Lactose intolerance or lactose overload in babies is not caused only by lactase deficiency, but also by factors like low fat feeds from the mother, allergens in the mother’s diet and even wrong or incorrect positioning of the baby during breastfeeding. These factors cause quick gastric clearance and then, fermentation of lactose in the colon. Another issue that may lead to lactose overload is damage to the GIT of babies, especially the brush border of the small intestines.
Clinical features of lactose intolerance/overload: Lactose intolerance need not necessarily be caused by lactase deficiency. It could be a result of various factors that affect the baby’s digestion of consumed lactose. Most of the time, LI occurs when the small intestine’s lactase levels exceed the amount of lactose to be digested. Some of the clinical features of lactose intolerance/overload in babies include:
1. GIT microflora ferments the excess lactose, producing gases like carbon dioxide, hydrogen and methane and lactic acid.
2. Lactose fermentation causes osmolarity of lumen’s contents, increasing the volume of water to be retained in the abdomen
3. Gastric clearance happens quickly, leading to damage of the mucous membranes of GIT
4. Symptoms like excessive flatus, diarrhea with explosive, watery and mucousy stools, perianal acid burns and colic and unsettling behaviors may occur.
Breastfeeding can be a cause: Improper breastfeeding can be the cause of lactose overload in babies. If the baby is not positioned correctly or feeds inappropriately, it may fail to get the high fat content present in the hindmilk of the mother. When there is no supply of hindmilk, the gastric clearance happens quickly, resulting in lactose indigestion and intolerance. This is because, the lower the fat levels of mother’s milk, the higher the intolerance in babies. Most of the common problems that may reduce baby’s fat intake:
1. Short breastfeeds due to maternal breast pain/damage/nipple problem
2. Minimal milk intakes due to incorrect positioning or poor attachments
3. Timed feed schedules that may reduce the baby’s fat intake or hindmilk intake
4. Infant oral thrush may also be a cause
5. Sucking problems including suck confusion or infant infections
Mother’s diet and allergens: Sometimes, mother’s milk itself may cause lactose intolerance in babies. This maybe because of the low fat/high sugar diet of the mother or due to improper maintenance of the supply of breast milk. This results in irregular sucking, incomplete feeding and intake of low-fat milk. The basic problem is with the mother’s diet. Some mothers take insufficient nutrients because of their lack of food consciousness or on account of their busy schedules. Some others willingly engage in a low fat diet in order to reduce the weight gained during pregnancy. This leads to inadequate fat intake in babies and which in turn can directly contribute to their lactose intolerance.
The best cure for lactose intolerance in babies can be achieved through the following:
1. Regulate the breastfeeding habits of the mother
2. Monitor the fat levels of the milk
3. Regulate the diet of the mother – engage in high fat foods
4. Stop allergens that come through maternal diets
5. Monitor the stool color of the baby from time to time to know its GIT condition
