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Why do some children not tolerate lactose?
Lactose intolerance in children is classified as a carbohydrate disorder. The causes of this disease can be both primary and secondary.
The primary cause of lactose intolerance is no or low enzyme activity digesting this disaccharide. A molecule of sugar ingested with food cannot then be broken down into its components, i.e. galactose and glucose, what causes intestinal complaints. Usually root causes are genetically determined and unfortunately irreversible.
When it comes to secondary causes, they are most often associated with intestinal abnormalities and offer a chance for resolution or relief of symptoms after the cause has been removed. Intestinal disorders that may predispose to lactose intolerance include:
- Celiac disease - due to atrophy of intestinal villi in the course of celiac disease, secondary problems with carbohydrate digestion appear,
- Inflammatory bowel diseases, e.g. Crohn's disease- due to the inflammatory process involving the intestinal wall, the breakdown of sugars is difficult,
- Infections and parasitic diseases - colonization of the gastrointestinal tract by microbes causes damage to epithelial cells, impairing the proper digestion of carbohydrates.
Also, taking certain medications, e.g. antibiotics, may cause temporary lactose intolerance - an antibiotic consumed without an adequate shielding sterilizes the gastrointestinal tract, enabling its easier colonization, e.g. by viruses or pathogenic bacteria. This, in turn, causes epithelial damage and a disorder of digestion and absorption of disaccharides, giving symptoms associated with their intolerance.
Lactose intolerance in children or milk allergy? What are the symptoms?
Lactose intolerance in children is very common mistaken for an allergy to milk proteins due to very similar symptoms. In fact, however, these are very different disease entities, so they should be correctly diagnosed. Lactose intolerance relates to abnormalities related to the intestines and impaired function of the enzyme, while milk allergy is related to the immune system's response to the protein molecules it contains.
The main symptoms of lactose intolerance are flatulence, abdominal cramps and pain, nausea and gas, sometimes it is also diarrhea, vomiting or belching. Due to the lack or deficiency of the enzyme digesting lactose, it penetrates into the large intestine, where with the participation of bacteria it is broken down in anaerobic process into organic molecules. During this process, very large amounts of gas are formed, which, accumulating in the baby's intestines, also cause him unpleasant and bothersome colic.
Symptoms of intolerance can occur at any age, but most often they appear quite early and have a turbulent course. When parents start to suspect a child's lactose intolerance, they should consult a doctor who will recommend appropriate treatment for their age and severity.
Diagnosis of lactose intolerance
If lactose intolerance is suspected in a child, you should see a doctor who, after collecting a thorough interview, will examine them and order the appropriate tests. Studies useful in diagnosing this condition include, among others :
- hydrogen breath test - this is the best non-invasive study, but due to the lack of cooperation it is not possible to perform in infants. It consists in the oral administration of a certain amount of lactose and measurement in the exhaled air secreted during its decomposition by intestinal hydrogen bacteria. This result will be higher in the sick than in the healthy,
- Endoscopic examination of the intestine with specimen collection and determination of disaccharidase activity - the highest diagnostic value test,
- Genetic research - they are carried out to determine whether intolerance is primary and is related to lactase deficiency or deficiency.
In addition, it is also carried outan attempt to eliminate and challenge food to confirm the occurrence of symptoms associated with lactose intake. However, this is only an auxiliary procedure, which, however, aims to select products that will have to be discontinued if necessary to use an elimination diet.
How do we treat lactose intolerance?
Therapy for this disease includes the introduction of a diet consisting in the elimination of products that cause symptoms of intolerance. The most difficult step, but it is necessary to apply this diet to an infant.
Due to the fact that breast milk contains large amounts of lactose (about 6-7%, when cow's milk contains only about 3-4%), it is necessary to stop breastfeeding and switch to appropriate artificial mixtures. Your child's GP or pediatrician will recommend if your child is intolerant to lactose special lactose-free milk replacers, which will be completely safe for him. In older children, as a rule, it is not necessary to completely eliminate dairy products, but only to limit their amount in the diet to well tolerated by the child. It also often happens that despite lactose intolerance in milk, they can easily consume products derived from its fermentation as yogurt or kefir.
The elimination diet carries the risk of deficiencies in the body of nutrients and minerals such as protein and calcium. In this case, emphasis should be placed on their appropriate supplementation, because they are substances necessary for the proper growth and development of the young body.
Another solution to the problem of lactose intolerance is the use of special preparations containing a laboratory synthesized enzyme that breaks down lactose. Thanks to this, after eating the products in which it is found, it will be able to be properly digested and undesirable symptoms of intolerance will not occur.
Although lactose intolerance in children is often confused with an allergy to milk proteins, both diseases differ in the causes of their formation. Often, however, they can coexist or overlap. If your baby is suspected of any of these diseases, please consult your doctor to confirm the diagnosis and apply appropriate therapy to reduce the severity of symptoms such as colic, diarrhea or stomach aches and cramps. Following the rules usually brings very good results, and a small toddler suffering from lactose intolerance, after eliminating it from the diet begins to feel and function much better, and the health and well-being of their child is most important for the parent.