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Subject:
From:
Lynn Carter <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 30 Nov 2005 12:32:00 -0600
Content-Type:
text/plain
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Many thanks to all of you who responded on and offlist.  Here is a 
summary of the offlist replies for the archives.  The bottom line is 
that the test is not appropriate or useful for an otherwise healthy, 
thriving baby.  Alas, the mom did not follow up at 48hrs as she had 
agreed after our original conversation, nor has she responded to a msg 
on her answering machine.

> http://users.bigpond.net.au/allergydietitian/fa/inflact.html
>
> "
> Incomplete absorption of lactose in normal infants in response to 
> usual feeding patterns is known as functional lactase deficiency. This 
> has been shown to be common in the first week of life and may persist 
> up to five months of age (2) . Moore et al (3) demonstrated that 66% 
> of normal infants at six weeks of age and 60% at three months of age 
> had positive breath hydrogen tests. The results were similar after 
> human milk and lactase containing formula (66% versus 72% at six 
> weeks, 61% versus 78% at three months). Miller et al (4) found that 
> breath hydrogen excretion in breastfed infants varied significantly 
> within the same day and on different days and therefore questioned the 
> usefulness of breath hydrogen testing as a clinical tool for the 
> diagnosis of lactose intolerance. Similar percentages of infants could 
> be expected to have stools positive for reducing substances. The 
> usefulness of testing for reducing substances in the diagnosis of 
> lactose intolerance is therefore also highly questionable."
>
> THere are also Clinitest policies around saying that it is a normal 
> variant for neonates to have reducing substances in their stool:
> http://www.utmb.edu/poc/SOP_StoolClinitest%2004-04.pdf
>
> http://www.medscape.com/viewarticle/458683_print
> (free registration required if you don't have it already)
>
> excerpt: "A study of healthy full-term infants found that stool 
> Clinitest was 2+ or greater (equivalent to >/= 0.75% reducing sugar) 
> in 49% of the infants, and 4+ in 16% of this population, particularly 
> if they were breast-fed.[14]"
>

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