Lactose Intolerance In Children

Food intolerance not mediated by some disturbance of the immune mechanism may be due to untoward metabolic responses to food. There are some undoubted examples of this, such as enzyme defects, pharmacological reactions or irritant effects, but also a great deal of controversy. However, some claims of harmful effects of certain foods and their components remain unproven.

Lactose is the carbohydrate present in all mammalian milks. Lactose intolerance results from a deficiency of the enzyme lactase which is normally present in the brush border of the enterocytes lining the small bowel. The symptoms of lactose intolerance are diarrhoea and failure to thrive with foamy, acid stools, and the presence of lactose in the stool. This can be detected simply by testing the liquid stool for reducing substances.

Very rarely lactose intolerance is present from birth (primary lactase deficiency), and would be incompatible with prolonged survival unless the infant was placed on a lactose-free formula. Secondary lactose intolerance is much more common and is seen in all conditions where there is damage to the intestinal mucosa. Thus it may occur with, or following, such diseases as gastro-enteritis, coeliac disease, or CMPI. In these conditions it is usually transient. Treatment consists of avoiding lactose containing foods until the bowel has recovered its lactase activity. Soya infant formulas contain no lactose and are suitable for this purpose provided the rest of the diet is lactose free. This is, in all respects similar to a milk-free diet but some fermented products, such as certain cheeses may in fact be lactose free and could be included in the diet. It is important to remember that some drugs may contain lactose.

Another form of lactose intolerance is seen in most racial groups other than Caucasians. This is the gradual disappearance of lactase activity from the bowel mucosa during later childhood so that in many peoples a proportion of the population is lactose-intolerant by adolescence, particularly boys. On ingestion of milk, abdominal distension, pain and diarrhoea occurs and these individuals quickly learn to avoid or limit milk or to ingest it only in a fermented form where the lactose has been converted to lactic acid. The nutritional importance of this phenomenon is that raw milk might not be a suitable dietary supplement for these older children and adolescents and that they might consequently become calcium deficient.

By: Thomas Sector

Article Directory: http://www.articledashboard.com

Find more advices and tips around parenting, visit the health articles blog now.