophic changes after prolonged tube feeding or with celiac disease (intolerance to the cereal protein gluten).

Lactose overload

In addition to these two types, there is a condition similar to the signs of hypolactasia - lactose overload. At the same time, the necessary enzyme is produced in the intestines of the baby in sufficient quantities, but due to the large volume of the "front reservoir" in the breast between feedings, too much "front" milk with a high content of lactose and other carbohydrates accumulates (more than 130).

Also, as noted by the famous pediatrician E.O. Komarovsky, lactose overload can occur due to the banal overfeeding of a child (details in the video below): this condition does not require treatment, but the correct organization of breastfeeding.

Symptoms of the disease

The following symptoms of lactase deficiency may indicate the disease in question:

Bloating.
Liquid stools (may be frothy and sour-smelling).
Restless behavior of the baby during or after feeding.
Poor weight gain or even weight loss (in severe cases of LN).

Sometimes profuse regurgitation is added to the symptoms.

In primary hypolactasia, the first few weeks of a baby's life, LN does not appear at all, then flatulence appears, followed by abdominal pain and liquid feces.

A distinctive feature of secondary hypolactasia is the appearance in the stool a large number mucus, greens and undigested pieces of food.

In the case of an overload with lactose, the child gains weight well, but at the same time he is worried about pain, and the feces can be green and sour.

Hypolactasia or common allergy?

It is not uncommon for an allergy to breast milk or complementary foods to be taken by an inexperienced pediatrician for lactase deficiency, which leads to the appointment of improper treatment. food allergy on breast milk is provoked by the diet of a nursing mother, and her specific pathogens are:

Gluten. Even in the absence of celiac disease (gluten protein intolerance) in a child, a nursing mother should limit the intake of gluten-containing products in the first months of lactation.
synthetic additives. The diet of a nursing mother should exclude any canned food. Sweets are better to eat white - without dyes.
Spices and herbs.
Dairy. Cow or goat milk is markedly different in terms of chemical composition from human. Proteins of cow's and goat's milk often act as a strong allergen for a newborn.

Instead of treating LN and switching to artificial formulas, it is better for a nursing mother to start by adjusting her diet by excluding milk protein and other food allergens from it.

The first meal should be vegetable puree(zucchini, potatoes, cauliflower). This is the only way to determine the presence or absence of hypolactasia for sure.

Against ordinary infantile colic, dill water will suffice.

Diagnosis of lactase deficiency

There are several different tests that can be used to confirm LN:

Biopsy small intestine. The most reliable, but also the least used method. The reasons are obvious: anesthesia and penetration of biopsy forceps into the intestines of the newborn.
Hydrogen test. Measurement of the amount of hydrogen in the air exhaled by the patient.
Lactose curve (blood test).
Analysis of feces for carbohydrates. The most popular, but the least reliable method, since there are still no exact instructions with the norms of carbohydrates in feces.
Coprogram analysis.

Treatment

It must be remembered that the presence of one or two signs of hypolactasia does not at all mean that the child is sick. Only the combination of all of the above symptoms with a poor analysis can indicate a true LN. Lactase deficiency in children is treated by the following methods.

Proper organization of the GW

The instruction includes the following items:

do not express milk after feeding;
you can change the breast only after the baby has emptied it completely;
try to breastfeed with one breast, but more often;
it is advisable not to skip night feedings;
it is not recommended to take the baby from the breast if he has not yet had enough;
correct attachment to the chest.

Refusal of food allergens

Especially dangerous are cow and goat milk proteins, because of which children are allergic to mother's breast milk.

Use of lactose-free foods as complementary foods

Expressing a small portion of milk before feeding

This is the last of the "home" treatments.

Doctor prescribing lactase enzyme

A typical example is the drugs "Lactase Baby" and "Lactazar" in capsules or "Baby Doc" in the form of drops. Usually, the course of using the enzyme is canceled at 3-4 months of the life of the baby, when the production of its own lactase begins in its intestines. Enzymes from drugs are very effective and relatively safe, which is confirmed by many reviews. Care must be taken when purchasing such enzyme supplements, as there have been cases of counterfeiting of the Lactase baby drug.

Treatment of "dysbacteriosis"

It implies the restoration of both the microflora and the very condition of the intestinal walls (i.e., the treatment of the underlying disease in secondary hypolactasia - for example, gastroenteritis). Often accompanied by the use of "Lactase baby", "Baby Doc" or other drugs with lactase.
Attention moms! In the treatment of dysbacteriosis, the baby may be prescribed drugs such as bifidumbacterin, plantex or analogues. It is important to know that they contain lactose and should not be taken with LN.

Feeding lactase-fermented breast milk, low-lactose or lactose-free formula

It is practiced only in the most extreme and rare cases, when milk intolerance is congenital, and the enzyme deficiency manifests itself extremely strongly (this is observed in one child out of 20 thousand). Such supplementary feeding is usually a temporary measure. Long-term use of lactose-free formulas can cause the baby to completely refuse breast milk. Moreover, it has not yet been studied long-term consequences artificial feeding in infancy. From the nearest side effects the child is at risk of allergy to soy protein, and soy includes most of these mixtures. Even more common is allergy to cow's or goat's milk protein, the second major component of lactose-free formulas.

As noted by the same E.O. Komarovsky, there is a clear commercial connection between the appearance in the country of low-lactose and lactose-free mixtures and the widespread appeals of doctors to treat “lactase deficiency”. So, Komarovsky has already collected more than 50 reviews from nursing mothers, whose doctors strongly (and unreasonably) recommend that they abandon breastfeeding in favor of artificial nutrition.

Conclusion

Lactase deficiency is a fairly common phenomenon among children, characterized by the fact that milk is not absorbed by the body of the newborn. At the same time, the appointment of lactose-free or low-lactose mixtures is justified only in congenital pronounced LN, which must be confirmed and clinical picture, and "bad" analyses. In other cases, it is enough to wait until the baby’s own lactase “ripens” in the intestines, helping him ferment milk with the help of dietary supplements (“Lactase Baby”, “Baby Doc”, “Lactazar”, “Tylactase”, “Lactraza”, etc.), changing the diet of a nursing mother (during the period of breastfeeding, there are no products containing milk protein and other allergens), taking dill water against colic, proper organization of breastfeeding and proper complementary foods.

Lactose deficiency in infants is a rather serious and even dangerous problem. After all, such a violation is associated with the inability of the body to absorb dairy products, including mother's milk. Therefore, every parent should be aware of the main symptoms of such a condition, because the sooner treatment is started, the greater the chances of a successful recovery.

What is dangerous in the chest?

To begin with, it is worth noting that milk (including breast milk) contains a sugar called lactose. It is he who covers almost 40% of the energy costs of the child's body. The process of digestion of this carbohydrate occurs with the participation of the enzyme - lactase. Lactose deficiency in infants is accompanied by a deficiency of this enzyme, which makes it impossible for the normal absorption of such a product. However, lactose is directly involved in the development of the brain and the formation of the retina. That is why the deficiency of such a substance leads to unpredictable and often sad consequences.

Lactose deficiency in infants and its forms

To date, it is customary to distinguish between two main forms of such a violation:

Primary, or congenital, insufficiency is most often associated with genetic characteristics and is hereditary. The same form is often found among premature babies.
Secondary develops after birth against the background of diseases digestive system including some intestinal infections.

Lactose deficiency: symptoms of the disease

The main symptom of the disease is diarrhea - bowel movements occur 10 - 12 (sometimes more) times a day. At the same time, the feces are liquid, foamy, green in color with a sour smell. During illness, fermentation processes intensify in the digestive tract, resulting in the accumulation of excess gases in the intestines. Thus, the child constantly suffers from bloating and pain in the abdomen, often refuses to eat, pulls his legs to his stomach, constantly cries, sleeps poorly. Often you can notice abundant regurgitation, up to vomiting. In the absence of treatment, the baby slowly gains weight, and in the most severe cases, there is a developmental lag.

Lactose deficiency in infants and diagnostic methods

To date, there are many ways to check the work of the child's body:

first of all, they analyze fecal masses for the level of carbohydrates;
in addition, they also check the pH of feces - in case of insufficiency, this indicator changes;
in some cases, the doctor prescribes diet diagnostics - the child is prescribed a lactose-free diet and the change in condition is monitored;
the most accurate is a biopsy of the intestinal mucosa, followed by examination of samples for lactase activity.

What is the child to do?

In fact, the treatment here is individual and depends on the causes of the development of insufficiency and the age of the child. For example, quite often, special artificial mixtures with a low or zero lactose content are introduced into a child's diet. If the baby is breastfed, then you need to feed him only with expressed milk, after dissolving a tablet or powder containing the lactase enzyme in it.

Breastfeeding is a natural and necessary process for a newborn baby. The longer it lasts, the more complete the development of the baby will be. However, it happens that the child cannot digest mother's milk or artificial formulas based on cow's milk. The number of such children reaches 20% of all newborns. In this case, they speak of lactose intolerance - milk sugar. If there is such a problem, then the symptoms of lactose deficiency in newborns and infants appear very quickly. It is impossible not to notice them. The main thing is to quickly establish proper nutrition baby.

First you need to understand the terminology so as not to confuse what the baby still has enough of and what it lacks.

Lactose is a component of breast milk, the content of which reaches 85%. It is necessary for the proper assimilation of trace elements, the formation immune system, intestinal microflora.

In the baby's body, lactose (milk sugar) breaks down into glucose and galactose. Glucose provides 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 small intestine child. It is he who breaks down the lactose that enters the baby's body along with milk.

It turns out that the lactose contained in milk is always enough for the baby, but there may be problems with lactase if, for some reason, the enzyme is not produced in the baby.

It is customary to talk about lactose intolerance or lactase deficiency.

Where does lactose intolerance come from and what are its types?

There are three reasons why milk sugar is not absorbed by the baby, whether the baby is breastfed or formula fed:

Heredity is a genetic failure due to which the centers for the production of lactase do not function properly. This is primary lactase deficiency.
Diseases of the digestive tract - in this case, the production of lactase in infants is suppressed by the current disease: infectious diseases, enterocolitis, allergies, worms. This is secondary lactase deficiency.
Underdevelopment of the digestive organs - observed in premature or born on time, but weakened children. This type of disease is called transient.

The disease occurs in two forms. If lactase is not produced at all, then this is complete lactase deficiency - alactasia. If it is synthesized only in a certain amount, then there is a partial deficiency of the enzyme - hypolactasia.

Dr. Komarovsky - a popular pediatrician with 30 years of experience - has a slightly different point of view on this issue. He believes that the problem with lactase deficiency is largely contrived and only a very small percentage of babies really have real difficulties with digesting lactose. His practice shows that the basis of the rejection of milk is the usual overfeeding of the child. Lactase in a newborn or baby is produced in sufficient quantities, but so much milk is given to him that the baby cannot digest it. The doctor offers to establish the truth by visiting a pediatric gastroenterologist and conducting special tests.

How to spot lactose intolerance in your baby

Signs of lactose deficiency are easy to notice immediately after the birth of the baby. If left unattended, the health of the child can be seriously affected. Symptoms of insufficient lactase production are:

Refusal of the breast shortly after the start of feeding - the child begins to actively suckle the breast, has a good appetite, but after a while becomes restless, whiny, stops eating
Pain in the abdomen, colic - a symptom manifests itself during feeding or after it, the baby cries and twists its legs
Spitting up to the point of vomiting
Rumbling and bloating
Changes in the color, smell and shape of stools - most babies develop diarrhea, some children become constipated
Increased gas formation
If diarrhea appears, then the stool foams, has a greenish color, the smell becomes sour, there are lumps in the feces. The frequency of bowel movements reaches 12 times per day. This condition is called fermentative dyspepsia.
Atopic dermatitis
newborn weight or baby does not grow, and in the worst cases, malnutrition develops - insufficient body weight, that is, the baby loses weight

It is important to remember and know that the signs of lactase deficiency overlap with the symptoms of dysbacteriosis, intestinal infections, rotavirus. Only a gastroenterologist can make an accurate diagnosis based on examination and laboratory tests.

Diagnosis of lactose intolerance

If lactase deficiency is suspected, the doctor will take the following measures:

Examines and learns all the nuances of feeding and behavior of the baby
Conducts diet diagnostics - the mother is invited to reduce or remove dairy products from the child's diet. The results are recorded in a special diary
He does an analysis for lactase deficiency - the baby's feces are taken for laboratory testing. The presence of carbohydrates is determined - the norm is 0.25%, pH - with lactose intolerance becomes less than 5.5
In rare cases, due to the complexity of the procedure, a study of lactase activity is performed directly in the small intestine.
If there is a suspicion of the hereditary nature of the disease, then how to determine lactose deficiency in this case, there is also a way - to conduct a genetic test

How to help a child with lactase deficiency

When the diagnosis of lactose intolerance is confirmed and the nature of the disease is determined, then a treatment method is selected. When a hereditary form is identified drug therapy carried out throughout life. Treatment of the secondary form begins with the elimination of the root cause.

For all types of lactose intolerance, the following activities are carried out:

Complete rejection of products with lactose or a decrease in its amount
Taking lactase enzyme before breastfeeding
When breastfeeding, the transition to combined - alternating with artificial nutrition up to 6 months
Expression of foremilk, which contains a maximum of lactose
Choosing the right formula - soy-based, lactose-free, low-lactose, with added lactase enzyme

The choice of treatment regimen is determined by the doctor. Parents should not experiment with the health of the baby, because the consequences can be irreversible.

Prevention and forecasts

Prevention of lactase deficiency begins with a responsible attitude to pregnancy - the child must be born full-term and with a normal weight. For a newborn, prevention consists in the exclusion infectious diseases GIT. Unfortunately, it will not work to prevent the development of a hereditary form. The main thing is to learn about such cases in the history of the family in time.

Predictions for lactose intolerance are as follows:

Primary - not treated
Secondary - lactase synthesis is restored partially or completely. Depends on the severity of the underlying disease and treatment
Transient - passes with appropriate treatment as the gastrointestinal tract develops by 6 months or earlier

Every mother cares about the health of her child. Therefore, it is so important for her to carefully look after the baby in order to detect primary symptoms possible pathologies and start treating them on time. It is quite rare, but it is considered a dangerous condition for a child - congenital lactose intolerance, when the baby cannot absorb mother's milk. Children with this disease need special dietary nutrition. Because they cannot consume dairy products, they need to ensure that the fragile body absorbs vitamins D and calcium in sufficient quantities by others. possible ways.

Lactose deficiency will be discussed in detail in this article.

Description of pathology

Lactose intolerance is a pathology in which the child's body is not able to independently absorb the protein contained in milk. Such a diagnosis is voiced in the first months of a baby’s life, since the baby is fed only breast milk during this period. You need to know that the signs become more pronounced, it all depends on the amount of milk - if there is a lot of it, then the consequences of such nutrition are more difficult to bear. Lactose deficiency can pass into adulthood.

What is lactase, lactose and its intolerance? Lactase is a special enzyme that is produced by intestinal cells. It is he who can break down lactose, which is the main ingredient in milk of various origins. Lactase should break down complex sugars into simple ones so that they are quickly absorbed into the intestinal wall of the child. These are the so-called galactose and glucose. Sugar is very important for our body - it is one of the main sources of energy. When there is very little lactose produced in the intestines, or lactose synthesis has stopped altogether, such undigested milk eventually leads to diarrhea. In such a milky environment, bacteria always start up, which, producing waste products, form gases - main reason bloating and colic.

How is lactose intolerance classified?

By its type, lactose deficiency is divided into primary and secondary.

First view

In this case, lactase is produced in the intestines, the amount of it is in order, but its effectiveness is on reduced level, this is the main reason why milk is not absorbed by the body. There are very rare cases when such an enzyme is not produced at all.

At primary view there is one subtype of lactose deficiency - transient. Quite often observed in premature babies and may be the reason that lactase begins to be produced only from 37 weeks, and at a period of 34 weeks such an enzyme is just beginning to be produced by the body. The transient type of insufficiency often quickly disappears within a couple of weeks after birth, when the baby grows and gets stronger.

What else is lactose intolerance?

Secondary type of insufficiency

With this type of lactase deficiency, enterocytes are affected, and it is because of this that the production of the enzyme is disrupted. Very often, the cause of this type of disease is allergic reactions in the intestines, as well as various inflammatory processes. Timely approach to treatment and diagnosis can cope well with this ailment.

Symptoms of lactose deficiency

How does the disease manifest itself? The following signs are possible:

Contrary to the above symptoms, lactose deficiency in children has almost no adverse effect on appetite. The child may pounce on the chest with great zeal, but after a while he will begin to cry and draw his legs to his stomach at the same time.

In the first days, lactose deficiency almost does not manifest itself in any way - the signs are cumulative in nature and appear on the rise. First of all, bloating makes itself felt, then the baby begins to feel pain in the tummy, and at the final stage, the stool is broken. Symptoms of lactose deficiency in children under one year old should be known to all parents.

It is extremely important: almost all of the listed signs are characteristic in the first place during primary lactose intolerance. Secondary insufficiency, in addition to these signs, is expressed primarily in the presence of green stools, mucus and lumps in feces.

Diagnosis of the disease

There are few signs of the disease to accurately diagnose the disease. In order to correctly diagnose and prescribe appropriate treatment, various laboratory research. Usually, the doctor provides referrals for the necessary tests.

Carbohydrate analysis of feces.

Needed in order to determine the concentration of carbohydrates. This is the fastest, easiest, and cheapest way to find out how much carbohydrate is in your stool. Based on these results, it is possible to determine how well lactose is digested. The normal content of carbohydrates in children under one year old is not more than 0.25. Minor deviations of 0.5% are normal, but if this number exceeds 1%, then this will be a serious case. There are also disadvantages to this analysis - according to the results, it is possible to identify the presence of lactose intolerance, but it is impossible to find out the cause of such a pathology.

Biopsy of the small intestine mucosa.

This analysis will determine how active lactase is in the actions of the digestive tract. This is a simple method for detecting milk protein intolerance.

Analysis of feces for dysbacteriosis.

If an allergic origin of the child's disease is suspected, then he may be sent for another blood test.

Dr. Komarovsky conducted statistics, during which he found out that 18% of the total number of newborns suffer from lactose intolerance. This is almost every fifth baby who was born in our country. At this disease adults can easily tolerate this disease, since they do not need to consume milk alone, and they have the opportunity to go on a diet that would exclude lactose. With young children, this method will not work, because mother's milk for them is the basis of nutrition. So, it is better to detect the disease and then use all the necessary methods as early as possible so that the child has time to adapt.

Genetic test for lactose intolerance

Important in the diagnosis is a molecular genetic study for a predisposition to lactase deficiency. The analysis will help differential diagnosis causes of lactose malabsorption and in the selection of an appropriate diet.

Treatment

If the diagnosis of the baby is still confirmed, then this does not mean that you need to abandon mother's milk in his diet. Mom can also safely continue to breastfeed the baby, while giving him medicines that contain lactase before feeding ("Lactase Enzyme" and "Lactase Baby"). Such a disease should be treated as soon as possible, thus, it will be possible to protect against complications in the future.

Doses prescribed by a doctor are strictly individual. As the enzymatic system of the infant begins to develop, the doses of the medicine will gradually decrease. What needs to be done in order to prepare the medicinal mixture before feeding:

Features of complementary foods

For children with altered stools with lactose deficiency, complementary foods are introduced a little earlier. At the same time, it is necessary to ensure that the diet is varied and balanced in terms of nutrients.

What can you feed a child?

It is very important to prepare cereals and mashed vegetables without milk, using diluted lactose-free mixtures for this.

Juices from fruits and berries can be given as early as 6 months, but it is also important to monitor possible appearance allergic reaction. Little by little it will be possible to add various dairy products, such as cheese, live yoghurts.

Milk and other dairy products in the diet of a child who is older than one year should be replaced with low-lactose meals. If they cannot be purchased, then you can give the baby lactase capsules.

In the presence of milk protein intolerance, the child should not eat any food that contains condensed milk and other milk fillers. And you will have to forget about many sweets.

Treatment of lactose deficiency should be carried out only under the supervision of a physician.

What else should be excluded from the diet?

It is necessary to reduce consumption to a minimum or completely eliminate:

caffeine. Do not drink tea and coffee, they contain this substance;
sugar;
baking;
do not take alcohol in any form and strength;
you need to carefully read the labels on products in stores, do not eat products with dyes and preservatives (this will be extremely difficult to do, since the main assortment of stores contains these substances);
food with a high content of hot spices, pickles - cucumbers, mushrooms and others;
no matter how insipid it is to eat dishes without seasonings - but this is necessary during breastfeeding;
do not eat anything that can cause allergies in a child, for example, various exotic fruits or berries, and red vegetables should not be eaten;
you can not eat yeast bread;
legumes;
grape.

Diet for lactose intolerance is very important.

What can be eaten?

Products for lactose deficiency should be carefully selected.

Successful recovery largely depends on the nutrition of the child and mother, as well as on the intake medicines that contain the right amount of lactase.