Jeong Sim
WRTG3030
Lactose Intolerance in Infants
Table of Contents
1.Information
i) Lactose and lactose intolerance
ii) Lactose intolerance in infants
2.History
3. What causes Lactose intolerance
i) Effects to adults
ii) Effects to infants
4. Symptoms of lactose intolerance in infants
i) Causes to adults
ii) Causes to infants
5. Diagnosis and Test
i)Test for adults
ii)Test for infants
6..Treatment
Information about Lactose and Lactose Intolerance
Lactose is a sugar derived from galactose and glucose that could found mostly in milk and
small amounts in sweet or sour whey. In order for lactose to be absorbed, the lactose must be
broken down by an enzyme called lactase. As lactose travels down the small intestine and
into the body, it is split into glucose and galactose by lactase, in order for our body to absorb
it. Lactose intolerance is a common medical condition that results in diarrhea, abdominal pain,
and gases caused by reduced or absent activity of enzyme lactase. Lactose intolerant
individuals have insufficient levels of lactase which leads to this medical condition.
Although very rare, infants could be born with lactose intolerance. This medical
condition has been recorded to be more common in premature infants. When a baby is born
premature, its body does not produce enough lactase to break down large amounts of milk.
Genetics also play a role, as it could be passed down genetically. A baby born from parents of
Asian descent are more likely to develop lactose intolerance within the first few years after
birth.
History of lactose
The lactose found by physician Fabrizio Bartoketti was published in 1633. In 1700, a
venetian pharmacist Lodovico Testi published a booklet of testimonials to the power of milk
sugar to relieve, among other ailments, the symptoms of arthritis. In 1812, Heinrich Vogel
found that glucose is a product of hydrolyzing lactose.
What causes Lactose intolerance
People with lactose intolerance have a hard time digesting lactose because their small
intestine does not produce enough lactase, which is produced in the intestinal villi. Lactase is
a enzyme that help your body digests lactose. The lactose that is not digested creates gas in
your colon. The lactose intolerance may be either genetic or environmentally induced,
however, the symptoms are caused in both ways. The LCT gene provides the instructions for
your body to create lactase. The specific DNA sequence in the MCM6 gene helps control
whether the LCT gene is turned on or off. The lactose deficiency also could be linked to
certain heritages. By Physicians Committee for responsible medicine's research,
approximately 70 percent of African Americans, 90 percent of Asian Americans, 53 percent
of Mexican Americans, and 74 percent of Native Americans are lactose intolerant. 90 percent
of Asian Americans are lactose intolerant, which is a huge percentage, and researchers have
found that diets within ethnic regions contribute to whether the body produces enough lactase.
Symptoms of lactose intolerance
Between 30 minutes and 2 hours after having lactose, you may have one or more of these
symptoms. Which is bloating, cramps, diarrhea, painful gas, nausea, flatulence, borborygmi,
and vomiting. The symptoms typically increases with the amount of lactose consumed. Even
with lactose intolerance, you may tolerate a small amount of lactose.
In rare cases, infants are lactose intolerant. Symptoms in infants include severe foamy
diarrhea, diaper rash, vomiting, dehydration, weakness and irritability, and slow weight gain.
Lactose intolerance is not the same with food allergy to milk. Symptoms of a milk allergy are
usually more severe than those from lactose intolerance.
Diagnosis And Test
If you get symptoms after drinking milk or eating dairy products or other lactose
containing foods, it is fairly clear that you have lactose intolerance. Tests are not usually not
needed, but here are some tests for lactose intolerance.
-Lactose tolerance test.
The lactose tolerance test gauges your body's reaction to a liquid that contains high levels of
lactose. Two hours after drinking liquid, you will undergo blood test to measure the amount
of glucose in your bloodstream. if your glucose lever does not rise, it means your body is not
properly digesting and absorbing the lactose drink.
-Hydrogen breath test.
This test also requires you to drink a liquid that contains high levels of lactose Then your
doctor measures the amount of hydrogen in your breath at regular intervals. Normally, very
little hydrogen is detectable, but if your body does not digest the lactose, it will ferment in the
colon, releasing hydrogen and other gases, which are absorbed by your intestines and
eventually exhaled. Larger than normal amounts of exhaled hydrogen measured during a
breath test indicate that you are not fully digesting and absorbing lactose.
-Stool acidity test.
For infants and children who can not undergo other tests, a stool acidity test may be used for
them. The fermenting of undigested lactose creates lactic acid and other acids that can be
detected in a stool sample.
-Small bowel biopsy.
This procedure can be performed to diagnose malabsorption problem. It is an invasive
procedure and is only indicated where the child in failing to thrive for unknown reasons.
-Intestinal biopsy.
An intestinal biopsy can confirm lactase deficiency following discovery of elevated hydrogen
in the hydrogen breath test. Modern techniques have enabled a bedside test, identifying
presence of lactase enzyme on upper gastrointestinal endoscopy instruments
-Stool sugar chromatography
Chromatography can be used to separate and identify undigested sugars present in faces.
Although lactose may be detected in faces of people with lactose intolerance, this test is not
considered reliable enough to conclusively diagnose or exclude lactose intolerance.
-Genetic diagnostic
It is used in primary lactose intolerance. Lactase activity persistence in adults is associated
with two polymorphisms. These polymorphisms may be detected by molecular biology
techniques at the DNA extracted from blood or saliva samples. The procedure consists of
extracting and amplifying DNA from the sample, following with a hydridation protocol in a
strip. Colored bands are obtained as final results, and depending on the different combination,
it would be possible to determine whether the patient is lactose intolerant. This test allows a
noninvasive definitive diagnostic.
Treatment
Management
Lactose intolerance is not considered a condition that requires treatment in societies where
the diet contains relatively little dairy. However, those living among societies that are largely
lactose tolerant may find lactose intolerance troublesome. Although no way to reinstate
lactase production has been found, some individuals have reported their intolerance varies
over time, depending on health status and pregnancy.
Avoiding lactose containing products
Since each individual's tolerance to lactose varies, according to the U.S. National institutes of
Health, "Dietary control of lactose intolerance depends on people learning through trial and
error how much lactose they can handle. Label reading is essential, as commercial
terminology varies according to language and region. Lactose is present in two large food
categories: conventional dairy products and as a food additive, which may contains traces of
lactose.
Breastfed Baby
For a breastfed baby may experience a secondary lactose intolerance following a bout of
gastroenteritis. Because breast milk will aid the recovery of baby's small intestine breast
feeding should be continued. Many breastfed babies experience symptoms similar to lactose
intolerance. For a healthy, thriving infant symptoms are related to an oversupply of lactose or
from large, frequent feeds and not due to lactose intolerance. Symptoms can nearly always be
helped without stopping breast feeding.
For a formula fed baby
If lactose intolerance is suspected following a bout of gastroenteritis, then milk and milk
products can be eliminated from the diet for a period of time. If symptoms go away, it is
normally possible to return your baby to his normal diet within a few weeks. Reintroduce
regular formula by substituting the lactose free formula in increasing proportions over 2 or 3
days. If no improvements in bowel movements or abdominal symptoms are seen following a
trial on lactose free formula, or if other symptoms develop, have your baby seen by a doctor
so that the baby can be assessed other reasons for these symptoms.
Help baby
Through a consultation at BabycareAdvise, we can assist you to discover the true cause of
your baby's discomfort of irritability, and how you can encourage his contentment. If the baby
is breastfed, we can advise on feeding management to reduce any discomfort may be
experiencing, while supporting you to continue to successfully breastfed. If the baby is
currently formula fed, recommend ways to reduce the baby fussiness and manage difficult
bottle feeding problems.
Dairy products
Lactose is a water-soluble substance. Fat content and the curdling process affect tolerance of
foods. After the curdling process, lactose is found in the water based portion, but not in the fat
based portion. Dairy products that are "reduced fat" or "Fat free" generally have sightly
higher lactose content. Low fat dairy foods also often have various dairy derivatives added,
such as milk solids, increasing the lactose content
Dairy products, including fat free, 1 percent, 2 percent and whole milk, some of the breads,
margarine, salad dressings, cereals, butter, yogurt, cheeses, sour cream, candy and sweets
made with milk would have lactose in it.
Bibliography
Lactose Intolerance Sutter Health Palo Alto Medical Foundation. Sutter Health Palo Alto
Medical Foundation.
www.pamf.org. Web. 2012
Most Human Being are lactose intolerant by Arjun Walia. CE. Collective Evolution.
www.collective-evolution.com. Web. April 3, 2013.
Lactose intolerance Genetics home reference. Genetics Home Reference.
ghr.nlm.nih.gov. Web. May 2010.
What is Lactose Intolerance? Physicians Committee. Physicians Committee.
www.pcrm.org. Web.
Healthy living with lactose intolerance. WebMD. WebMD.
Lactose. MedicineNet. MedicineNet.
www.webmd.com. Web
www.medicinenet.com. Web