Preterm Birth International Collaborative Australasia Branch: Expert Consensus on Diagnosis and Treatment of Neonatal Lactose Intolerance (2025).
- 2026-03
- Pediatric discovery 4(1)
- Zhengli Wang
- Shuping Han
- Xinzhu Lin
- Hui Wu
- Lingfen Xu
- Jun Tang
- Wei Hao
- Chao Yu
- Xiaomei Tong
- Juan Zhang
- Rong Ju
- Xiaoli Xie
- Long Chen
- Fang Li
- Xingwang Zhu
- Liping Xu
- Lanlan Geng
- Wei Zhou
- Xueyun Ren
- Chuanfeng Li
- Guoping Chen
- Wenyan Tang
- Jiang Duan
- Zhi Zhao
- Tao Pan
- Zhongliang Li
- Yingli Wu
- Siqi Zhuang
- Ying Ouyang
- Falin Xu
- Zheng Chen
- Yiyang Liu
- Zhoujie Peng
- Lei Bao
- Yu He
- Lin Kong
- Xianlan Zheng
- Lijuan Xu
- Qiao Shen
- Qian Zhang
- Junli Li
- Junjun Wang
- Yuan Shi
- PubMed: 42021958
- DOI: 10.1002/pdi3.70044
Study Design
- Methods
- comprehensive literature review, modified Delphi method
- Funding
- Unclear
This consensus aims to standardize the diagnosis and management of neonatal lactose intolerance (LI). A multidisciplinary working group was established under the auspices of the Preterm Birth International Collaborative (Australasia Branch). The development process included a comprehensive literature review of databases, which identified 61 publications. Recommendations were formulated using the Grading of Recommendations, Assessment, Development and Evaluation system for evidence evaluation. A modified Delphi method was used to achieve consensus. The consensus establishes that neonatal LI presents with nonspecific gastrointestinal symptoms, requiring stool assessment for diagnosis. Screening tests include fecal reducing sugar or urinary galactose tests, and the diagnosis is confirmed through elimination testing while excluding mimics. Treatment prioritizes lactase-supplemented breastfeeding; formula-fed infants receive lactase or reduced-lactose formulas. Probiotics with β-galactosidase activity can be used as an adjuvant therapy, and evidence-based lactase preparations are recommended, particularly for preterm infants. Treatment duration should be individualized, with a general minimum of 2 weeks; however, the routine use of lactose-free formula to prevent LI in preterm infants is not recommended. This consensus provides practical evidence-based guidance to standardize the diagnosis and management of neonatal LI, aiming to reduce variation in practice and improve patient outcomes. It emphasizes the importance of maintaining breastfeeding while incorporating lactase supplementation and highlights the need for further high-quality research, particularly randomized controlled trials, to refine diagnostic criteria and therapeutic strategies for preterm and very preterm infants. The recommendations are intended to support clinicians in making informed decisions while promoting family-centered care.