Premature Babies and LI

Here's a question I wish I could have been more help with.

my baby was born at 28wks 5 wks ago and is not tolerating his breastmilk via tube feeds - this is why i am following up the LI lead

This was my reply:

The research I have says that premature babies develop the ability the manufacture lactase very rapidly and so normally do not have LI.

Here's one mention of the problem that may be of some relevance.

"Early initiation of half-strength lactose-containing formula or breast milk results in rapid induction of lactase activity in the brush border and less feeding intolerance. A recent study suggests that full-strength lactose formula resulted in more feeding intolerance than low-lactose formula in premature infants; thus, the precise lactose concentration of lactose for inducing lactase activity is still undetermined."

A little-known fact is that lactase-production does not reach full strength in the intestines until almost the last week before birth. Foodreactions.org gives this chart:

> 23rd week ------------------------- 10% of full term
> between 25th and 34th is ------ 30% of full term
> between 34th and 35th week -- 70% of full term

Therefore all premature babies are born lactose intolerant. Although some sites suggest that the lactase-making ability is still lacking until the baby achieves what would have been a full term, this is not supported by most experts. Babies may need non-dairy liquids or lactose-free milks for the first feedings, but should regain their ability to drink breastmilk of a proper formula shortly thereafter.