Neonatal Lactose Intolerance: Causes, Symptoms and Treatment
Neonatal lactose intolerance refers to a series of gastrointestinal symptoms caused by inadequate digestion of lactose present in breast milk or cow’s milk. Lactose is a major source of energy and plays an important role in optimal growth and development of newborns; therefore neonatal lactose intolerance presents a major concern. This study published in the Pakistan Journal of Pharmaceutical Sciences provides an overview of the causative factors, clinical manifestations and treatment measures associated with neonatal lactose intolerance.
Factors that result in lactose intolerance may be (i) congenital, wherein an autosomal recessive inheritance may cause reduced lactose activity and non-adaptation to breast milk; (ii) primary, wherein a reduction in lactose enzyme gene expression ensues later in life especially in premature infants; (iii) secondary, wherein lactose intolerance results from infectious diarrhoea, systemic infections, malnutrition, chronic inflammation of the intestinal mucosa or decreased secretion of lactose enzyme.
Vomiting, diarrhoea, abdominal distention and abdominal pain are common clinical manifestations of lactose intolerance. The severity of the symptoms often relates to the amount of lactose ingested. The diagnostic measures used for testing lactose enzyme deficiency include hydrogen breath test, faecal pH and reductive sugar detection, lactose tolerance test, urine galactose detection, gene detection and rapid lactose test. However, not all the tests can be efficiently adapted for diagnosing neonates.
Dietary avoidance of lactose is the most common treatment option. Lactose-free formula or low-lactose formula can be opted based on the severity of clinical symptoms. Other strategies include administration of active lactose enzyme-generating probiotics or consumption of lactose enzyme supplemented milk.
In conclusion, suitable diagnostic approaches specifically catered to neonates as well as treatment measures such as use of lactose-free milk and probiotics may lead to improved outcomes in infants with lactose intolerance.
News Source: Liu J, Chang J, Yao A, et al. Diagnosis and clinical observation of lactose-free milk powder on treatment of neonatal diarrhea. Pak J Pharm Sci. 2016;29(1):309–314.