Lactose Intolerance in babies Flashcards
What is lactose intolerance?
Lactose intolerance caused by a lack of lactase, which usually hydrolyses lactose into glucose and galactose which are easily absorbed into bloodstream.
Instead, the lactose is fermented by gut microbiota which produces gases and causes symptoms.
What are the main causes of lactose intolerance?
Primary - lack of dairy in diet causes reduced production of lactase.
Secondary - temporary intolerance due to gut damage from gut infection, antibiotics, or undiagnosed coeliac.
Congenital - rare genetic form where babies are born with minimal or no lactase.
Temporary - premature babies whose small intestines are not develop enough at birth, but improves as they get older.
What is the difference between a lactose intolerance and milk allergy?
Lactose intolerance - lack of lactase. Causes only GI symptoms such as gasiness, diarrhoea, stomach upset.
Milk allergy - either IgE-mediated (immediate reaction) or non-IgE-mediated reaction (takes upto 48 hour).
IgE causes rashes, angioedema (swelling face), itchy throat, wheezing, SOB, sneezing, as well as GI reactions.
Non-IgE causes rashes, eczema, blood/mucus in stools, contipation, as well as GI reactions.
What is the onset of lactose intolerance?
1-3 hours after consumption.
What are some common symptoms of lactose intolerance?
Loose watery stool with degree of urgency.
Perianal itching due to acidic stools
Vomiting
Stomach rumbling, pain, and bloating.
Flatulence.
What is some lifestyle advice for lactose intolerance in infants?
Small amounts of lactose may be asymptomatic, so experiment with the amount you feed them.
If no lactose is tolerated, refer to dietitaton who will ensure sufficient nutrients in diet, especially calcium.
Lactose-free formula is available from pharmacies. Avoid soya formula as contains hormones which can interfere with development.
If breastfeeding, can use lactase substitute drops in a small amount of pumped milk and either give via bottle or spoon just before feed.
Eliminating lactose from mothers diet will have no effect as it is produced by breasts.
What are some counselling points for Colief lactase drops?
Breastfeeding:
1. Express a few tbs of breastmilk into sterilised container.
2, Add 4 drops.
3. Give to baby on sterilised spoon.
4. Breastfeed as normal.
Formula:
1. Prepare as usual.
2. Add 4 drops to warm formula (not hot).
3. Wait 30 minutes, shaking ocassionally.
4. Feed as normal.
