The prevalence and persistence of lactose malabsorption among very young Jamaican children - abstract

Deficiency of intestinal lactase is widespread among otherwise healthy non-Caucasian adults. Limited available data suggest that very young children in some racial groups also may be affected. In a rural Jamaican district of Elderslie, where poverty, disease, and malnutrition are commonplace, dried skim milk was introduced as a food supplement for weanling children. These children, previously unaccustomed to milk-drinking responded to this new lactose source with frequent episodes of diarrhoea. To determine whether lactase deficiency might contribute to the apparent milk tolerance, a systematic study of lactose absorption was undertaken. Of the 600 children under 4 in the district, 94 were selected randomly for study. Capillary blood was drawn at 0, 15, 30, and 60 minutes after ingestion of 2 gms/kg of lactose. The Ames Reflection Meter/Dextrostix system was used to determine blood glucose. With a blood glucose rise of 25 mg percent or less as the criterion, 53 (56 percent) of the 94 children proved unable to absorb lactose. While two-thirds of the chilren under 12 months absorbed lactose, only one-third of those older enjoyed a similar capacity (p < .05). 9 of the 53 malbsorbers were being breast-fed at time of study. Similar tests in Kingston revealed 14 of 20 urban children were lactose malabsorbers. Neither sex, anthroponmetric status, milk consumption, symptoms of lactose intolerance, nor duration of breast-feeding correlated with lactose absorption. 52 of the original 53 malabsorbers at Elderslie were re-tested 6 months later and 11 (12 percent) displayed normal blood glucose rises. Particular important is the additional observation that this absorptive defect is at least sometimes reversible. Further study is required to relate these phenomena to other aspects of intestinal function and to determine their nutritional significance in children whose diet is marginal (AU)