Hi,

There is no references mentionning the presence of lactase in breastmilk. There are many other enzymes such as lipase, but no lactase.

Actually, all mammals babies survive because they themselves produce lactase in their jejunum. They need to produce that enzyme as all mammals milk contain lactose and in humans the quantity of lactose is the highest (followed by primates) for many reasons, but brain development seems to be an important one. Babies that do not produce lactase have primary lactose intolerance and it is a pathology (extreme example = galactosemia)... There are many intances when babies have secondary lactose intolerance, as after an bout of flu or after having received antibiotics. But in all those cases, continuing breastfeeding will help as breastmilk will help build up the instestinal flora and return the gut to its normal functionning. In the case of a premie, as they have so many immaturities, they can have difficulty in digesting many elements from an artificial source, but if anything can be given by mouth, it is breastmilk. If the premie has difficulty with breastmilk, he is probably not ready to receive anything by mouth...

Dany Gauthier, IBCLC
Student in Physical Anthropology
Montreal, Canada
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