Special lactose-free formulas are the optimal nutrition for a child whose body does not absorb lactose well or does not absorb lactose at all. The need for them also arises when the baby is not able to absorb galactose. Two diseases that require a change in diet are not so rare, which is why the question arises about the types of mixtures that are indicated for them.

Lactase deficiency is quite common, so formula for babies with this problem is not difficult to find

Labeling and composition of lactose-free mixtures

The lactose-free mixture is marked with the abbreviation “BL” (in English “LF”). This sign indicates that this mixture is made without lactose or its content does not exceed 0.1 grams per liter. The protein needed by a newborn can be presented in several varieties in this diet. For children suffering from allergic reactions to the presence of protein in their diet, lactose-free mixtures with whey protein and albumin are suitable. Both types of protein can be presented in a ratio of 50/50 or 40/60, however, lactose is partially present in such lactose-free mixtures.

Lactose is not used at all in mixtures made on the basis of calcium caseinate. The presence of galactosemia or food allergies in the baby, against which it develops, requires preferring a lactose-free mixture.

They use proteins such as soy isolate, hydrolyzed whey or casein protein. A severe form of allergy determines the choice of the type of baby food from lactose-free mixtures with the replacement of protein with synthetic amino acids.

Full information about the mixture must be found on the back of the package - there should be the marking “BL”

When should it be used?

The prescription of lactose-free formulas is practiced when a child is diagnosed with complete or partial intolerance to galactose or lactose. Name of diseases:

1. Lactase deficiency is the improper production of the lactase enzyme. It is divided into primary and secondary forms. Primary deficiency implies the complete absence of the enzyme, secondary deficiency is determined by a decrease in its activity.
2. Galactosemia is a disease in which there is a failure in the process of converting galactose into glucose.

The form of the disease is determined by the doctor, who also prescribes a lactose-free formula for feeding the newborn. Conclusions on the diagnosis of lactose or lactase deficiency are made only on the basis of laboratory tests (more details in the article:). Liquid in a baby is not evidence of lactase deficiency and is not a reason to resort to lactose-free formulas. Decide on nutrition replacement only after examining the child.

Caution in determining the diagnosis, especially independently, is due to the fact that lactase deficiency is not always a sign of pathology. The body of babies up to 2-3 months is characterized by low lactase activity, which is included in the normal indications. Similar symptoms occur during an allergy to cow protein. With this diagnosis, other types of nutrition that do not contain provoking allergens are required.

Types of mixtures and their characteristics

Manufacturers offer several varieties of the product. Your doctor will help you choose the one that suits your child. Here is a list of the most popular mixtures:

• NAS lactose-free (we recommend reading:)– recommended from 0 to 12 months. The weight of one package is 400 grams. The ratio of protein derived from whey and casein is 60/40, and the mixture includes maltodextrin. It is used for lactase deficiency and disorders in the small intestine, which does not absorb certain nutrients.
• Bellakt– applies from 0 to 12 months. The composition is identical to the first mixture. Recommended for feeding children with lactase deficiency, suffering from colic, and prolonged diarrhea. One jar – 400 grams.
• Nutrilak lactose-free plus– for children from 0 to 12 months. The protein ratio (whey and casein) is 50/50, there is maltodextrin. Indications: rejection of milk sugar and gluten by the child’s body, galactosemia, diarrhea of ​​various etymologies. The weight of one package is 350 grams.
• Nutrilon Premium lactose-free (we recommend reading:)– indicated for nutrition from 0 to 12 months. Protein is replaced with casein. Contains glucose syrup. Prescribed to children whose bodies are lactose intolerant.
• Similak Low Lactose (we recommend reading:)– the mixture is close to breast milk, there is no palm oil (we recommend reading:). Added probiotics and nucleotides to improve digestion and boost immunity.
• Celia lactose free– from 0 to 12 months. One package – 400 grams. Protein to casein – 60/40. Contains maltodextrin. It is used in the nutrition of children who have suffered acute gastroenteritis, with regular diarrhea, and who are lactose intolerant (see also:).
• Grandmother's basket lactose-free– from 0 to 12 months. Ingredients: casein, glucose syrup, maltodextrin. It is prescribed when the child’s body does not tolerate lactose.

Mixtures used for food allergies

What mixtures are suitable for galactosemia?

When choosing which infant formulas can be used with a diagnosis of galactosemia, we pay attention to those products that contain soy protein isolate (free from fats and carbohydrates). Let us classify them as the optimal type of food for a child with galactosemia, since they contain neither lactose nor galactose of animal or plant origin. In addition, the use of lactose-free mixtures with a dominance of casein, based on synthetic amino acids and casein hydrolysates, is allowed. Products containing 50-60% whey protein are not recommended. Sample list:

• Nutrilak soy;
• Frisosoy;
• Nutrilon soy;
• Humana SL.

The baby is transferred to a new type of formula gradually so that the baby’s body can adapt to the changes

The transition to eating lactose-free formulas is carried out step by step. Increase the proportion of new food over 5-7 days, starting with 1/5-1/10 daily feeding, reaching a complete refusal of breast milk. This regimen will help a child with galactosemia better adapt to a new type of diet. It can also be used in cases of lactase deficiency.

The doctor decides which brand is best for your baby. The specialist will select the best option for the baby, taking into account the characteristics of his body.

What are the side effects?

It is important for a nursing mother to know whether such milk formulas can cause a negative reaction in the baby. The list of side effects is short and includes:

• products based on soy protein can cause an allergic reaction in the baby;
• long-term use of such nutrition causes disturbances in the gastrointestinal tract: colic, diarrhea, flatulence, dysbacteriosis;
• Replacing breast milk with formula at one time can cause constipation.

When feeding, many parents notice that their children have difficulty digesting food. Children often experience severe discomfort associated with digestion and refuse to eat. One of the most common causes of this unpleasant phenomenon is lactase deficiency.

It occurs when a child’s body, due to structural features or damage to intestinal cells or infectious diseases, produces an insufficient amount of the lactose enzyme.

When choosing food, you should look for special markings on the packaging. The letter combination LF - BL indicates that infant formula is lactose-free, or its share of the total mass is 0.1 grams per 1 liter and no more.

Proteins necessary for the baby’s body to grow normally are present in lactose-free infant formulas in their own varieties that do not cause a negative reaction.

Lactose-free mixtures

What is lactose-free formula, what are the differences between it and regular baby food? By lactose-free mixture we mean the complete absence of lactose in the presence of all other easily digestible nutrients necessary for the child’s body, as well as an increased content of microelements.

The pediatrician decides which lactose-free formula is best for your baby - based on the results of examination and diagnosis.

1. lactose-free;
2. lactose free;
3. lactose-free plus;
4. premium

Nan (Nan) lactose-free

The composition of the formula is very close to the composition of breast milk, which helps the normal growth and development of the child.

Characteristic:

• weight: 400 g;
• composition: corn syrup, vegetable oils, whey proteins, microelements;
• indicated for use: for disorders of the small intestine;
• age: from birth to one year.

Pros: close to the composition of breast milk.

Minuses: There may be changes in color and an unpleasant odor in the child's discharge.

Bellact lactose free

Product for children with dietary needs. Contains vitamins, macro- and microelements for the harmonious development of the child.

Let's take a closer look:

• weight: 400 g;
• composition: minerals, prebiotics, vitamin complex, nucleotides, amino acids, maltodextrin;
• age: from 0 to 12 months;
• Indicated for use: in case of lactose inability to digest, in children who have had diarrhea.

Pros: without flavor enhancers, does not contain dyes, preservatives, well digestible.

Minuses: You may be allergic to some of the ingredients in the product.

Nutrilak (Nutrilak) lactose-free plus

The product meets the needs for basic nutrients and energy.

Description:

• weight: 350 gr.;
• composition: gluten, proteins, a complex of macro- and microelements, maltodextrin, a set of vitamins;
• indicated for use: lactose intolerance or diarrhea syndrome, galactosemia;

Pros: strengthen and stimulate the nervous system, brain, muscle and bone tissue.

Minuses: bitter taste, smell, sometimes causes allergies.

Nutrilon (Nutrilon) premium

Nutrilon mixtures are close to human milk and are recommended for preventing diseases.

Characteristics:

• weight: 400 g;
• composition: prebiotics, milk protein, lactose, fatty acids, complex of vitamins and minerals, taurine;
• Indicated for use: acute sensitivity to food;
• age: No. 1 from 0 to 6 months, No. 2 – from six months.

Pros: help the development of immunity, prevents the occurrence of intestinal infections, stimulates the brain, central nervous system, and visual function.

Minuses: contains palm oil.

Grandmother's basket lactose-free

Baby food "Babushkino Lukoshko" is developed and produced taking into account modern requirements and scientific trends.

Let's take a closer look:

• weight: 400 g;
• composition: casein, fatty acids, glucose syrup, taurine, trace elements;
• indicated for use: for lactase deficiency, galactosemia;
• age: from birth to 12 months;

Pros: lack of whey proteins.

Minuses: high price.

Celia (Celia) LF (lactose free)

The product ensures the baby's normal development and growth. Karinka 2, Celia LF.

Let's take a closer look:

• weight: 400 g;
• composition: complex of minerals, vegetable oils, whey protein, vitamins, probiotics;
• indicated for use: lactase deficiency, recovery from gastroenteritis, diarrhea;
• age: from birth to 1 year.

Pros: have a beneficial effect on the intestines, improve immunity.

Minuses: palm oil content.

Similac () low lactose

The product helps reduce gas formation and prevent diarrhea.

Description:

• weight: 375 g;
• composition: whey protein concentrate, vegetable oils, calcium caseinate, minerals, taurine;
• indicated for use: lactase deficiency, in the period after diarrhea, gastroenteritis;
• age: from birth to 1 year.

Pros: supports the natural protective functions of the body, promotes the development of the baby’s immune system.

Minuses: contains casein, which often causes allergic reactions.

Enfamil (Enfamil) lactose-free

Contains special fatty acids - ARA, DHA, which contribute to the formation of the brain and the development of the child's vision.

Characteristics:

• weight: 400 g;
• composition: whey proteins and casein (20/80);
• indicated for use: primary and secondary lactase deficiency, rehabilitation after acute gastroenteritis or diarrhea;
• age: from 0 to 1 year.

Pros: easy digestion and absorption of the product.

Minuses: contains casein.

Lactose-free formulas for children who are prone to food allergies

Newborn babies are allergic to milk mixture. The main reason is intolerance to the containing components. How does a hypoallergenic composition differ from a regular one? The hypoallergenic product for newborns contains highly purified soy protein and is absolutely lactose-free.

Therefore, the product is suitable for children who are intolerant to lactose, cow's milk proteins.

List of lactose-free formulas for children prone to food allergies:

1. Nutrilon amino acids;
2. Alphare Amino;
3. Nutrilon Pepti TSC;
4. Nutrilak soy;
5. Humana SL.

When you meet a pediatrician who throws up his hands and says “think for yourself what lactose-free formula to give your baby,” think about the need to consult with another doctor regarding the causes of the allergic reaction and help in choosing the baby’s diet.

Nutrilon (Nutrilon) amino acids

A product developed on the basis of non-essential and essential amino acids for children from birth with food allergies. Picture 3, Nutrilon amino acids.

Characteristic:

• weight: 400 gr.;
• composition: amino acids, glucose syrup;
• indicated for use: in the presence of food allergies, intolerance to cow's milk proteins and lactose;

Pros: all necessary minerals and vitamins.

Minuses: increased osmolarity.

Alfare Amino

Balanced nutrition based on amino acids for infants with allergic reactions and food intolerance from birth.

Description:

• weight: 400 gr.;
• composition: amino acids, corn syrup, potato starch, triglycerides;
• indicated for use: intolerance to lactose, soy, cow's milk, problems in the small intestine;
• age: from birth to 12 months.

Pros: a full range of essential minerals and vitamins.

Minuses: high price.

Nutrilon (Nutrilon) Pepti TSC

The food product is intended for dietary nutrition. Made from whey proteins with nucleotides.

Description:

• weight: 450 gr.;
• composition: hydrolyzed whey protein, glucose syrup, mineral complex;
• indicated for use: non-acceptance of cow's milk protein, soy;
• age: from birth to 12 months.

Pros: easily absorbed, strengthens the immune system.

Minuses: slightly bitter taste.

Nutrilak (Nutrilak) soy

Characteristics:

• weight: 350 gr.;
• composition: mineral complex, soy protein isolate, glucose syrup, set of vitamins;
• indicated for use: in case of non-acceptance of cow's milk protein, lactase deficiency, galactosemia;
• age: from birth to 12 months.

Pros: not genetically modified, with increased biological value.

Minuses: contains palm oil.

Friso soy

A highly adapted product based on soy isolate, lactose is replaced by glucose, maltose and glucose polymers.

Let's take a closer look:

• weight: 400 gr.;
• composition: vegetable oils, soy protein isolate, glucose syrup, complex of mineral salts, microelements;
• indicated for use: for hypo- and alactasia of various origins, galactosemia, allergy or sensitivity to cow's milk protein;
• age: from birth to 1 year.

Pros: It is fully absorbed and tolerated by the child’s body.

Minuses: no added amino acid tryptophan.

Humana SL

Description:

• weight: 500 g;
• composition: complex of vitamins and microelements, soy protein isolate, vegetable oils, mineral salts;
• indicated for use: for poor absorption of lactose (hypo- and alactasia), galactosemia, non-acceptance of cow's milk proteins, allergies to sucrose, fructose;
• age: from birth to 1 year.

Pros: the protein and electrolyte content helps avoid increased stress on the kidneys.

Minuses: high price.

Which lactose-free mixture is better?

What is the best lactose-free product is a pressing question that will be answered for loving parents by experts who decided to compile a list of the best lactose-free formulas for infants:

1. "Nan lactose-free";
2. "Enfamil Lactofri";
3. "Nutrilon lactose-free."

When are lactose-free formulas prescribed?

If a child exhibits symptoms of indigestion, parents should definitely consult a doctor. If partial or complete lactose intolerance is confirmed, the doctor prescribes a lactose-free food product for the child.

How to switch to lactose-free formula

Having decided on the need to switch to a lactose-free formula, the doctor usually recommends a product from a certain manufacturer, taking into account test data, the characteristics of the child’s body, and will provide instructions on how to correctly switch to a lactose-free formula.

When breastfeeding

When completely replacing mother's milk, lactase preparations are used. They are added to a small volume of expressed milk, kept for about twenty minutes, and then fed to the baby before the main breastfeeding. To partially replace mother's milk, use lactose-free formulas for infants for three to five days, gradually increasing complementary feeding and bringing its volume to two-thirds of the usual norm.

With artificial feeding

Lactose in milk nutrition is necessary for the infant's body, but if artificial feeding is necessary, admixtures with a reduced lactose content are prescribed and a further gradual transition to lactose-free formulas is prescribed.

What to do if you are constipated when artificially feeding lactose-free formulas:

1. review the admixture, check the correct intake;
2. consult a doctor.

During

When expanding the diet, when the symptoms of lactase deficiency remain, use a medicinal nutritional mixture mixed with cereals and various dishes made with milk.

How to switch from lactose-free formula to regular? The transition must be carried out gradually. At the beginning they feed with impurities with a small content of lactose, then they give the regular one and replace the lactose-free one.

Lactose-free mixtures for lactase deficiency

To prevent and treat lactase deficiency diseases, all kinds of lactose-free products containing carbohydrates converted into glucose are used.

The baby is switched to a lactose-free diet immediately when a diagnosis of primary lactase deficiency is made.

When breastfeeding and concomitant lactase deficiency, the medicinal mixture is given to the child first in small doses and gradually increased to 1/3 - 2/3 of the norm for mother's milk consumption during one feeding. The period during which babies adapt to consuming lactose-free formulas is usually 3-5 days.

Is it possible to mix lactose-free mixtures with regular ones? The pediatrician will decide upon examination.

Low-lactose formulas are used instead of lactose-free ones if the child is bottle-fed. During the complementary feeding period, it is recommended to cook porridge with the same mixtures.

Special nutrition with a reduced lactose content is also prescribed for premature babies.

Table of mixtures with reduced lactose content registered in the Russian Federation:

If the baby's problems have disappeared, it is not recommended to switch from a lactose-free formula to a regular one until the test for lactase deficiency is repeated.

Lactose-free mixtures for galactosemia

Metabolic failure due to insufficient fermentation during the absorption of galactose -. For an allergic reaction, Pregestimil, Frisosep AS, Nutramigen are used. The composition of nutritional mixtures differs from other lactose-free mixtures by the inclusion of soy protein and casein hydrolysate. Additional list of lactose-free mixtures recommended for use: Frisosoy, Nutrilak soya, Humana SL.

Side effects of lactose-free formulas

Negative reactions in the baby’s body to lactose-free nutrition:

• the presence of soy protein is a possible allergic reaction;
• transition from breastfeeding to artificial feeding - constipation is possible;
• long-term use - possible occurrence of colic, dysbacteriosis, diarrhea.

A characteristic feature of digestive problems in newborns is impaired intestinal absorption of one or more nutrients.

Conclusion

If a baby notices a negative reaction to lactose (abnormal bowel movements, skin rashes, itching) or signs of poor absorption, parents should consult a doctor as soon as possible. Timely and correct prescription and use of lactose-free nutrition will help to avoid serious consequences for the child’s body, as well as provide it with everything necessary for growth.

Such children need specialized nutrition with a reduced amount of lactose, since their intestines cannot digest and absorb it in sufficient quantities. We wrote in detail about the symptoms of lactase deficiency.

Low-lactose milk formulas differ from lactose-free formulas in that they contain a small amount of lactose, which varies from manufacturer to manufacturer. Read more about low-lactose mixtures.

In this article we will provide a list of low-lactose mixtures and consider their characteristics, composition and features so that you can choose which low lactose is the best?.

Similak

The Similak company produces baby food "Similak Low Lactose", it is intended for children from birth to one year and is sold in metal cans, net weight 375 g.

The food is suitable for the prevention and treatment of secondary lactase deficiency and normalization of intestinal disorders - diarrhea, constipation, colic, and can also be used as the main diet for the first 2 weeks after an acute intestinal infection.

Caution: Not suitable for the treatment of galactosemia.

Composition: Similak Low Lactose includes equal parts whey proteins and casein – 50/50, amount of lactose – 0.2 g/100 ml.

Contains prebiotics, important for the child’s comfortable digestion, and nucleotides, important for strengthening and developing the immune system.

The composition includes minerals - magnesium, sodium, iodine, iron, zinc, copper, phosphorus, selenium and manganese.

The complex of vegetable oils is represented by soybean, sunflower and coconut oils.

The low-lactose Similac mixture does not contain palm oil, GMOs, dyes or preservatives.

The manufacturer warns that the product is best prepared for one feeding, in the amount of one serving. If you get a lot of it, then remember that the “extra” part should only be stored in the refrigerator and no more than a day. Remember: Do not reheat food from the refrigerator in the microwave!

Bellakt

The manufacturer of baby food, the Bellakt company, has in its line of products “Bellakt Low Lactose” for children from birth to one year, produced in boxes of 400 g.

Like other low-lactose and lactose-free products, this one can be used not only to treat lactase deficiency, but also to prevent intestinal disorders.

Composition of the mixture Bellakt Low-lactose includes maltodextrin, cow's milk, whey proteins predominate, their ratio to casein is 60/40.

The low-lactose mixture Bellakt contains vitamins A, B, C, D, E, K and minerals magnesium, sodium, calcium, potassium, as well as nucleotides, taurine, choline and inositol - important for the growth of bones and the baby’s gastrointestinal tract.

The energy value of the product is 66 kcal.

Nestozhen

“Nestozhen low-lactose” is available in boxes, net weight 350 g and can be used for feeding children from birth.

It is prescribed as a remedy for lactase deficiency, as well as to normalize digestion after intestinal disorders and their consequences, for example, diarrhea.

Carbohydrates are represented by maltodextrin and glucose syrup, fructose and glucose. Contains nucleotides and folic and Omega-6 acids, but does not contain Omega-3 acids.

Vegetable oils in the composition of Nestozhen Low Lactose are rapeseed, sunflower and coconut.

Minerals included: potassium, calcium, phosphorus, iron, iodine, sodium, magnesium.

Low-lactose mixture Nestozhen solves the problem of constipation, since it contains prebiotics, very beneficial bacteria that are designed to remove harmful substances from the intestines and have a beneficial effect on its myctoflora.

The manufacturer emphasizes that its product does not contain preservatives or starch.

Humana

The Humana company produces two types of baby food for babies with lactase deficiency problems - these are Humana LP and Humana LP+SCT. It is available in boxes, net weight 300g. Both products are suitable for the treatment of lactase deficiency and the prevention of intestinal disorders - regurgitation, colic, diarrhea. Unlike other low-lactose formulas for children, Humana formulas can only be given to children from six months.

Composition of Humana mixture It is distinguished by the presence of skim milk and the predominance of casein, which is about 90%.

The source of carbohydrates is maltodextrin and glucose syrup.

Contains vitamin B complex, as well as A, C, D and K.

Minerals - calcium, sodium, magnesium, iron, zinc, copper, potassium and chromium.

Humana's low-lactose mixture does not contain flavors, colors, preservatives or gluten, but it does contain prebiotics and banana dietary fiber, which contains pectin, which ensures regular and soft stools.

Humana LP + MCT differs in the content of medium chain triglycerides, hence the SCT in the name. It can be used as the only source of food for a child; porridge can be cooked on it.

Nutrilon

The Nutricia company previously also produced low-lactose food under the Nutrilon Low-Lactose brand. Now it cannot be found on the shelves of our country, its production ceased in 2009, a replacement for this product in the Nutrilon line can be lactose-free Nutrilon, which we wrote about.

In general, Nutrilon Low-Lactose was not very different from other low-lactose medicinal mixtures in composition; it contained taurine, biotin, choline, minerals - potassium, chlorine, sodium, phosphorus, magnesium, zinc, iron, etc., as well as vitamins A, B, S, D, E, K.

These dry low-lactose mixtures are present on the Russian baby food market.

After reading the article about therapeutic and prophylactic low-lactose mixtures, You will learn:

• 1

  What is lactase deficiency?

• 2

  What symptoms of lactase deficiency are observed in babies?

• 3

  What laboratory methods can confirm the presence of lactase deficiency?

• 4

  How can lactase deficiency be treated with nutritional correction?

• 5

  What low-lactose formulas are available?

• 6

  What is the best low lactose formula?

• 7

  What other low lactose formulas are available?

• 8

  How to properly administer a low-lactose mixture?

• 9

  How is complementary feeding introduced in conditions of lactase deficiency?

• 10

  How to expand the diet after stopping the low-lactose formula?

• 11

  How long do you use low-lactose formulas?

• 12

  How do I know if a low-lactose formula is right for my baby?

Lactase deficiency

Lactase deficiency is a condition of the body in which there is a deficiency of a special enzyme (lactase), which helps the body break down complex carbohydrates into simpler molecules. Thus, the lactase enzyme breaks down lactose, the main carbohydrate in milk, forming two molecules: galactose and glucose. Simple sugars, in particular galactose and glucose, are capable of being absorbed into the bloodstream, saturating the body with energy. Thus, a deficiency of the lactase enzyme in the body leads to impaired absorption of milk sugar and poor tolerance to foods containing lactose. From a medical point of view, lactase deficiency is distinguished between primary and secondary.

Primary lactase deficiency develops when a breakdown of the genetic code is observed in the body, and a person cannot tolerate any dairy products throughout his life. Lifelong treatment is required. Fortunately, there are very few people suffering from total lactase deficiency - alactasia - 10% of the entire planet's population. In children suffering from alactasia, adult relatives with the same problem are always identified, who help the doctor navigate the situation.

Secondary lactase deficiency associated with damage to intestinal cells due to any disease or immaturity of the digestive system as a whole.

Conditions that can lead to secondary lactase deficiency:

1. acute intestinal infections due to damage to the intestinal mucosa by microbial toxins or their direct effect on the wall of the small intestine;
2. atrophic changes in the mucous membrane after a long absence of food (we are talking about a lack of food for more than 7-10 days). For example, after long-term intravenous nutrition, in an intensive care unit, etc.
3. various intoxications;
4. food allergies;
5. disruption of intestinal microbiocenosis;
6. immaturity of the enzymatic system;
7. damage to the mucous membrane of the small intestine when using medications (more typical for older children);
8. prematurity. All children born before 35 weeks of gestation have lactase deficiency. Often combined with intolerance to whole milk proteins. That is why all premature babies are recommended to be fed with specialized milk formulas.

In infants, including premature infants, lactase deficiency is mostly temporary. Depending on the degree of enzyme deficiency, the duration of carbohydrate intolerance can vary, from 1-2 months to 5-6 months, and longer in premature babies.

Symptoms of lactase deficiency

Among the clinical symptoms, the most noticeable are:

1. frequent watery, foamy stools with a sour odor;

   For children in the first month of life, the norm is considered to be mushy or even loose stools up to 5-10 times a day. In the second month of life, the normal frequency of stool for a child is from 1 to 5 times a day. For children over 2 months of age, bowel movements are considered normal - 1-4 times a day.

2. frequent and profuse regurgitation, in severe cases - episodes of vomiting;
3. severe gas formation in the intestines, accompanied by attacks of intense abdominal pain - colic;
4. diarrhea that cannot be treated with conventional means (typical for older children);
5. retardation in weight, height and development;
6. When observing an infant, a relationship is often discovered between breastfeeding or formula containing lactose and a deterioration in the child’s well-being with the appearance of regurgitation, vomiting, or characteristic loose stools.

In the treatment of secondary lactase deficiency, various methods are used, completely depending on the nature of feeding and the severity of lactase deficiency.

Methods used to confirm the diagnosis

The minimum diagnostic examination for suspected lactase deficiency is:

1. Examination of stool for carbohydrates. Infants should have no free carbohydrates in their feces or very few of them. Therefore, their detection is a sign of impaired absorption of carbohydrates, in particular lactose.
2. Coprogram study with pH determination or isolated determination of stool pH. Coprogram information may indicate a violation not only of the carbohydrate composition of the diet, but also indirectly reflect the ability to properly digest protein and fats. With combined digestive disorders, soaps, neutral fats, fatty acids, an abundance of mucus, etc. appear in the coprogram.

   A change in stool acidity towards acidification of the environment, that is, stool pH less than 5.5, indicates the predominance of fermentation processes. If the stool pH is 5.5 or lower, then there is lactase deficiency.

3. A test with the introduction of enzyme preparations during breastfeeding or a test with the introduction of a low-lactose (or lactose-free) mixture for 2-3 days, instead of the usual diet for bottle-fed children.

   If 24-48 hours after the diagnostic administration of a low-lactose product there is a positive trend in the regression of existing symptoms, feeding with a specialized formula is continued.

In addition to the above research methods, can be carried out:

1. genetic research if congenital lactase deficiency is suspected (especially if there are cases of refusal of dairy products by one of the close relatives);
2. breath tests indicating the content of lactose breakdown products in the exhaled air. The specificity of this test involves the age of children over 4 years old.

Treatment with nutritional correction

Scheme for correcting lactase deficiency according to the National Strategy for Feeding Children in the First Year of Life:

With natural feeding	With artificial feeding
The maximum amount and long-term preservation of mother’s milk in the baby’s diet is of primary importance. Treatment begins with the prescription of enzyme drugs: Amount of lactose in 100 ml of the finished mixture: 1.0 grams	Protein component with a predominance of whey proteins 60/40; Added maltodextrin; Used in children with secondary lactase deficiency, after diarrhea, to reduce colic.
Nestozhen Low-lactose Amount of lactose in 100 ml of the finished mixture: 0.19 grams	The carbohydrate component is represented by glucose syrup, maltodextrin, and a little lactose. Used for lactase deficiency and after diarrhea.
Humana LP Amount of lactose in 100 ml of the finished mixture: 1.1 grams	Casein content is about 90%; Added maltodextrin and potato starch; Used for acute intestinal infections, diarrhea of ​​various types, partial lipase deficiency, secondary lactase deficiency, flatulence, colic, regurgitation.
Humana LP + SCT Amount of lactose in 100 ml of the finished mixture: 0.5 grams	Characterized by a predominance of the casein fraction; Contains glucose syrup and maltodextrin; Contains medium chain triglycerides (MCTs), which promote better absorption of fats. MCTs are broken down without the participation of pancreatic and intestinal lipase, which compensates for the immaturity of pancreatic enzymes. It is used for digestive disorders of various origins, for intestinal disorders in the acute stage and during the recovery period.
Nutrilon Low Lactose Amount of lactose in 100 ml of the finished mixture: 1.33 grams	This mixture was discontinued in 2009; the Nutricia company, like many others, abandoned the production of a low-lactose mixture due to the arrival of “comfort” mixtures on the market. (more about comfort mixtures in this article)

The best low lactose mixture

The choice of a low-lactose mixture for the treatment of secondary lactase deficiency is strictly individual and is determined by the amount of lactose that the child is able to independently absorb. A child can be prescribed specialized nutrition only after examination and assessment of his ability to break down lactose. Since the amount of lactose in all formulas is different, it is difficult to say which milk formula is needed for a particular child and is most often selected experimentally. The course of treatment with a low-lactose mixture lasts, on average, from 1 to 3 months. This time is enough for the body to learn to produce its own enzymes for the normal digestion of dairy products. After a course of therapy and relief of symptoms of lactase deficiency, under the supervision of a doctor, the child is gradually transferred to a normal diet.

Low lactose mixtures

Lactase deficiency is quite often combined with various digestive disorders, so among the low-lactose mixtures there are representatives from other groups of milk formulas.

Among hypoallergenic mixtures with partial protein hydrolysis, with high hydrolysis of whey proteins and casein, amino acid-based mixtures, anti-reflux mixtures and comfort mixtures, there are products with a reduced lactose content, which are used for combined pathologies of the digestive system:

Introduction to the diet of a low-lactose mixture, complementary foods and subsequent expansion of the diet

In cases of lactase deficiency in formula-fed children, a low-lactose mixture is administered with the maximum content of this carbohydrate that the baby can tolerate without causing the appearance of clinical symptoms. The need to maintain lactose intake in the body is due to:

1. Lactose is a natural probiotic, in the presence of which the intestinal microflora develops most favorably.
2. Lactose is also the only source of galactose, which is formed during its breakdown. Galactose is used to produce galactolipids, including cerebrosides, which are necessary for the proper formation of the central nervous system and myelination of nerve fibers.
3. Galactose (a breakdown product of lactose) is necessary for the synthesis of hyaluronic acid, which is part of the vitreous body of the eye and synovial fluid.

A low-lactose formula is introduced into each feeding, gradually replacing the usual milk formula. Introducing new foods into a child's diet is very important. Children suffering from lactose intolerance require careful monitoring, keeping a food diary indicating the type of product, its quantity and its tolerance. Complementary feeding dishes for children of the first year of life with lactase deficiency are prepared not with milk, but with the medicinal mixture with a reduced lactose content that the child receives. At 5 months of life, it is advisable to introduce gluten-free porridge (rice, corn, buckwheat) or pureed vegetables with coarse vegetable fiber (cauliflower, zucchini, pumpkin, carrots) with the addition of vegetable oil as the first main complementary food.

Next, add meat puree. Fruits and fruit juices (diluted 1:1 with water) are introduced into the diet of children with lactase deficiency later, usually after 6-7 months. In children of the second half of life, it is possible to use dairy products where the lactose content is insignificant: cottage cheese washed from whey, butter, hard cheese.

Duration of use of low-lactose mixtures

In case of primary (congenital) lactase deficiency, a low-lactose diet is prescribed for life. For transient lactase deficiency, low-lactose mixtures are used upon achieving remission of the underlying disease; as a rule, after 1-3 months, the diet is gradually expanded by introducing lactose-containing milk mixtures, under the control of clinical symptoms (diarrhea, flatulence) and laboratory tests (examination of stool for carbohydrates).

Criteria for the effectiveness of diet therapy using low-lactose mixtures

1. improvement of the child’s general condition;
2. improved appetite;
3. disappearance of regurgitation and vomiting;
4. disappearance of flatulence;
5. normalization of stool (usually 2-4 days from the start of treatment);
6. increased stool pH;
7. reducing the content of carbohydrates (lactose) in feces;
8. positive dynamics in body weight. After 5-7 days from the start of diet therapy, weight should begin to increase.

Thus, the main method of treating lactase deficiency is diet. Timely correction of nutrition in children with lactose intolerance makes it possible to obtain positive dynamics in the child’s condition in the shortest possible time and prevent the development of complications.

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The use of lactose-free or low-lactose mixtures is associated with intolerance to lactose - milk sugar, which is the main carbohydrate in milk. Lactose is broken down in the stomach under the influence of a special enzyme - lactase. And it is the decrease in the activity of this enzyme in the intestines that leads to milk intolerance.

Many people are lactose intolerant, but have no problems because they do not consume dairy products, but this digestive feature becomes a problem for infants, for whom milk is the main food product.

The following types of lactase deficiency (LD) are distinguished:

• Congenital (inherited);
• Transient (associated with the immaturity of the newborn’s body);
• LN in adults.

In this case, lactase deficiency can be primary or secondary. The primary one is genetically determined, and the second type occurs in acute and chronic intestinal diseases (for example, celiac disease, intestinal infections). A distinction is also made between complete lactase deficiency (alactasia) and partial deficiency (hypolactasia).

The main signs of lactose intolerance are:

1. Loose, foamy, sour-smelling stools soon after drinking milk;
2. Stomach ache;
3. Baby's anxiety;
4. Increased gas formation in the intestines;
5. Insufficient weight gain.

From examinations to determine the disease, an analysis of stool pH is used, which decreases with lactase deficiency.

Milk intolerance is easily corrected with diet, but for newborn babies it is necessary to introduce special low-lactose or lactose-free formulas into the diet.

What is a low-lactose or lactose-free diet?

Such mixtures belong to therapeutic nutrition and are compositions with properties as close as possible to breast milk. Most corrective infant formulas are made on the basis of milk with a reduced content of casein, protein and mineral salts with incidental enrichment in minerals, vitamins and microelements. But lactose-free and low-lactose mixtures do not contain cow's milk at all and are made from soy. Such mixtures are also enriched with beneficial vitamins and microelements.

How to introduce formulas with reduced lactose content?

The choice of mixture depends on the type of disease. If lactase production is partially reduced, then low-lactose milk is first introduced (Nutrilak low-lactose, Nutrilan low-lactose, Humana-LP). Over time, intestinal functions can be restored and the lactase enzyme will begin to be produced sufficiently. In this case, the baby is transferred to regular food. If there is a decrease in lactase production, then it is necessary to transfer the child to a lactose-free formula (NAN lactose-free, Frisosoy).

In children with milk intolerance, the content of carbohydrates in stool should always be monitored. In this way, you can regulate your diet: if symptoms of lactose intolerance appear, increase the proportion of lactose-free mixtures, and if constipation occurs, increase the amount of lactose. Over time, you can stop using low-lactose milk and return to your normal diet. Premature babies whose milk intolerance is associated with intestinal immaturity can switch to dairy nutrition after 3-4 months.