26.01.2021

Lactase deficiency in newborns

In order for breast milk to be absorbed in the body of a newborn baby, the enzyme lactase, which breaks down milk sugar – lactose, is needed. It is necessary to distinguish between these consonant concepts in order to prevent terminological confusion. The concept of “lactose deficiency” does not exist. When a clinical picture of a violation of the digestion of breast milk is observed in infants, doctors make a diagnosis of lactase deficiency.

When it comes to this pathological disorder, they imply the development of a syndrome, which is formed against the background of the absence of lactase and is accompanied by the appearance of specific symptoms.

General ideas about the disease

Human lactose tolerance was formed during evolution and became possible due to the appearance of a specific gene in the DNA chain. In various ethnic groups inhabiting the globe, the frequency of distribution of this gene is different.

The presence of this type of fermentopathy can be guessed by the occurrence of certain symptoms when eating dairy products that disappear on the background of a dairy-free diet and reappear when returning to a normal diet.

In what cases can the disease occur?

Depending on the reasons, there are several types of fermentopathies that can form in absolutely any age category of patients.

First of all, there are two types of lactase deficiency – primary and secondary.

The causes of lactase deficiency in newborns in the first case are a decrease in the level of the enzyme while maintaining the integrity of the intestinal cells and can lead to the formation of the following pathological conditions:

  • Lactase deficiency in premature infants – due to the immaturity of all systems of a child born earlier than 35 weeks of pregnancy, as well as insufficient enzyme activity, subject to premature birth.
  • Lactase deficiency in infants is congenital – develops as a result of mutations in the milk sugar tolerance gene.

The secondary form of the disease develops as a result of damage under the influence of various unfavorable factors of the intestinal cell structures:

  • The development of pathogenic processes in this section of the digestive tract, which are dystrophic or inflammatory in nature. Provoking factors can be allergic reactions to foods, infectious intestinal lesions, or side effects of certain drugs.
  • A decrease in the surface area of ​​the intestinal mucous membranes, for example, as a result of surgery.
  • Changes in hormonal levels and metabolic disorders in the body.

Establishing the true causes of the development of a pathological condition plays a large role in determining the principles of further treatment.

What may be the consequences of the disease

In the absence of specific treatment for fermentopathy, a lack of lactase can lead to the development of the following disorders:

  • weakened immunity;
  • dehydration of the body as a result of massive fluid loss due to ongoing diarrhea;
  • the development of dysbiosis;
  • creating favorable conditions in the intestine for the growth of putrefactive microflora;
  • a decrease in the intensity of the processes of absorption of mineral substances, primarily calcium;
  • violation of peristalsis.

In the neonatal period and up to 1 year, the most dangerous complication of the development of this type of fermentopathy is the threat of dehydration (dehydration) of the child’s body.

What indicates the development of the disease

How does lactase deficiency manifest in infants? Symptoms of the pathological condition in babies are almost the same, the only difference between the manifestation of primary and secondary fermentopathy is due to the amount of dairy products consumed, which provokes the appearance of characteristic signs of the disease.

In the secondary form of the disease, specific symptoms appear when small amounts of products containing lactose are consumed. Primary fermentopathy is manifested when consuming a large amount of breast milk.

The signs of lactase deficiency in infants are as follows:

  • violation of peristalsis in a child – the appearance of vomiting, rumbling in the abdomen and pain;
  • flatulence;
  • loss of appetite;
  • a decrease in the intensity of weight gain in the baby;
  • stool with lactase deficiency in infants is watery, foamy (due to the accumulation of gases in the intestines), contains an admixture of greenery, has an unpleasant sour smell.

A rash with lactase deficiency in infants is possible only in clinical cases of the development of the secondary form of the disease, when food allergy is its provoking factor.

Diagnostic measures

How to determine lactase deficiency in infants? First of all, in differential diagnosis, much attention is paid to the symptoms that are noted in the baby:

  • Primary fermentopathy  often manifests as intestinal colic in a child. In most clinical cases, the baby’s body over time adapts to a lactase deficiency by stimulating the growth of a certain microflora in its intestines and the manifestation of pathological signs in the future is possible only with excessive consumption of milk.
  • With secondary fermentopathy  , the symptoms of the underlying disease come first. It is possible to guess about a decrease in the level of lactase in the body of a child using a dairy-free diet. At the same time, a significant improvement in the clinical picture of the pathological condition is noted.
  • The congenital form of the  disease appears after the first feeding of the baby in the form of uncontrollable vomiting and diarrhea.

How to identify lactase deficiency in infants on their own? Mom may suspect the development of this particular type of enzymeopathy, and not the usual colic of newborns, according to such signs as the stability of pathological symptoms and the lack of a therapeutic effect from agents that reduce flatulence: tummy massage, performing a bicycle exercise, holding a child with a column, and others. With the development of lactase deficiency, the baby’s condition is normalized only subject to a dairy-free diet.

Specific tests for lactase deficiency in infants are as follows:

  • analysis of feces for lactase deficiency in infants – the content of carbohydrates in it is determined, and the pH level is also established;
  • biochemical examination of feces to determine the type of microflora that inhabits the intestine;
  • biopsy examination of biological material obtained from the small intestine to establish lactase activity;
  • urinalysis to detect the presence of lactose in it;
  • genetic examination.

The timely conduct of specific diagnostics helps to exclude the development of severe pathological disorders in the baby that can provoke the formation of extremely serious complications. Differentiation of the root cause of the development of fermentopathy determines the principles of how to treat lactase deficiency in infants.

Therapeutic measures

When after examination nevertheless lactase deficiency in the infant is established, what should I do next? In any case, it is impossible to ignore such a violation. Correction of lactase deficiency is required using a medical approach, otherwise the growing child will be significantly behind in terms of intellectual and physical development.

Treatment, when certain symptoms indicate the development of lactase deficiency in a newborn or in an infant, is determined only by a doctor:

  • With the development of primary fermentopathy, one of the main principles of therapeutic measures is the organization of a diet – special mixtures are used for lactase deficiency in infants that do not contain lactose.
  • Additionally, certain medications are prescribed for lactase deficiency in infants, the active substance of which is lactase.
  • Bifidumbacterin or Linex for lactase deficiency in infants are used subject to a mild course of the disease. In this case, probiotics help normalize the microflora present in the intestines.
  • Treatment of secondary lactase deficiency in infants involves, first of all, the elimination of the root cause of the development of fermentopathy.
  • How to replenish calcium with lactase deficiency in infants? In this case, experts recommend using vegetables, bean curd, and legumes as a complementary food, in which an increased content of the mineral is noted. Use for this purpose complementary foods from dairy products is strictly prohibited.

Subject to the breastfeeding of the baby, the mother’s diet for lactase deficiency in the baby provides for a restriction in the consumption of dairy products, but not a complete rejection of them. In addition, from the diet of mothers with lactase deficiency in infants, it is necessary to remove products that provoke increased gas formation in the intestines (brown bread, sweets, grapes).

When does lactase deficiency in babies go? A full recovery of the child is possible only if the enzyme is not due to genetic factors. In all other cases, the correction of the diet allows you to improve the condition of the baby after 3-4 days, and a full recovery occurs a week after the start of treatment.

As a preventative measure for the development of fermentopathy, it is recommended to follow the rules of breastfeeding (breast replacement only after complete emptying, inadmissibility of interrupting the feeding process) and not to eat foods that may cause the development of allergic reactions.

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