Bennett has an idea of one possible culprit. She says doctors, who are not trained in the subtleties of infant development and feeding techniques, tend to overlook a common problem that mimics lactose intolerance: lactose overload, or simply "overfeeding." (La Leche League calls it "oversupply" or "foremilk/hindmilk imbalance.")
Lactose overload occurs when a baby gets so much lactose that it can't make enough lactase to keep up, resulting in undigested lactose and all the symptoms of traditional lactose intolerance (including positive results on tests for lactose intolerance designed for adults). This can happen when a mother has an abundant milk supply and switches sides often, before a breast is empty, so her baby is always getting mostly lactose-rich foremilk and not enough of the fatty hindmilk. It can also happen to formula-fed babies who get too much formula at a sitting. To relieve their upset stomachs, babies with lactose overload ask for more milk even when not hungry, adding even more lactose to their systems and making a vicious cycle.
The treatment for lactose overload is changing feeding patterns: not switching sides until a breast is drained (or even nursing on one side for more than one feeding) or giving less formula.
Although child health specialists like Bennett and online parenting gurus like Kellymom consider this phenomenon to be widespread, many pediatricians seem not to have heard of it at all.
Inaccurate diagnoses of lactose intolerance can lead to early cessation of breastfeeding.
In fact, Dr. Bhatia, who is a liaison between the Medical College of Georgia's sections on neonatology and breastfeeding, told me he was not aware of it, though he does counsel mothers to empty one breast before switching sides.
All these subtleties matter. (See our handy chart for a side-by-side comparison.) Inaccurate diagnoses of lactose intolerance can lead to early cessation of breastfeeding, with babies switched to expensive and nutritionally inferior lactose-free formulas. Misdiagnosed lactose intolerance (or milk allergy) can also lead to "unnecessary dietary restrictions that can sometimes last a lifetime," notes Bennett. "Milk and dairy are a prime source of calcium for children." Not to mention, "many adults who believe they are lactose intolerant believe this because it was misdiagnosed in infancy."
Milk — ours and other mammals' — is a fascinating and nearly magical substance. But as herbalists know, anything powerful can also cause problems. When it comes to our kids and milk, it's worth it to know what those problems are — and what they aren't.
Photo Credit: Shawn Huber of Ohio Snap Images
©2008 Miriam Axel-Lute and Nerve Media
About the Author
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Miriam Axel-Lute is a freelance writer, editor and poet. She is an
award-winning columnist for Metroland, and lives in Albany with her two partners and daughter. Her website is mjoy.org. |
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