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[Efficacy and safety of lactase additive in preterm infants with lactose intolerance: a prospective randomized
Li Wang1, Yi-Wen Wang1, Jin-Tong Tan1
1Department of Neonatology, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.
Insights
Lactase additive safely and effectively improves lactose intolerance in preterm infants. This treatment reduced symptoms like vomiting and gastric retention, showing significant benefits within two weeks.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Pediatric Nutrition
Background:
- Lactose intolerance is a common issue in preterm infants, potentially hindering growth and causing discomfort.
- Current management strategies for infant lactose intolerance vary, necessitating research into effective interventions.
Purpose of the Study:
- To evaluate the efficacy and safety of lactase additive in managing lactose intolerance in preterm infants.
- To compare the effects of lactase additive with placebo and probiotics on clinical symptoms and biochemical markers.
Main Methods:
- A randomized controlled trial involving 60 preterm infants diagnosed with lactose intolerance.
- Infants were assigned to receive either lactase additive or placebo with probiotics and abdominal massage.
- Key outcomes measured included fecal pH, reducing sugar, growth indicators, and intolerance symptoms over two weeks.
Main Results:
- The lactase group showed significantly reduced milk vomiting and gastric retention compared to the control group after one week.
- By the second week, the lactase group exhibited significantly lower milk vomiting and abdominal circumference differences.
- A higher proportion of infants in the lactase group had improved fecal pH and reduced signs of lactose malabsorption.
Conclusions:
- Lactase additive is a safe and effective intervention for improving clinical symptoms of lactose intolerance in preterm infants.
- The study supports the use of lactase additive as a beneficial treatment option for this vulnerable population.
Objective:
To study the efficacy and safety of lactase additive in improving lactose intolerance in preterm infants.
Methods:
A total of 60 preterm infants with lactose intolerance who were admitted to the Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to December 2019 were randomly divided into a lactase treatment group and a control group, with 30 infants in each group. The infants in the lactase treatment group were given 4 drops of lactase additive (180 mg) added into preterm formula or breast milk, and those in the control group were given placebo, oral administration of probiotics (live combined Bifidobacterium, Lactobacillus and Enterococcus powder) at half an hour after feeding (1 g each time, twice a day), and clockwise abdominal massage around the belly button at 1 hour after feeding for 15 minutes each time, 3 times a day. Fecal pH, fecal reducing sugar, growth indicators, symptoms of lactose intolerance, and laboratory markers were measured at the end of the first and second weeks after intervention.
Results:
Finally 29 infants in the lactase treatment group and 26 infants in the control group completed the trial. At the end of the first week after intervention, compared with the control group, the lactase treatment group had significantly lower frequency of daily milk vomiting and gastric retention amount (P < 0.05) and a significantly higher proportion of infants with fecal pH > 5.0 (P < 0.05). At the end of the second week after intervention, compared with the control group, the lactase treatment group had significantly lower frequency of daily milk vomiting and 24-hour abdominal circumference difference (P < 0.05) and a significantly higher proportion of infants with the absence of gastric retention, fecal pH > 5.0, or negative reducing sugar in feces (P < 0.05). No adverse reactions associated with the lactase additive or probiotics were observed during the trial.
Conclusions:
Lactase additive can safely and effectively improve the clinical symptoms caused by lactose intolerance in preterm infants.
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