Dear All:

I am a hospital-based LC in Florida. I am new to Lactnet and am really
enjoying and learning.

I do have a question that I would like to pose regarding lactose free
formulas and indications for use.  Since the cow-milk based lactose free
formula has come out (L...free), a large percentage of babies in our hospital
are declared "lactose intolerant".  The nurses claim that babies who have
emesis on standard formula feeds and are switched to this stuff, are
instantly cured.  They used to give soy-based formulas when there was a
problem (also no lactose).  As far as I know, L...free does not have
hydrolyzed protein.  I don't think that the fat is appreciably different from
standard formula either.  The pediatricians also switch babies to L-free with
the first sign of difficulty (sometimes even the breastfed kids).  My
understanding of lactose intolerance in infancy is that it can occur (1)
(usually temporarily) after a bout of gastroenteritis resulting from damage
to the gut which decreases lactase (2) in prematurity -  but I'm pretty sure
that Lawrence states with reference to digestibility of lactose in human milk
feeds that the premature gut challenged with lactose will usually be able to
meet the challenge (the stimulation causes increased lactase synthesis) -
Sorry, I don't have the exact quote.  I know that premature infant formulas
have other carbohydrates to make them more digestible.

My questions are:

Is the lactose in formula different from the lactose in human milk? (Is
bovine lactose different from human lactose or is there better tolerance
because of other ingredients present in human milk?).

What is the true incidence of lactose intolerance at birth in the full term?
in the preemie?

Is there any real indication for this new formula?

Thank you..................

Linda Englander RN IBCLC
Tampa, Florida