Kathy wrote:
>Lactose is in breastmilk, and babies have lactase,
>and more of it as they grow older...

and Denise replied:
>>Hmmm....  don't know your definition of 'older' but it is pretty well
known
>>that in many cultures (mostly the ones where animal milks weren't a part
of
>>their diet ie. Australian aboriginal, American Indian, most Asians) that
>>after weaning from their mothers they do become lactose intolerant because
>>they don't produce lactase much anymore.

The way I understand it; premature infants are relatively deficient in
lactase and do develop more of it as they get closer to term in their
corrected gestational age.  If premature enough an infant can have a primary
developmental lactose intolerance that s/he will outgrow.  The more
premature, the worse the potential problem.  If any infant has had an
intestinal disturbance severe enough to harm the brush border s/he can have
an acquired or secondary lactose intolerance that s/he can also outgrow over
time as healing occurs.  These can all be dose related too.  There may be
some lactase, enough for partial feeds or normal feeds  but not enough for
the low fat feeds that cause gastric dumping and require larger volume to
obtain adequate calories.  Bacteria in the gut can also help to break down
some low volumes of lactose even in the absence of lactase.

In doing a little web searching to check on gestational age for the
development of lactase I found this very interesting summary of lactose
intolerance.  Go to
http://emedicine.com/cgi-bin/foxweb.exe/showsection@d:/em/ga?book=ped&topici
d=1270
If anyone goes to this site and understands the difference between
congenital lactose intolerance ("very rare") and neonatal lactose
intolerance ("also rare and resolves after the age of 6 months") as
discussed on this web page I'd sure appreciate a little help  because I
don't understand what they mean by neonatal lactose intolerance.   Is it a
different entity entirely or are they talking about a primary developmental
problem and/or an acquired secondary problem?

Carla (in Maryland)

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