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Fri, 16 Jan 1998 10:01:51 -0700 |
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Re: the discussion on dairy allergies and lactose intolerance:
Allergies are a reaction to protein.
Lactose intolerance is a reaction to carbohydrate.
All human beings are lactose intolerant at some level of dietary intake;
almost all human infants have a high threshold for lactose tolerance.
I have found that by encouraging mothers to breastfeed longer at a feeding
one can improve symptoms of "lactose intolerance": the physiological
mechanism being that the increased fat content of hindmilk slows down the
passage of the breastmilk through the gastrointestinal tract and allows the
infant's body more time to make lactase enzyme to digest the amount of
lactose present. Increased fat also leads to increased satiety and
contentment after a feed in human beings, relative to a low-fat meal.
(Assuming a healthy individual, not a middle-aged woman with gall-bladder
dysfunction, for example.)
The amount of lactose in the mother's diet does not influence the amount of
lactose in breastmilk. Breastfeeding women will make lactose endogenously
(in their own bodies) even if consuming no lactose whatsoever. One does
not have to drink animal milk to make breastmilk.
Lactose is an important nutrient for infants. Lactose in breastmilk is
very important for infant brain development and healthy maintenance of
brain tissue. Human babies are meant to ingest a lot of lactose,
regularly--hence its appearance in breastmilk. How well *adults* handle it
at a high or low level depends on their genetic inheritance.
The argument for colic being a neurological developmental issue seems very
sound to me. Not all fussiness is colic. Many reasons for fussiness can
be discovered and dealt with successfully without labeling a baby
"colicky." I agree with more holding of the baby--for one thing, moving
the baby around improves muscle tone, relative to leaving the baby for long
periods in a crib or "bucket" (baby car seats, which aren't left in cars
anymore). This enhances the passage of gas through the digestive tract,
alleviates boredom, is more stimulating to the brain, and in many other
ways contributes to a more contented baby.
I approach every other avenue to solving baby fussiness before instigating
a restricted maternal diet, my rationale being (1) the other avenues are
more likely to be fruitful for the majority of mother-baby dyads and (2)
restricting the maternal diet puts the mother at risk. I agree, naturally,
that in some cases a true allergy or protein intolerance is the issue and
maternal dietary changes will improve the outcome, therefore being worth
the risk to the mother.
Arly Helm
MS, Nutrition and Food Sciences
IBCLC
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