Dr. Komarovsky about lactase deficiency

Every fifth child is being treated for lactase deficiency in Russia today. This diagnosis, which only a decade and a half ago was considered only a scientific term that has little to do with practice, has now become more than popular. However, pediatricians have not come to a common opinion, and therefore it is difficult to find a more controversial and incomprehensible question regarding the health of infants. Evgeny Olegovich Komarovsky, a well-known pediatrician and author of books, articles, shares his opinion on lactase deficiency.

This is manifested by frequent bouts of diarrhea, colic in babies, abdominal distention and increased gas formation in older children, pain in the abdomen, which usually appear a half to two hours after the child has drunk milk.

Most often, such a diagnosis is given to children whose age is up to a year. Quite rarely, babies up to 6-7 years old suffer from lactase deficiency. After this age, the physiological extinction of the production of the enzyme occurs, since nature does not provide for the consumption of milk by adults. It is extremely rare for a pathology to persist in adults, but this is considered to be a variant of the norm, since milk is not an important product for their bodies.

Lactase deficiency can be congenital, primary. It is also secondary, acquired. This failure occurs in case of damage to the walls of the small intestine. This may be due to a previous infection (rotavirus, enterovirus), toxic poisoning, severe damage to helminthic invasions, and an allergic reaction to cow protein.

In relation to this diagnosis, modern medicine has quite bright predictions: in 99.9% of cases, the enzyme deficiency passes on its own, while eliminating the causes that caused it.

For adults, lactase deficiency is not a problem, says Yevgeny Komarovsky. Nothing bad will happen if a person simply does not eat dairy products. However, for babies whose milk is the basis of nutrition, things are somewhat more complicated.

A decrease in lactase may be genetically determined, says Yevgeny Komarovsky. If mom or dad does not tolerate or did not like milk in childhood, then the probability of having a baby with a lactase deficiency is quite high.

In all other cases, it was not without the influence of pharmaceutical magnates, who really need to sell lactose-free milk formulas for artificial feeding in large volumes.They cost much more than other food, but parents who have been put in a hopeless situation are willing to pay as much as they want, as long as the infant lives and develops normally.

In premature babies, the lack of lactase can be explained by the immaturity of the body, they often experience transient deficiency. It passes by itself - as the maturation of organs and systems. The severity of the disease may be complete or partial.

To dispel doubts or confirm a diagnosis that has become so popular lately, Various additional diagnostic methods are used:

• determination of the acidity level of feces;
• carbohydrate analysis;
• dietary tests.

In the course of tests under the supervision of a physician for the time being canceled breast-feeding, adapted mixtures.

For lactose-free or soy mixtures, give the child for 2-3 days. With a decrease in clinical manifestations, a diagnosis of “lactase deficiency” is made.

In all cases (except for severe congenital diseases, which, as already mentioned, occur only in 0.1% of cases), lactase deficiency is of a purely temporary nature.

The most common cause of milk sugar intolerance in children is a banal overfeeding. Parents are trying so hard to feed the child that they give him the amount of the mixture or milk that exceeds all conceivable norms. As a result, a child, who is fine with enzymes, is diagnosed with lactase deficiency only because his small body cannot break down such a large amount of milk sugar.

Babies who suck breast milk is given much more difficult. Sometimes moms and dads don't understand what exactly the child wants. The child wants to drink and screams, and they give him food, believing that the crumb is hungry. This can also lead to transient lactase deficiency.

A temporary (transient) shortage of the lactase enzyme does not need treatment, Komarovsky says. The production of the enzyme in the right quantity will be restored immediately after the cause of the disturbance has been eliminated (the baby will no longer be overfed, the drinking regime will be observed).

When secondary lactase deficiency caused by intestinal viral infections, the child is prescribed special drugs. It is desirable to limit the power, to reduce its volume. Sometimes it is appropriate to start giving your baby probiotics.

A child with a genetically determined lactase deficiency is given lactose-free mixtures for up to six months, and then gently, gradually begin to introduce into the diet dairy products.

Nursing mom should not be alarmed by seeing the greenish liquid feces with a sour odor. This is a reason to appeal to the pediatrician, but not the reason to wean the baby from the breast. Moms should not begin to mock themselves. The opinion that maternal nutrition affects the lactose content of milk is nothing more than a myth. Lactose in breast milk always contains the same amount, which does not depend on the gastronomic preferences of the woman, time of day and frequency of feedings.

• In order for the artificial artist not to overeat, you need to give him a mixture from a bottle with nipple with a small hole. The harder it is for him to suck, the sooner he will feel a feeling of fullness. The less likely that he will eat too much.
• If you are going to reduce the amount of lactose in food, you need to find out which products contain it the most. The absolute leader in the percentage of lactose is breast milk (7%), and cow and goat milk sugar contain approximately equal amounts (4.6% and 4.5%, respectively). In the milk of a mare and donkey lactose is contained almost as in the female - 6.4%.
• If you have thoughts about purchasing a lactose free mixture, you should first try to give the child low-lactose Nutrilon and the same Nutrilak.

More lactase deficiency will tell Dr. Komarovsky in the video below.