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Updated: Aug 19, 2026

Measuring Lactase Enzymatic Activity in the Teaching Lab
Published on: August 6, 2018
Influence of changes in lactase activity and small-intestinal mucosal growth on lactose digestion and absorption in
Robert J Shulman1, William W Wong, E O'Brian Smith
1Department of Pediatrics, Baylor College of Medicine, US Department of Agriculture/Agricultural Research Service Children's Nutrition Research Center, Texas Children's Hospital, Houston, TX 77030, USA. rshulman@bcm.tmc.edu
Background:
Feeding intolerance (ie, achieving and maintaining full enteral feedings) is a significant problem in preterm infants. A relation exists between feeding intolerance and incomplete lactose digestion.
Objectives:
We sought to identify the factors relating to lactose digestion and absorption, lactase activity, and small-intestinal mucosal growth.
Design:
Lactose digestion and absorption, lactase-specific activity, and lumen-to-mucosa water flux as a measure of small-intestinal mucosal surface area were determined by using the triple-lumen perfusion technique on 2 occasions 3 wk apart in 10 preterm infants (x+/-SEM gestational age: 28.0+/-0.2 wk).
Results:
Lactose digestion and absorption and lactase activity doubled between studies (P=0.035 and P=0.041, respectively). The change in digestion and absorption was related to lactase activity (P=0.034, R2=0.38). Lactase activity correlated with gestational age at birth (P=0.012, R2=0.51). The number of days of feeding explained 80% of the variability in small-intestinal mucosal surface area (P=0.001).
Conclusions:
To our knowledge, this is the first study to measure directly lactose digestion and absorption, lactase activity, and small-intestinal surface area in preterm infants. Changes in lactose absorption relate primarily to lactase activity rather than to mucosal growth. We showed directly a relation between enteral feeding and small-intestinal mucosal growth.
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