The article is consulted by Obstetricians and Gynecologists from the Department of Obstetrics and Gynecology at Vinmec International General Hospital in Hai Phong.
Lactose intolerance (lactose from milk) is a common phenomenon experienced by many people. Milk is an important food source that helps pregnant women supplement various nutrients, including calcium. So, what should pregnant women do in the case of lactose intolerance?
1. What is Lactose Intolerance?
Lactose intolerance is a condition in which a person cannot fully digest lactose, the sugar found in milk, when consuming dairy products. This leads to symptoms such as bloating or diarrhea after eating or drinking these products. Another term for this condition is "lactose malabsorption." While lactose intolerance is generally harmless, it can cause significant discomfort and inconvenience for those affected.
The cause of lactose intolerance stems from a deficiency of the enzyme lactase in the small intestine. Lactase is responsible for digesting lactose found in food and drink. Normally, lactase breaks down lactose into the simpler sugars glucose and galactose, which are then absorbed directly into the bloodstream through the intestinal lining. When there is a lack of lactase, lactose remains undigested and moves to the colon, where it interacts with naturally occurring bacteria, resulting in the signs and symptoms of lactose intolerance. However, many people with low levels of lactase can still tolerate lactose-containing products without any symptoms. In fact, most individuals with lactose intolerance can manage their condition without completely eliminating lactose-containing foods, such as milk.
Deficiency of the enzyme lactase can be due to many causes. The 3 subtypes of lactase deficiency are as follows:
- Primary Lactose Intolerance: This is the most common form and is often genetic. It primarily affects adults as they age. Individuals with primary lactose intolerance gradually produce less lactase, the enzyme needed to digest lactose, making it insufficient for an adult's dietary needs. The prevalence of primary lactose intolerance varies geographically, being most common in Northwestern Europe and decreasing as one moves south through Europe and into the Middle East. It is less common in Asia and much of Africa, although lactose intolerance is prevalent among nomadic communities in Africa.
- Secondary Lactose Intolerance: Also known as acquired lactose intolerance, this can affect both children and adults. It occurs when the small intestine decreases lactase production after illness, injury, or surgery related to the small intestine. Conditions such as gastroenteritis, celiac disease, and Crohn's disease can cause secondary lactose intolerance. This form may be reversible, partially reversible, or irreversible, depending on the underlying cause.
- Congenital Lactose Intolerance: This rare form is genetic and occurs in infants who are unable to produce lactase from birth. These children cannot digest lactose at any stage of their life, including adulthood. Because they cannot tolerate lactose, they cannot consume breast milk. Before the 20th century, infants with congenital lactose intolerance often did not survive, but advancements in medical understanding and the availability of lactose-free products have significantly improved survival rates.
2. What Should Pregnant Women with Lactose Intolerance Do?
For many women, the ability to digest lactose increases during pregnancy, especially in the third trimester. Therefore, even if they have lactose intolerance, pregnant women can often consume fresh milk and other dairy products without any problems.
Milk is an essential food for pregnant women, as it provides good nutrition and is a rich source of calcium. The calcium requirement during pregnancy is quite high. Pregnant women need about 1,000 mg of calcium per day, and adolescents who are pregnant may require up to 1,300 mg of calcium daily.
If pregnant women experience lactose intolerance or simply dislike the taste of fresh milk and other dairy products, they can consider the following tips:
- Incorporate Calcium-Rich Foods: Add foods high in calcium to the daily diet, such as cashews, broccoli, edamame, chickpeas, pinto beans, tofu, spinach, and other fortified food and beverage products. If they enjoy cashew milk, they should choose varieties that are fortified with calcium.
- Calcium Supplements: Consider using calcium supplements to help meet daily calcium needs.
- Small Amounts of Milk: Many individuals with lactose intolerance can still consume small amounts of fresh milk in meals, such as half a cup, without experiencing significant symptoms or only mild discomfort.
- Lactose-Reduced Products: Explore products that contain low or no lactose, including milk, cheese, and yogurt.
- Fermented Products: Yogurt and other fermented products, such as cheese, are often better tolerated than regular fresh milk. In yogurt, lactose is partially broken down by bacteria, making it a more digestible option.
- Vitamin D is essential for the body to absorb calcium, especially during the later stages of pregnancy. Therefore, pregnant women should not forget to supplement with vitamin D alongside calcium.
Vinmec International General Hospital offers a comprehensive maternity care program for expectant mothers from the early months of pregnancy. This program includes regular check-ups, 3D and 4D ultrasounds, routine anomaly screenings, and standard tests to ensure the mother stays healthy and the fetus develops properly. In addition to regular medical consultations, expectant mothers receive dietary and exercise advice to help manage weight gain effectively while ensuring optimal nutrient absorption for the fetus.
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Articles refer to sources: mayoclinic.org and webmd.com
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