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Lactose overload
Causes…
Lactose overload is caused by:
• unbalanced feeding practices — feeding in a way where ingested lactose outweighs
natural levels of lactase
• newborns not receiving their natural requirement of the saliva enzyme, amylase.
Lactose overload is the imbalance of lactose in relation to the body’s naturally produced
levels of lactase. Lactose is the carbohydrate — sugar — found in all milk and other foods.
Lactase — found in the small intestines — helps to change lactose into the absorbable
compounds of glucose and galactose. Galactose is vital for a newborn’s brain development
and nerve tissues while glucose provides their major source of energy and is essential for
growth and cell development. Therefore lactose is a must in a newborn’s diet. Amylase is
an enzyme that also helps to break down lactose. It can be found in breast milk and saliva.
When newborns swallow minimal amounts of saliva, they struggle to get enough amylase
to aid this digestive process.
Breastfeeding mothers hold higher levels of lactose in the foremilk — the first milk a
newborn drinks at each feed. Therefore, ‘demand feeding’ (feeding a baby every time they
supposedly exhibit ‘hunger cues’), providing top-ups (usually defined as feeding a bottle of
expressed milk or formula after breastfeeding), breastfeeding from both breasts in one sitting
or cluster feeding (continually swapping from one breast to the other feeding for hours —
which mothers are often recommended to do in the evenings because their baby’s heightened
communication from Digestive Overload is misdiagnosed as hunger or a ‘growth spurt’) has
newborns receiving more lactose than their natural lactase levels can cope with. When this
happens, the gastro-colic reflex pushes some of this undigested lactose into the large bowel.
The lactose is then fermented by bacteria which causes discomfort as it continues through
the intestines and bowel.
Lactose overload can become a problem once colostrum — the first form of breast milk
— has changed to the fattier milk or if a baby is overfed with a formula that contains lactose.
Behaviour indicating overload can happen at any time, with frequency generally lessening
when solids are introduced. Because lactose is found in dairy products, lactose overload
is often described as dairy overload or intolerance, but these are different. Dairy overload
happens from a digestive imbalance of casein, whey and/or fat and dairy intolerance is
generally a reaction to casein, but not an allergy (see p. 28).
26 | Lactose overload
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