[QUOTE=Excalibre]
Human milk has more lactose than cow’s milk. Goat milk isn’t lactose free, either.
I know lactose intolerance is the big new thing, but it’s vanishingly rare in infants and if it can be fixed by switching to breastmilk, it has nothing to do with lactose.
[/QUOTE]
http://breastfeed.com/resources/articles/lacintolerance.htm
*The buzzword to explain colicky, gassy babies these days seems to be lactose intolerance, a condition that is often misdiagnosed and actually very rare, according to pediatrician Jack Newman. This breastfeeding expert is the author of The Ultimate Breastfeeding Book of Answers, and the founder of the first hospital-based breastfeeding clinic in Canada in 1984.
According to Newman, most symptoms of lactose intolerance, such as fussiness, gas and watery, green bowel movements, are typically the result of either misguided breastfeeding techniques or a sign that the baby is allergic to proteins in the cow’s milk that his mother is drinking. “Lactose intolerance is often an artifact of poor breastfeeding advice,” explains Newman. "The answer to these symptoms is not simply to take the baby off the breast, as too many pediatricians recommend, but to fix the breastfeeding. The symptoms are easily treatable 90 percent of the time."In most cases, the symptoms improve dramatically when the mother eliminates cow’s milk from her diet or alters her breastfeeding methods, according to both Newman, who practices in Toronto, Canada, and Mary Kay Smith, a certified lactation consultant at Mt. Sinai Hospital in Chicago, Ill.Newman says he wasn’t at all surprised the by the results, noting that the majority of such cases can be treated by altering breastfeeding methods – something that’s been known for years. In fact, a 1998 study in The Lancet, an international medical journal, reported that allowing the baby to empty the first breast alleviated the problems in 79 percent of the infants.
Because lactose intolerance is so difficult to confirm, the only sure way to diagnose infants is through a biopsy of the small intestine. According to La Leche League, the diagnosis seems to be handed out somewhat casually. “I think lactose intolerance is just a catchall phrase some pediatricians are using to explain away problems with breastfeeding that they don’t understand,” says Smith…
is that mothers are frequently advised to automatically switch the baby from one breast to another, which doesn’t allow the baby to empty the first breast. Because the amount of fat in the milk increases the longer the baby nurses at the breast, switching him too soon may mean he’s getting a low amount of fat – leading to fewer calories and more feedings. Due to the low fat content of the milk, the stomach empties quickly and a large amount of milk sugar, also known as lactose, reaches the baby’s intestines all at once. The baby’s system may not be able to handle so much milk sugar and in turn have the symptoms of lactose intolerance, Newman explains.
Lactose intolerance is the body’s inability to digest the milk sugar, or lactose, in dairy products; whereas with an allergy, the body reacts to the proteins in those products. The confusion likely arises because cow’s milk proteins and lactose are in the same products, Smith says. While true lactose intolerance in infants is unusual, a reaction to cow’s milk is the most common allergy in children.
In the case of milk allergies, the mother should stop taking dairy products for seven to 10 days to see if there’s a change, Newman says. If not, she can begin using dairy again. And even if there is improvement, she should slowly reintroduce dairy back into her diet to determine how much, if any, the baby can tolerate. Most often, cow’s milk is the main reason for the allergy.
There are still rare cases of true lactose intolerance in infants. According to Smith, this is something that would be evident in the days immediately after the mother’s milk started coming in. The baby would have extreme cases of diarrhea and would not be gaining weight. Even then, the mother can almost always continue breastfeeding, and supplement the baby’s diet with a lactose-free formula by tube feeding. A pediatrician may also recommend a medication, such as lactase drops, to help the baby digest the lactose.
It’s that “milk allergies” and “lactose intolerance” are often misdiagnosed or misunderstood. Breastfeeding is almost always the best. Soy milk is a last gasp way to go, but some use it as a first solution.
Both “milk allergies” and “lactose intolerance” are rare.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&list_uids=3201972&dopt=Citation
A cohort of 1,749 newborns in the municipality of Odense were followed prospectively for the development of cow’s milk allergy (CMA) during their first year of life. Altogether 39 fulfilled the criteria for CMA (2.2%). Out of the 39 infants, 17 developed symptoms of CMA during breast-feeding, in all cases before the age of 3 months. Nine of these were solely breast-fed at the time of diagnosis, giving a one year incidence of CMA in exclusively breast-fed infants of 0.5% (9/1,749) in a study population with a frequency of exclusive breast-feeding of 52% at 3 months of age. None of the infants had signs of CMA in the neonatal period. Review of records from the newborn nursery revealed that all 9 infants had been exposed to cow’s milk formula in amounts corresponding to approximately 0.4-3.0 g of beta-lactoglobulin (BLG) during the first three days of life. Human milk samples were analyzed by enzyme-linked immunosorbent assay (ELISA) for the content of bovine BLG. Detectable amounts (0.5-45 ng/ml) were found in 3/9 samples of human milk against which the infants reacted clinically. Analysis of the size distribution by high pressure liquid gel permeation chromatography in combination with ELISA indicated a molecular weight of BLG corresponding to that of monomeric BLG (18 kD). Possibly early inadvertent and occasional exposure to cow’s milk proteins may initiate sensitization in predisposed neonates. Subsequent exposure to minute amounts of bovine milk proteins in human milk may act as booster doses eliciting allergic reactions.
http://www.springerlink.com/content/v134084v383t7236/
Abstract Incidence and clinical manifestation of cow’s milk protein intolerance (CMPI) were studied in 1158 unselected newborn infants followed prospectively from birth to 1 year of age. No food changes were required in 914 infants who were used as healthy controls. When CMPI was suspected (211 infants), diagnostic dietary interventions according to a standard protocol were performed. After exclusion of lactose intolerance, two positive cow’s milk elimination/challenge tests were considered diagnostic of CMPI. Two hundred and eleven symptomatic infants were examined for possible CMPI. A large group of 80 infants improved on a lactose reduced formula. In 87/211 infants CMPI was excluded (sick controls). Finally CMPI was proven in 26 infants. The calculated incidence rate for CMPI was 2.8%. The principal symptoms in infants with CMPI were gastrointestinal, dermatological and respiratory in 50%, 31% and 19% respectively. A positive family history for atopy (first or second degree relatives) was more frequent in either CMPI infants (65%), or sick controls (63%) when compared to either healthy controls (35%) or infants improving on a low lactose formula (51%). Differences between patients with CMPI and sick controls were only found for the presence of atopy in at least 2 first degree relatives [(5/26 in CMPI infants and 4/87 in sick controls (P<0.05)] and for multiorgan involvement [10/26 infants with CMPI as opposed to 12/87 in the sick control group (P<0.02)]. These statistical differences are too weak to be of clinical value.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7704117&dopt=Citation
Reproducible clinically abnormal reactions to cow’s milk protein (CMP) may be due to the interaction between one or more milk proteins and one or more immune mechanisms, possibly any of the four basic types of hypersensitivity reactions. At present, evidence for type I, III and IV reactions against CMP has been demonstrated. Immunologically mediated reactions, mainly immediate IgE-mediated reactions are defined as cow’s milk protein allergy (CMPA). Non immunologically reactions against CMP are defined as cow’s milk protein intolerance (CMPI). Many studies on “cow’s milk allergy’” have not investigated the immunological basis of the clinical reactions. It is not possible to differentiate between CMPA and CMPI solely on clinical symptoms. No single laboratory test is diagnostic of CMPA/CMPI. Therefore, the diagnosis still has to be based on strict well-defined elimination and milk challenge procedures. Before 1950 CMPA/CMPI was rarely diagnosed. Since 1970 widely varying estimates of the incidence from 1.8% to 7.5% have been reported, mainly reflecting differences in diagnostic criteria and study design. Based on strict diagnostic criteria the incidence of confirmed CMPA/CMPI in infancy seems to be about 2-5% in developed countries. Symptoms suggestive of CMPA/CMPI may be encountered in about 5-15% of infants emphasizing the importance of controlled elimination/milk challenge. In breastfed infants reproducible clinical reactions to CMP in human milk have been reported in about 0.5%. Most infants with CMPA/CMPI develop symptoms before one month of age, often within one week after introduction of cow’s milk based formula. The majority have > or = 2 symptoms and symptoms from > or = 2 organ systems. About 50%-70% have cutaneous symptoms, 50-60% gastrointestinal symptoms, and about 20-30% respiratory symptoms. In exclusively breast-fed infants with CMPA/CMPI severe atopic eczema is a predominant symptom. Debut of CMPA/CMPI after 12 months is extremely rare. The basic treatment is complete avoidance of CMP. In infancy a proven hypoallergenic CM substitute is needed. Due to clinically important residual allergenicity in some hypoallergenic formulae controlled clinical testing is necessary in each case before use. Goat’s milk proteins share identity with CMP Raw untreated cow’s milk and unhomogenized cow’s milk is as allergenic as normal pasteurized and homogenized milk products. The prognosis of CMPA/CMPI is good with a remission rate about 45-50% at one year, 60-75% at two years, and 85-90% at three years. Associated adverse reactions to other foods develop in about 50%, and allergy against inhalants in 50-80% before puberty.(ABSTRACT TRUNCATED AT 400 WORDS)
It is true that Human milk contains lactose:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9363415&dopt=Citation
The composition of human milk varies over the course of lactation and in each individual. The volume of breast milk produced is related to the weight of the infant. Human milk is markedly different from cows’ milk, both in terms of macronutrients and micronutrients. This includes the types of fatty acids present and factors affecting their absorption. The types of proteins present and their relative proportions and both qualitative and quantitative differences in the non-protein nitrogen fraction. There is much less lactose in cows’ milk than breast milk and the oligosaccharide fraction is very different. Their are major differences in content and absorption rates of vitamins and minerals from breast milk compared to cows’ milk or formula milk. Vitamin D and vitamin K status are possible problems for the breast-fed infant in certain circumstances. The nutritional status of the mother appears to influence fat concentration and thus the energy content of breast milk as well as its fatty acid composition and immunological properties. There is no coherent evidence, however, that the protein or lactose concentrations are greatly affected. There is some evidence that the concentration of vitamins in the breast milk are influenced by the mother’s intake. Minerals are less variable, with the exception of selenium. The response of the infant to human and formula milk differs with respect to endocrine function, stool motility, immune function and renal function. Infant formula milks are designed to mimic human milk as much as possible, but this is unlikely to ever be completely successful. A number of important compositional differences between human milk and formula milk remain. This includes the types and proportions of fatty acids present (which may be of developmental importance), the nature of the non-protein nitrogen component (also possible developmental importance) and the presence of immunoglobulins and fibronectin (which may protect the infant against infection).
But still mothers milk has a lot of other stuff that can make a child that seems to have a bad reaction to cow’s milk better if put back on breast milk.