Temproary intestinal lactase deficiency in light-treated jaundiced infants

Acta Paediatr Scand. 1977 Jan;66(1):91-6. doi: 10.1111/j.1651-2227.1977.tb07813.x.

Abstract

The intestinal lactase activity in six newborn jaundiced light-treated infants with diarrhea and in eight normal controls were compared by lactose tolerance test (LTT). The ability to hydrolyze lactose was minimal in the jaundiced infants during light-treatment compared to the controls which could absorb lactose very well. Peroral intestinal biopsies were taken from the newborn jaundiced infants during light-treatment. By histochemical technique no intestinal lactase activity was found in these intestines. When the jaundiced infants with diarrhea were given lactose-free diet, the stools normalized. The effect was reversed when breast milk was given while the baby was still jaundiced and light-treated. These findings indicate that the increased amounts of unconjugated bilirubin in the intestine of jaundiced infants during light-treatment inhibit the intestinal brush-border lactase. When the icterus fades the lactase is again active. The practical consequence is to give light-treated infants lactose-free diet if they get diarrhea, and to reintroduce breast milk or other lactose containing diet when the baby is no longer icteric.

MeSH terms

  • Bilirubin / metabolism
  • Diarrhea / enzymology
  • Diet
  • Humans
  • Infant, Newborn
  • Intestinal Absorption
  • Intestinal Mucosa / enzymology
  • Intestinal Mucosa / pathology
  • Jaundice, Neonatal / enzymology
  • Jaundice, Neonatal / therapy*
  • Lactose / metabolism
  • Lactose Intolerance / diet therapy
  • Lactose Intolerance / etiology*
  • Lactose Tolerance Test
  • Light / adverse effects*
  • Phototherapy

Substances

  • Lactose
  • Bilirubin