How to act for mom when one of the components breast milk not absorbed by the child's body? It would seem that the situation is abnormal. The product, which was created by nature itself especially for the child, begins to harm him. Indeed, in a state of lactase deficiency (and this is the name of this problem), any dairy products become synonymous unpleasant sensations in the stomach. And newborns experience them especially acutely. Nevertheless, there is a way out of this situation.
The composition of the milk is as follows: proteins fats carbohydrates. The latter are represented by milk sugar - lactose. It, like any other carbohydrate, is needed by the body for energy production. The beauty of this instance is that it breaks down easily, which means it quickly restores strength. An enzyme with a very similar name, lactase, takes over the work of breaking down lactose. It is produced by the small intestine and converts lactose into two other components, glucose and galactose.
However, there are babies whose lactase secretion is reduced for one reason or another (hypolactasia). It happens that this enzyme is not produced by the intestine at all. Then the doctors talk about alactasia. Why such a condition occurs in a baby is known.
First of all, it can be inherited. If this was observed in parents or grandparents, it is possible that this condition will occur in the child.
Often, alactasia occurs in children who were born prematurely.
Sometimes there is another clinical picture. Impaired lactase production is a consequence of a specific problem from the gastrointestinal tract. For example, after the baby suffered intestinal infection or a prolonged state of dysbiosis.
The problem has been detected. The state of lactose intolerance does not go away unnoticed even for an adult's body. As for the newborn, the manifestations of the problem are quite eloquent.
The baby begins to cry 10 minutes after eating. And if with colic it is enough to help the air escape so that it does not stretch the intestinal walls, then with lactase deficiency the condition will not be alleviated by any known method.
Stool disorder is also one of the indicators of the problem. Frequent, green, foamy - a picture somewhat similar to dysbiosis. But doctors describe the condition as fermentative diarrhea.
In some cases, the situation is aggravated by vomiting. It is so abundant that it cannot be confused with regurgitation.
The fact that the child has stopped gaining weight (or even losing it) confirms once again that there is a problem. And it should be solved promptly. First, take a stool analysis to determine the amount of carbohydrates in it. If it is higher than 0.25%, it means that lactose is not absorbed.
How exactly to correct the condition depends on what exactly it is provoked.
Lactose intolerance can be compensated for with certain medications or diet.
Lactase production, impaired by suppressed microflora or inflammation, will be restored after a course of treatment.
As for premature babies with alactasia, the situation may resolve itself. It is necessary to give the child's body time for the maturation of all functions.
A dietitian will recommend mixing breast milk with a lactase preparation. You need to express, add droplets to milk. And nutrition and treatment at the same time.
As an option, transfer the baby to mixed feeding (it is advised for children whose lactase secretion is not strongly suppressed). Once the mother exclusively breastfeeds, and the next two - she gives a mixture with a reduced lactose content.
: Babies who have alactasia will have to drink the mixture. Moreover, at first it will be a product that does not contain lactose at all. However, this is temporary. And gradually the baby will need to be transferred to a mixture with a low milk sugar content. Still, it is a very important nutrient for the body, which grows and develops rapidly.
The older the child becomes, the less concerned about the state of lactase deficiency. All this can be explained simply. The diet is more varied every day. And besides dairy products, the baby begins to try cereals, fruits, vegetables. That is, those products that are perfectly absorbed by the body. Doctors advise giving sour milk to the baby with lactose intolerance. In small amounts, but daily. Unlike ordinary milk, yogurt, kefir, narine, bifivit are much better accepted by the body.
A mixture with a low lactose content (or even without it) is useful not only for feeding, but also for making cereals. Because doctors advise alternating dairy-free products with dairy products. The second for a child with lactose intolerance are made precisely on the medicinal mixture.
Does the toddler have an undesirable reaction to soy? A goat milk-based mixture is suitable for him. It is a unique alternative for babies sensitive to cow's milk or soy proteins. Recommended for the prevention of food allergies and digestive disorders.
Breast milk is the main source of nutrition for a newborn baby in the first six months of his life. But what if the baby has lactase deficiency, due to which he cannot absorb milk? Is it worth switching the baby to formula in this case, or can you continue to breastfeed him?
What is lactase deficiency?
Lactose intolerance is a disease that prevents a child's body from absorbing the protein in milk. The diagnosis is made in the very first months of the baby's life, since the baby during this period only feeds on breast milk. It is important to know that the symptoms become more pronounced depending on the amount of milk - the more there is, the more severe the consequences of such a diet. Lactase deficiency can persist into adulthood.
What's the matter? Lactase is an important enzyme produced by intestinal cells. It is he who breaks down lactose, which is the basis of milk of any origin. Latkaza breaks down complex sugars into simpler ones, which are absorbed faster into the baby's intestinal wall. These are glucose and galactose. Sugar is very important for the body - it is one of the main sources of energy. If too little lactose is produced in the intestines or its synthesis has completely stopped, then not assimilated milk leads to. In the milky environment, bacteria quickly grow, the waste of which is gases - the main one and bloating in the abdomen.
Types of deficiency
By its type, lactase deficiency is divided into primary and secondary.
First type
In the first case, lactase is synthesized in the intestine, its amount is normal, but its activity is at a low level, so milk is not absorbed by the body. Cases when the enzyme is not produced at all are extremely rare.
Primary lactase deficiency has one subspecies - transient. This is often found in premature babies and is due to the fact that lactase is actively produced only from 37 weeks, while at 34 weeks the enzyme is just beginning to be synthesized by the body. Transient failure usually quickly resolves a few weeks after birth, when the premature baby grows up and gets stronger.
Secondary failure
In case of secondary lactase deficiency, enterocytes are damaged, due to which the production of the enzyme is disrupted. Very often the cause of this form of the disease is various inflammatory processes in the gastrointestinal tract and allergic reactions in the intestine. Timely diagnosis and treatment will help you quickly cope with the disease.
Disease symptoms
Here are the most common symptoms of lactase deficiency in babies:
- Severe distension of the tummy after each feeding is one of the most noticeable and main symptoms of the disease;
- Bloating is often accompanied by rumbling, bubbling, and gas;
- Painful colic occurs due to the air in the intestines;
- The child may experience pain when having a bowel movement;
- Less often in infant there are contractions, this is impossible to miss. The child begins to bend with his whole body, becomes moody. The baby will try to pull his legs to his stomach, crying a lot at the same time;
- Pay attention to the child's chair. With lactose deficiency, the smell of sour milk emanates from the feces. If it contains lumps or mucus, you are most likely dealing with secondary lactase deficiency;
- The baby begins to spit up more often, he constantly vomits;
- The child behaves sluggishly and does not show interest in the world around him;
- Due to constant regurgitation, the baby begins to quickly lose weight. In less severe cases, the growth of the baby simply stops in place;
- The kid does not sleep well;
- The child's body is severely dehydrated - this symptom manifests itself already in the first days of a baby's life in cases of a pronounced lack of lactase.
Despite the listed signs, lactose deficiency in newborns does not at all have a negative effect on appetite. The baby can literally pounce on the chest, but soon he begins to cry, pulling his legs to his stomach.
In the early days, a lack of lactase rarely makes itself felt - the symptoms are cumulative and appear progressively. First, bloating makes itself felt, then the baby feels pain in the tummy, the last stage is stool disturbances.
Important: most of the listed signs are primarily characteristic of primary lactose intolerance. Secondary lactase deficiency, among other things, is expressed in green stools, lumps, etc.
How is the disease diagnosed?
Symptoms alone are not enough to accurately diagnose the disease. For the correct diagnosis and correct treatment, it is necessary to conduct several laboratory tests. More often the therapist gives a referral for tests.
Carbohydrate stool analysis
Needed to determine the concentration of carbohydrates. This is the quickest, easiest, and cheapest way to find out how many carbs are in your stool. These results can be used to determine if the lactose is absorbed enough. Normally, in babies under 1 year old, the carbohydrate content is not more than 0.25%. Small deviations of 0.5% are considered the norm, but if this number exceeds 1%, then this is already serious. There are disadvantages to such an analysis - according to the results, you can determine the presence of lactose intolerance, but you cannot find out the cause of the disease.
Small intestine biopsy
Allows you to determine the activity of lactase in the digestive tract. This is a classic method for detecting the presence of milk protein intolerance.
Analysis of feces for dysbiosis
If you suspect an allergic source of the disease, the child may be sent for an additional blood test.
Dr. Komarovsky cited as an example statistics according to which 18% of the total number of newborns suffers from lactose intolerance. This is almost every fifth child born in our country. At the same time, adults tolerate this disease more easily - they do not need to eat milk alone, and they can afford to go on a lactose-free diet. This will not work with babies, because mother's milk is the basis of their nutrition. Therefore, it is better to diagnose the disease and take all the necessary measures as early as possible so that the baby can adapt.
Treatment methods
If the baby's diagnosis is confirmed, this does not mean that you will have to give up mother's milk in the diet. Mom can safely continue to breastfeed her baby by giving him lactase-containing preparations before each feeding (for example, or Lactase Enzyme). The disease should be treated as soon as possible to avoid complications in the future.
Doses prescribed by a doctor are strictly individual. As the infant's enzymatic systems develop, the dosage of medication will gradually decrease. What you need to do to prepare the formula before you start feeding:
- Whichever brand of drug you choose, the steps are often the same. Strain some milk - 10-15 ml is enough;
- Pour into milk required amount powder. Note that Lactase Baby is easier to dissolve in liquid faster than Lactase Enzyme;
- Let the mixture brew for fermentation for 3-5 minutes. During this time, lactase will break down the milk carbohydrates found in liquid fore milk;
- Give the formula to the baby before feeding and then continue feeding as usual;
- Give your baby the preparation diluted in milk before each feed.
Features of complementary foods for lactose intolerance
For children diagnosed with lactose intolerance, complementary foods are introduced much earlier. At the same time, it is important to ensure that the diet is varied and nutritionally balanced.
How to feed such a child?
Important: cook porridge and vegetable puree without milk, use lactose-free mixtures for breeding.
Milk and dairy products in the diet of a child at an older age (from 1 year old) should be replaced with low-lactose dishes. If it is not possible to get them, give the child lactase capsules.
If milk protein is intolerant, children should not eat any food that contains condensed milk and milk fillers. You will have to forget about most sweets.
Goat milk
Lactase deficiency in newborns is also a contraindication to use, no matter how useful it may be. Goat milk and mixtures based on it are useful for preventing allergy to milk protein, improving digestion and strengthening immunity, but if the amount of lactase enzyme is insufficient, it will only harm the health of the child.
What kind of nutrition should mom follow?
In order to prevent lactase deficiency and allergy to lactose protein in a child, a nursing mother should take her own diet more seriously. For this, a balanced mother's diet has been developed for lactose deficiency in an infant. The first step is to reduce the amount of protein consumed. Cut out whole cow and goat milk.
Protein from milk, consumed in its pure form, is easily absorbed into the mother's blood, and from it passes into breast milk. If a baby is allergic to protein in cow or goat milk, the functioning of the not yet fully formed digestive system may be disrupted. This leads to a deficiency of lactase, and with it to lactose intolerance.
Try not to consume not only whole milk, but also other products based on it - butter, cottage cheese, yoghurts, kefir, cheese. Do not eat baked goods made with butter. Limit your consumption of beef - this meat contains the most protein, unlike pork or poultry.
An allergic reaction in a baby can occur to other proteins. In rare cases, sweets should be excluded from the diet of a nursing mother. As soon as allergens in the diet are eliminated, the work of the baby's digestive organs will gradually return to normal, and the symptoms of lactase deficiency disappear.
What else needs to be eliminated from the diet?
Minimize or eliminate use:
- dishes with a lot of hot spices, as well as pickles - mushrooms, cucumbers, etc.;
- no matter how bland dishes may seem without spices - for a while breastfeeding you will have to give up spicy herbs when cooking;
- do not drink alcohol, regardless of its strength;
- exclude caffeine from the diet, do not drink coffee and tea, which also contains this substance;
- carefully read the labels on goods purchased in stores, do not eat foods with preservatives and dyes (this item can be the most difficult to follow, since most of the goods on grocery shelves in stores contain all of the above);
- do not eat anything that can cause an allergy in a child - fruits and berries exotic for our latitudes, as well as any red vegetables.
Temporarily cut back on foods that lead to gassing. It:
- sugar;
- bakery products;
- yeast bread;
- legumes;
- grapes.
What can you eat if your baby is lactose intolerant?
Eat more:
- fresh vegetables and berries (with the exception of allergens), vegetables can be boiled, stewed or eaten raw;
- get into the habit of regularly drinking compotes from and (it is better to start with the first, since dried apricots are more allergenic);
- if you want something tasty, you can eat almonds, jelly and marshmallow, but in small quantities;
- eat more cereals, the ideal option is wheat germ;
- when the baby is six months old, you can gradually return fried foods to the diet in a small (!) amount of vegetable oil;
- from 6 months old you can eat exotic fruits in moderation, it is permissible to eat a little chocolate in the morning, but always black - it contains the least amount of milk and sugar.
Successful treatment of the disease largely depends on the diet of the mother and child, as well as on the intake of drugs containing the required amount of lactase.
Considering that breast milk is not suitable for the baby, do not end breastfeeding... Sometimes newborns refuse to breast, cry, however, first it is necessary to determine the real reason for this behavior.
Causes
Can breast milk not be suitable for a baby? Yes, if mom and baby are seriously ill, there is an intolerance to the components of the product. Milk is divided into front and back milk. It is necessary to let the baby suckle until the breast becomes empty. If you feed only the front composition, the newborn may develop a disorder, colic. At the same time, there is no feeling of satiety, since only hind milk contains a sufficient amount of fat and nutrients.
How to tell if breast milk is not suitable for your baby:
- the newborn cries and refuses to breastfeed;
- is capricious;
- spits up often;
- allergy appears.
The baby may be uncomfortable with breastfeeding due to anatomical features. This question is decided by a specialist. Sometimes the cause is a disease of the oral cavity, such as candidiasis. Prescribed medications will help get rid of it, and the baby will again breastfeed.
Problems with a bridle in a baby are solved surgically. If the breast shape is not suitable for the newborn, this issue is solved with the help of special silicone pads. Over time, the baby gets used to them and breastfeeds normally.
Position on the stomach
Position "column"
Colic appears during feeding, since when the breast is captured, air gets inside, which passes through the esophagus and is retained in the intestines. This also applies to mom's malnutrition. The baby is laid out on the tummy before eating, and after feeding, keep it upright.
Sometimes breast milk may not be absorbed, regurgitation appears when air enters the stomach or when overeating. An allergic rash is most often a negative manifestation of what mom ate.
Lactase deficiency
Milk is based on lactose. A child may not be suitable for breast milk if this component is intolerant. The present fructose, galactose, glucose are necessary for the formation of the nervous system, the vital activity of the baby. They are needed for the absorption of calcium and iron, suppress bacteria in the intestines.
During the feeding process, breast milk is often not suitable for a baby if he feeds only on front milk. They note diarrhea with a sour odor, gas formation. The baby cries and bends, he has dysbiosis.
Breast milk cannot be bad, as its composition depends on the woman's diet. If it changed the taste, there is secondary lactose deficiency. You can get rid of problems with the help of medication. The newborn should be fed with hind milk. It is in it that enzymes and bacteria necessary for cleavage. It is not difficult if you leave the baby to sleep with the breast in the mouth.
It is possible to determine that breast milk is not suitable for a child when passing an analysis for congenital lactose intolerance or in the presence of a Rh conflict between a mother and a baby.
This is the only well-established case. Otherwise, the woman herself can adjust the diet to continue breastfeeding.
If there are no enzymes necessary for the digestion of dairy products, breast milk is not suitable for a baby, and subsequently for an adult. It is recommended that such children be given dairy-free cereals and mixtures. It is not recommended to feed them with dairy products.
Change in taste
Sometimes the first milk that comes after colostrum has a bitter taste. The woman worries that her breast milk is bad. It is liquid and has a yellowish-white color. Subsequently, the liquid turns white, becomes thicker, the bitterness disappears. This happens if the mother feeds the baby on demand.
In winter, women who breastfeed often suffer from respiratory and viral infections. At this time, milk contains substances that will protect the baby from viruses. To maintain lactation, it is recommended to drink more, and wear a mask during feeding.
Some people think that milk is unsuitable for breastfeeding if mastitis or lactostasis is detected. You should not immediately switch to artificial feeding. If milk is not enough, it is expressed, and then the newborn is spoon-fed. The doctor will select medicines that are compatible with breastfeeding.
As a preventive method, the baby is given probiotics. More often they give problem breasts, and if there is a purulent process, healthy ones until the woman gets rid of the problems.
Prevention
A nursing mother needs to stick to a diet. Do not overuse exotic fruits, strawberries, chocolate. The baby has loose stools and rashes on the skin.
If a woman with HS abuses plant-derived protein, an allergy to gluten occurs. Prohibited foods include cereals: barley, oats, millet and rice. It is recommended to refrain from using such products for the first three months.
Allergy to cow's milk protein during lactation appears with the abuse of dairy products. The child has regurgitation, abdominal cramps, frothy stools. The same happens when using products with chemical additives, dyes and preservatives. They turn to a specialist for help. Following the recommendations will help get rid of the manifestation of an allergic reaction.
From the very beginning of feeding, a woman needs to use a special breastfeeding technique. It is important to be in the correct position for the baby to comfortably grip the nipple. This will avoid problems with cracked nipples and newborns swallowing air. If this happens, the child is given a healthy breast, and the patient is strained.
It is important for a woman to adhere to proper nutrition. Eliminate products that impair the taste of milk. This includes peppers, garlic, onions, legumes, and peanuts. You can not use pickles and smoked meats. Increase the consumption of dairy products, fruits, vegetables, boiled meat.
Successful breastfeeding takes place in a comfortable and calm environment. Mom needs more rest, is attentive to the newborn, noting all deviations.
Pediatrician recommendations for breastfeeding.
http://umnitsa-loshad.livejournal.com/254388.html - breastfeeding is not limited to the feeding process.
2. The composition of breast milk, the peculiarities of its assimilation, the satisfaction of the child's nutritional needs with breast milk.
The composition of breast milk is significantly different from that of artificial formula or animal milk. The process of its assimilation in the child's body differs from the process of assimilating its substitutes. Breast milk and formula have different effects on a baby's maturing digestive system. Breast milk provides all the needs of a growing body for at least 6 months and is an important component of a child's nutrition up to 1.5-2 years.
2.1. Features of assimilation of breast milk.
Less mineral content than cow's milk; this also reduces the stress on the child's immature digestive and excretory systems.
Thus, breast milk does not overload the immature stomach and pancreas of the newborn; The baby can receive breast milk without any harm to himself, even if he does not take any breaks in sucking at all (and sometimes this happens - for example, if the baby is sick or is under severe stress).
A child can and should be breastfeed at night - this does not overload his digestive system and helps maintain lactation.
Even if the baby receives more breast milk than it can digest, the excess will safely leave the body (in the form of white curdled lumps in the stool) without overloading the excretory system.
Related links.
http://www.rojana.ru/content/view/1079/267/ - the composition of breast milk.
http://www.macrobios.ru/?p\u003dreviews&row_id\u003d120 - breast milk, its composition, assimilation process, compatibility with the baby's digestive system.
Even the food that nature has given by rewarding a woman with breast milk may not suit the baby and even harm. It's all about the enzymes that make breast milk not metabolized.
There is a disease that prevents the absorption of dairy products - lactase deficiency. And the hardest thing is for those parents whose children encountered it in the first year of life, when milk is the main food of the baby.
The difference between lactose and lactase deficiency is that lactose is milk sugar, which is the main part of carbohydrates in milk, even breast milk, and lactase is an enzyme that helps break down lactose into particles so that it is further absorbed.
Lack of an enzyme in the baby's body (lactase deficiency) leads to the fact that the absorption of lactose is impaired and food products that contain milk sugar are poorly tolerated.
- The importance of lactose for the child's body
- Lactose is a very important element for the gastrointestinal tract, it influences the growth of healthy intestinal microflora, acting on the principles of a prebiotic.
- Reduces the pH of intestinal contents
- Takes an active part in the processes associated with the formation and development of the brain in the first month of life
- Takes part in the synthesis of B vitamins
- Helps the absorption of magnesium, calcium, manganese
Lactose increases the activity of its own enzymes
- anxiety of the baby when feeding
- bloating, gas education
- diarrhea, appears after each feeding, this is due to the fact that strong fermentation begins in the tummy, and diarrhea manifests itself with great force, the name is yellow foamy color, sour smell, the amount is directly related to feeding the baby (8-10 times a day )
- poor weight gain, unreasonable weight loss
- begins to lag behind in development
Symptoms begin to increase with the amount of milk consumed. In the first days of life, it is impossible to notice any symptoms, but in the following days they begin to appear: increased gas formation, pain in the tummy, and a little later, loose stools.
Symptoms may differ from child to child, only there is a clear link between feedings and diarrhea.
A type of lactase deficiency
The variety manifests itself depending on how active the enzyme that promotes the breakdown of lactose (lactose) is
Primary lactase deficiency
It appears due to a congenital absence of an enzyme. Primary lactase deficiency is an inherited disease.
Transient lactase deficiency
Very often it occurs in premature and weak babies and after a while the baby begins to feel better and recovers. Enzyme activity is normalized for short term.
Secondary lactase deficiency
Symptoms of lactase deficiency can be found in other enzyme disorders. Disorders are very rare and difficult to tolerate when fructose and glucose are poorly absorbed. The child has severe diarrhea after eating foods that contain these substances.
Another disease can be hidden behind the symptoms of lactase deficiency - this is galactosemia. It is a rare genetic disorder that is inherited and associated with metabolic disorders. As soon as any product that contains lactose enters the child's body, severe symptoms begin to appear that are dangerous for the baby's life (jaundice, vomiting, drop in blood glucose, the presence of sugar in the urine).
The main difference between lactase deficiency and galactosemia is that with lactase deficiency there is no vomiting, only regurgitation can be observed. If the child has vomiting, you should immediately contact a specialist.
How to diagnose that your baby is not absorbing breast milk
If the child has diarrhea or other symptoms of the disease, you should consult a specialist. To do this, you need to know exactly when the child's diarrhea began, whether it is related to feeding or to a change in the mother's diet.
The doctor will prescribe a series of tests and examine the baby. The easiest analysis that will show whether the baby has a carbohydrate intolerance is whether there are carbohydrates in the stool.
Since in children in the first six months, the diet is only breast milk, this analysis will show whether the child has digestive disorders and how carbohydrates are absorbed. It is done quite quickly and easily.
For the most accurate diagnosis, a mucosal biopsy is required. But this is a very complicated procedure that is performed under general anesthesia.
At the moment, doctors diagnose lactase deficiency, the appointment of a special drug that contains lactose. If, after taking it, the child begins to experience symptoms, then this is lactase deficiency. If the medicine did not cause any reactions, then the child needs additional examinations and analyzes.
Lactose deficiency with timely diagnosis responds well to treatment.
One of the stages of treatment is a special diet. If the baby is breastfed, the doctor prescribes special medications that contain lactase. For babies who are on artificial feeding prescribe mixtures with a minimum amount of lactose or those that do not contain lactose at all.
It is very important for parents to understand that breastfeeding should not be abandoned or combined with artificial. You just need to give the baby special medications added to the expressed milk, and then calmly give the breast. The drugs must be given before each feeding. The drug and its amount are selected individually by a specialist, and as the baby's own enzymes mature, the amount of the drug decreases. If the drug has caused constipation, then it is necessary for the doctor to reduce the amount of lactase.
First feeding
For babies who have lactase deficiency, the first complementary foods are best started with cereals that do not contain gluten (rice, corn, buckwheat). You can cook it in mixtures that do not contain lactose or in water. If the child, after the introduction of cereals, does not have a problem with the work of the tummy, then vegetable purees can be introduced.
Due to the fact that children who have lactase deficiency gain weight poorly, they need to introduce meat complementary foods earlier, at about 7 months.
All other products must be introduced according to the complementary feeding calendar.
After the introduction of a new product in children with lactase deficiency, it is necessary to carefully monitor the reaction of the body and, if anything, contact a specialist.
For children who are one year old, it is necessary to replace dairy products with fermented milk, which are better absorbed and easily tolerated.
Dr. Komarovsky will talk about lactase and lactose
