Lactose intolerance in persistent crying infants

ABSTRACT

Infants with the chief complaint of crying can present a diagnostic dilemma to the health care provider [1]. Excessive infant crying, or infantile colic, is a common and often stress-inducing problem for parents that can ultimately result in child abuse [2]. It appears to be caused by different etiologies, the role of lactose intolerance as a cause of infant irritability remains debatable. It has been hypothesized that some babies have a transient underlying lactase deficiency, leading to a buildup of lactose derived from breast milk or formula [3, 4]. The most accepted definition of colic is unexplained crying and fusing lasting for more than three hours per day, occurring more than three days per week, and for more than three weeks [5]. This study was carried out to evaluate the relation between infantile colic and lactose intolerance. 200 full term babies, aged less than one year, were chosen from pediatric outpatient department, at Demietta University Hospital. The studied infants were classified into cases [n-100] infants presented with a chief complaint of persistent crying [colic] after exclusion of other causes as otitis media, other infections, major congenital anomalies, or surgical problems as inguinal hernia. Controls [n=100] healthy non crying infants. Each infant enrolled in the study was submitted to detailed medical history and thorough clinical examination, anthropometric measurements and ratio, and stool pH determination by color fast pH indicator strips. Stool pH was considered acidic if it was less than 6 and normal if it was >/= 6. The majority of cases [85%] were had acidic stool pH versus only [3%] of control with highly statistical significant difference; p. value 0.000. Among those cases with acidic stool pH; 94% were stopped to cry after two weeks of lactose free milk administration. Lactose intolerance appears to be a common cause of infantile colic which could be evaluated relatively easily by using stool acidity test [fecal pH] or dietary elimination and challenge which leads to improvement of symptoms