True and false lactase deficiency. How to understand?
What are the signs LN? Abdominal pain since when? - 2-3 minutes or 15-20 minutes from the beginning of feeding? So constipation or watery liquid with foam? Weight gain is always? But often mothers of children with like signs LN another kilmallock eat tons :((How to understand?Malabsorption, lactose - lactose malabsorption. Or lactase deficiency (LF)To understand what I like most about paediatric textbooks published before the beginning of the era of lactase-baby, Lachezar, etc., in short, lactose intolerance is clinically manifested by diarrhea, vomiting, bloating, pain in the abdomen after feeding milk. If you continue suckling breastfeeding develops dystrophy. When the reduction of milk or its abolition is improving the state of the child and the increase of body weight.For diagnostics it is proposed to use the pH of the feces less than 5.5 and increase excretion of carbohydrates in Calais 2D% or more ( due to lactose, xylose, galactose, glucose) (Shabalov, "Childhood diseases" 1993) You all know that now the "norm" for some reason is considered to be 0.25 g%. These children I see around a couple of times a year. the other indicators I and you come across as times are between 0.25 and 2 (and, in fact, you never know what a sugar formed these numbers? Maybe xylose with glucose?)Based on that.We all do not see children with lactase deficiency, leading to malnutrition. We see children that have carbohydrates in the stool more than 2%. (and when the see is usually a fat kid without the slightest signs of dystrophy)We see that the purpose of the enzyme lactase in the vast majority of cases does not affect the baby's crying, the churning in his stomach, stool frequency.Signs LN: diarrhea - children breastfed stools loose, this is the norm, due to the frequent liquid stool, children gain weight well or normal. Painful condition "diarrhea" in violation of the intestinal absorption always leads to malabsorption of nutrients and dehydration in acute situations or degeneration gradually. Constipation can not be a sign of LN. Diarrhea with LN - osmotic diarrhoea - based excess water drawn into the lumen of the large intestine due to the fact that at LF lactose in the small intestine did not split, fell in thick, slightly split by bacteria, but many remained - the osmotic pressure increases, the liquid goes into the lumen of the bowel - diarrhea. This is a common mechanism for intestinal viral infections and cholera - damage to the villi of the small intestine by viruses or bacteria is not formed lactase (and other frumenty too, of course) - osmotic diarrhoea, sometimes so strong that a person dies in a few hours ( even and toxins act, but it's not important now). Sometimes doctors use the term "shut-diarrhea" and associate it with the LF. I feel ashamed for them. Because "stop diarrhea" is a condition that develops on the background of long-term fecal blockage in the colon, when slaughtered kalbimi stones atonic rectum (all thick full) leaking intestinal juice through open anus.Dystrophy - it develops not only because of malabsorption and splitting one lactose. Breach of this sugar leads to changes in suction and other nutrients, there is a General disturbance of digestion and absorption, so attached and malabsorption of fats and proteins. (Which we never see in "our" "bisectorial" - see the forum AKEV and coprogram, which are sent as horror-horror about who Jacob is constantly writes - it's all right)Abdominal pain - if LN likely caused by hyperextension redundantly generated gas loops of bowel. Accordingly, for such pain syndrome need some time. Abdominal pain during feeding can not be associated with LN. ("Pain and anxiety during feeding I personally often consider the signal to be placed, most often it is this model. ) Bloating is full of gases colon. I don't understand the connection "pain" immediately after the start of feeding with lactase deficiency. If someone understands the mechanism of its occurrence - explain please.Vomiting when LN - please note that vomiting is not a regurgitation of the baby. It is most likely due to toxic effect is partially absorbed in the blood lactose and General metabolism, always accompanying real "diarrhea". And occurs in primary congenital deficita lactase, beginning immediately after birth and quickly leading to toxicity and malnutrition.Eating mother Islamology - does not apply to LF. If she digests kilmallock normally let him eat. This can be important if you have poor digestion of proteins and allergies to cow's milk proteins, but to LF it has nothing.Now about LF in General. It is not peculiar to young mammals in General. With age the young mammals lose the ability to break down lactose. And the adult is not split, but not necessary. In humans several thousand years ago entrenched gene that controls sufficient production of lactase in adulthood and most adults ( 98% in Europe , and some parts of Asia and Africa, only 10% of adults) deal with milk and dairy products. By itself lactose malabsorption adults develops gradually after 4-5 years of age. This is the norm for our species. Congenital lactose malabsorption in infants is transmitted in an autosomal recessive type and therefore extraordinary rare and leads to death if it is not possible to organize a lactose free diet and can not gain a foothold in generations (well now you can because lactose free mixes)(And here about almond milk - it is mentioned in Shabalova as the basis of nutrition for children with true lactose intolerance.)What to do with this information and our mothers,who are sure that their children suffer from a lack of lactose?(what to do with doctors - I don't know) We can this information with them to share. Let cormet their children lactase, if you want, just ask them not to do so, as written in the instructions, and fill the lactase directly to the child during feeding, Wyspa her out of the capsules and mixing with a small amount of milk, water or rhinestone in the mouth. If mom after 3-5 well 7 days do not see the changes ( and they usually don't see) - point in future use no lactase.All we see now is a natural process that does not require treatment, they require time and disappear by themselves. But because modern people want to be treated, and doctors want to treat, all actively waiting for care in all situations from drugs and pills, because waiting is hard. So I think this thought and her mothers trying to convey - not everything that happens requires treatment.Sincerely, L. Kazakov CenturyRelated articles:breastfeeding! - Research: dental health and breastfeeding, part 2Breastfeeding! - Yakov Yakovlev, pediatrician, K. M. N..