https://ijmri.de/index.php/jmsi
volume 4, issue 3, 2025
802
POTENTIAL RISKS OF LACTOBACILLI USE IN LACTASE DEFICIENCY IN
BREASTFED INFANTS
Khadzhaev Tokhir Avazkhanovich
Central Asian Medical University, Fergana, Republic of Uzbekistan
Abstract:
Lactase deficiency in early infancy leads to impaired digestion of lactose, the primary
carbohydrate in breast milk, resulting in gastrointestinal symptoms. In the search for gentle
treatment strategies, probiotics—particularly lactobacilli-based preparations—have gained
attention. However, in some cases, their use in infants with lactase deficiency may not only fail
to improve the condition but may exacerbate symptoms. The aim of this study is to analyze the
potential adverse effects of lactobacilli on the clinical course of lactase deficiency in breastfed
infants.
Keywords:
lactase deficiency, breastfeeding, probiotics, lactobacilli, infants, complications.
Introduction
Lactose is the main carbohydrate in breast milk and requires the enzyme lactase for digestion. In
infants, both transient and congenital forms of lactase deficiency can occur. Lactobacilli are used
to support intestinal microbiota and metabolic regulation, but their enzymatic activity may
enhance fermentation processes, particularly in the presence of undigested lactose in the small
intestine.
Materials and Methods
The study included 40 infants aged 1 to 4 months with clinically and laboratory-confirmed
lactase deficiency. Participants were divided into two groups: the main group (n=20) received
probiotics (Lactobacillus acidophilus, L. rhamnosus), while the control group (n=20) received
only lactase enzyme supplements. Monitoring was conducted over 14 days based on
gastrointestinal symptom scoring, stool pH levels, and weight gain.
Results
In the main group, from days 3 to 5, worsening of symptoms was observed: increased gas
production, frequent watery stools, and perianal irritation. Average weight gain was 10–12%
lower compared to the control group. In 25% of cases, probiotics had to be discontinued. Stool
pH remained low (4.5–5.0), indicating ongoing fermentation.
Discussion
The observed negative dynamics in the main group are likely associated with the β-galactosidase
activity of lactobacilli, which may accelerate the metabolism of undigested lactose into organic
https://ijmri.de/index.php/jmsi
volume 4, issue 3, 2025
803
acids and gases. In infants with enzyme deficiency, this can cause mucosal irritation, motility
disturbances, and deterioration of general condition.
Conclusion
Despite the popularity of probiotics, their use in infants with lactase deficiency requires an
individualized approach. Prior diagnostic evaluation, assessment of enzymatic activity, and
careful monitoring of tolerance are essential. Inappropriate use of probiotics may aggravate the
course of the disease.
References
1. He T., Priebe M.G., Zhong Y., et al. (2020). Effects of probiotics on lactose intolerance: A
systematic review. Clinical Nutrition, 39(3), 743–751. https://doi.org/10.1016/j.clnu.2019.03.016
2. Szajewska H., Kolodziej M. (2021). Probiotics for the prevention of antibiotic-associated
diarrhea
in
children:
A
meta-analysis.
Pediatrics,
147(4),
e2020035225.
https://doi.org/10.1542/peds.2020-035225
3. Shulman R.J. et al. (2019). Intestinal fermentation and symptoms in infants with colic. J
Pediatr Gastroenterol Nutr, 68(3), 341–347. https://doi.org/10.1097/MPG.0000000000002213
4. Rao S.C., Srinivasjois R., Patole S.K. (2011). Prebiotic supplementation in preterm neonates:
Updated systematic review and meta-analysis. Pediatrics, 128(1), e88–e94.
