Lactose maldigestion in breast-feeding Gambian infants

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 24; no. 3; pp. 257 - 263
• Main Authors: Northrop-Clewes, C.A. (University of Ulster, Coleraine, Northern Ireland.), Lunn, P.G, Downes, R.M
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott-Raven Publishers 01.03.1997; Lippincott
• Subjects: Aging; ALIMENTATION AU SEIN; BEBES; beta-Galactosidase - metabolism; Biological and medical sciences; Body Height; Body Weight; Breast Feeding; ENFANT EN BAS AGE; GAMBIA; GAMBIE; Gastroenterology. Liver. Pancreas. Abdomen; Humans; Infant; Intestinal Mucosa - metabolism; LACTANCIA MATERNA; Lactase; LACTOSA; LACTOSE; Lactose - urine; Lactose Intolerance - diagnosis; Lactose Intolerance - metabolism; Lactulose - metabolism; Lactulose - urine; Mannitol - metabolism; Medical sciences; Other diseases. Semiology; Permeability; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Gambia; Africa; Human; Nutrition; Enzyme; Lactase; Gut; Infant; Breast feeding; Feeding; Result; Brush border; Lactose; Intestinal malabsorption; Glycosidases; Digestive diseases; Hydrolases; Intestinal disease; Clinical investigation; Biological effect; Localization; O-Glycosidases
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1097/00005176-199703000-00005

Background: The ability of breast-feeding infants to utilize lactose, the major carbohydrate in breast-milk, is dependent on the presence of the enzyme lactase (E.C.3.2.1.108). Lactase is located in the brush border of the small intestine and because of its exposed position it is extremely vulnerable to pathogenic damage. Breast-fed Gambian infants have poor growth associated with intestinal damage beyond 3-4 months. The aim of this study was to assess the ability of Gambian infants aged 2-15 months (N = 113) to digest lactose and to see how this varied with age, intestinal permeability, and growth performance. Methods: Lactose maldigestion was estimated by monthly measurements of urinary lactose and lactulose following an oral dose of the latter. Results: Both urinary lactose excretion and lactulose maldigestion increased with age (p ().0001 ANOVA). Up to 6 months the mean urinary lactose: lactulose excretion ratio was within the quoted normal range ( 0.4). Beyond this age, mean values were hypolactasic. Lactose maldigestion was related to poor growth in both weight and length (r