Lactase insufficiency in children
What is lactose deficiency? This diagnosis is heard by many young mothers, however, many of them do not quite know what it is. Lactose insufficiency( LN) is the inability of the body to absorb lactose - milk sugar, which is one of the most important components of milk, due to the lack or decrease in the activity of a special enzyme produced in the intestine. This enzyme is called lactose and is produced by special cells located in the small intestine, or rather, in its mucosa - by enterocytes. Undivided lactose, in large quantities falling into the intestines, causes fermentation processes, and also promotes the multiplication of pathogenic bacteria.
Lactose insufficiency may be primary( i.e., congenital) and secondary( caused by an intestinal disease, as well as a food allergy).Secondary lactose deficiency occurs much more often and it is associated not with a decrease in the enzymatic activity of lactase( as in the case of primary LN), but with damage to the enterocytes that produce this enzyme. Primary lactose insufficiency often develops "incrementally" and manifests itself not in the first days of life( when a portion is literally several grams), but when the baby begins to consume more milk, that is, 3-4 weeks, and sometimes later.
There are the following signs of lactose insufficiency in children:
is a liquid frothy stool that has an acidic odor. In this case, the chair can be either very frequent, or moderate and even rare, and in some cases the child does not get to do his "big things" without help;
- bloating and associated with these painful sensations;
- crying and restless behavior during and after feeding;
is a poor set or even a loss in weight.
Often, lactose insufficiency in the baby begins to think when the child is constantly observed a liquid frothy stool, colic and abdominal pain. Often doctors are in a hurry to diagnose and translate the crumbs into a special mixture that does not contain lactose( or low-lactose mixture), sometimes even advising mother to finish breastfeeding, arguing that the child is not able to absorb breast milk. However, such a diagnosis should be made only after a thorough examination( which includes the analysis of feces for carbohydrates, if necessary, a blood test for allergens and a number of special studies, and, in addition, an analysis for dysbiosis, which makes it possible to differentiate the picture for LN and latent intestinal infection).In general, the children of the first months of life( in particular, small and premature babies), who eat only milk, receive a lot of lactose, which their body simply does not have time to process. Often, it is associated with violations of stool, regurgitation and colic, but by 3-4 months of life crumbs the situation comes back to normal. In this case, they speak of transient lactose insufficiency.
Treatment of lactose deficiency is prescribed by a pediatrician. If the baby is breastfed, then do not rush to transfer it to the mixture. It is possible to preserve natural feeding - for this, the mother will have to decant a little milk before each feeding and dissolve the prescribed lactase drug in the doctor. After the child drinks the medicine, he can be given a breast and continue feeding in the usual mode. An artificial twitch requires a special lactose-free or low-lactose mixture. Older children, porridges and mashed potatoes should be cooked not on milk, but on the same special mixture, and also include lactic acid products in the diet( which, as a rule, do not cause such reactions as pure milk).If, for any reason, the child uses dairy products, he must first give a preparation of lactase( but it is better to try to exclude such foods from the diet).The duration of treatment depends on the type and intensity of the disease and is regulated by the doctor.
Secondary LN in children often occurs after a poisoning or intestinal infection. In this case, the specific treatment of the child is not required, it's just that for a while the milk in its diet should be replaced with lactic acid products. If lactose deficiency is caused by an allergic reaction, then it is necessary to revise the nutrition of the child and / or the nursing mother to determine the allergen and to exclude it from the menu( for a while or forever).