अक्सर पूछे जाने वाले प्रश्न
This is a very common problem in otherwise healthy infants. In infant Colic babies, there is inconsolable crying for three hours a day, three days per week, for 3 weeks. Infant colic usually occurs several weeks after birth, with a peak around 6 to 8 weeks. Symptoms usually disappear spontaneously by the age of 3 to 4 months.
Some babies with colic may have temporary lactose intolerance (TLI). TLI may cause bloating, gas and abdominal pain which may cause a baby to cry.
Milk, infant formulas, breast milk and dairy products all contain a sugar called lactose. Lactase is an enzyme naturally produced in the small intestine. Its function is to break down the lactose in the diet into simple sugars. These can then be absorbed as part of the normal digestive process.
For some babies with colic, temporary lactose intolerance can cause bloating, gas and abdominal pain, which may make a baby cry. In some there can be Nappy Rash due to acidic pH of stool. Research has shown that symptoms of colic usually disappear at around the age of 3 to 4 months.
78% babies suffering from infantile colic show signs of Lactose Intolerance due to Lactase Deficiency.
The term “Temporary lactose intolerance” in infants is the temporary inability of the gastrointestinal tract to break down the milk sugar, lactose.
Lactose must be broken down into the simple sugars, glucose and galactose, in order to be absorbed by the body. This undigested lactose in milk and other dairy products produces lactic acid and gas which may cause severe discomfort, bloating and gas that makes the baby cry.
By 3 to 4 months of age, a baby’s digestive system should be developed sufficiently to produce adequate amounts of lactase for proper digestion of lactose in the diet.
“Lactose intolerance” is a condition of one or more of the following symptoms after the ingestion of lactose or lactose-containing food substances: abdominal pain, diarrhea, nausea, flatulence and/or bloating.
The amount of lactose that will cause symptoms varies from individual to individual, depending on: amount of lactose consumed, the degree of lactase deficiency, and the form of food substance in which the lactose is ingested.
Temporary Lactose Intolerance can result in temporary digestive discomfort caused by undigested lactose in food. This can contribute to colic in some infants. There can be nappy rash too in small infants.
Conditions like Rotaviral /Parasitic / Bacterial GI infection can cause Transient Lactase Deficiency/ Transient Lactose Intolerance. Since lactase is produced in the very tips of the folds of the intestine, anything that damages the gut lining can cause Transient lactose intolerance. Even subtle damage to the gut may wipe off these tips and reduce the enzyme production. Transient lactose intolerance may lasts for 6 to 8 weeks. Lactase activity returns to normal following healing of damaged epithelium
Study show 67% of Infants sufferings from Acute Diarrhoea; have reduced Capacity to tolerate Lactose.
Yamoo drop contains Lactase Enzyme (naturally present in a normal, developed gut). Yamoo Bottle is of 15 ml. Each 1 ml Contains Lactase enzyme 600 FCC units. 1ml will yield approximately 20 drops. 1 drop will be having approx 30 FCC Lactase Enzymes.
Yamoo works by breaking down most of the lactose (78%) in breast milk and/or infant formula before a feeding, making it easier to digest.
Adding Yamoo to the baby’s usual milk may compensate for a possible temporary lactose deficiency in the baby’s digestive system. Adding the drops to the baby’s usual milk greatly reduces the level of lactose in the milk.
Studies have shown that the hours of crying may be substantially reduced to when a baby’s usual milk is treated with Yamoo. Crying time gets reduced .
- Add 4 to 5 drops of Yamoo Drops to few ml of expressed breast milk.
- The foremilk contains most of the lactose.
- Wait a few minutes, give this mixture to the baby and then breast feed as normal
Reason for this method: The foremilk contains most of the lactose. Hence we recommend waiting only for few minutes and then giving this mixture to baby and then breastfeed as normal. This method forms a “coating” for the baby’s digestive system which allows the remaining breastmilk to be digested normally.
Add 4 to 5 drops of Yamoo per 50 ml of infant formula, when it is warm (30C to 40C). Shake well and then feed the baby.
Not at refrigerator temperature. The drops work very slowly on milk that is already chilled. The ideal temperature for the enzymes to work properly is between room temperature and body-heat, i.e. neither too hot nor too cold. This is why it is recommended that the drops are added when the formula is first made and allowed to cool to body temperature.
It should be stored in cool and dry place.
Yamoo can be used at every feed until the baby is three to four months old, by which time the symptoms of colic should have disappeared. Yamoo can then be withdrawn gradually from use.
Use yamoo each time you feed your infant until he/she is approximately 3-4 months old. Then gradually withdraw yamoo from use by:
- Halving the drops used per feeding,
- Then add yamoo only at alternate feedings,
- Finally, reduce to once a day until withdrawal is complete.
The source of Yamoo is Aspergillus oryzae . Lactase from Aspergillus Oryzae has high activity throughout the GI tract; even in stomach where pH is less than 3.5 unlike other formulations which are unstable at pH less than 3.5 (thus acts independent of pH). Source of Lactase impacts the pH stability of final preparation which decides the dosage, efficacy, safety & cost. Regulatory bodies like FSSAI (India) EFSA & USFDA , approve & recommend Aspergillus oryzae as a source for Lactase.
Aspergillus oryzae might be more effective than that from Kluveromyces lactis because of its increased stability over wider ranges of Ph and temperature. Aspergillus oryzae source is more thermostable than other kluveromyces lactis.
Lactase is considered as GRAS (Generally recommended as safe) by USFDA and EFSA (European Food Safety Association) Lactase enzyme is present in the GI tract of human beings.
- Recommendations from NICE (The National Institute for Health and Care Excellence) are available. (NICE guideline on infant colic 2014)
- For parents who are unable to cope with excessive crying, NICE recommends 1 week trial of Lactase.
- If Lactase therapy improves the symptoms, it can be given till 4 to 6 months during infancy, post which they start producing sufficient amount of Lactase.
Are there any other guideline which mentions or recommends Lactase in infants and paediatrics for Lactose intolerance?
American Academy of Pediatrics too supports the use of Lactase. They recommend use of lactase-treated dairy products or oral lactase supplementation
Can Yamoo drop be used in cases on Infant diarrhea due to GI infection(rotavirus, bacterial or protozoal )
It has already been discussed before. Conditions like Rotaviral /Parasitic / Bacterial GI infection can cause Transient Lactase Deficiency. Since lactase is produced in the very tips of the folds of the intestine, anything that damages the gut lining can cause Transient lactose intolerance. Even subtle damage to the gut may wipe off these tips and reduce the enzyme production. Transient lactose intolerance may lasts for 6 to 8 weeks. Lactase activity returns to normal following healing of damaged epithelium
Study show 67% of Infants sufferings from Acute Diarrhoea; have reduced Capacity to tolerate Lactose.
Yamoo drops can aide or facilitate digestion of lactose in milk by providing Lactase directly.
More than 1/3rd of Indians suffer from Lactase Deficiency. Lactase Deficiency is prevalent in all age groups & generally increases with Age. There is decline in expression of Lactase enzyme after 5 years of age. Lactose intolerance plays a contributory role in recurrent abdominal pain in children.
For older children, adolescent and adult, Walter Bushnell has launched Yamoo chewable tablets. Yamoo tablet contains 4500 FCC lactase.
We are recommending using 1-2 tablets, immediately before or with first bite/sip of dairy (lactose) containing meal/drink. Number of tablets depends on the food which a person is eating and how much lactose it has in it, coupled with the individual’s sensitivity to lactose. Tablet has to be chewed thoroughly before swallowing. If a person continues to consume food and drinks containing dairy after 20 to 45 minutes, he should take another tablet. If missed, we recommend taking immediately.
The dose of Yamoo (lactase) is dependent of the amount of lactose and the size of the meal consumed. In general, a larger meal remains in the stomach for longer and therefore less enzyme is required then when the same amount of lactose is consumed with a light meal or just a glass of milk. Generally 2,500 FCC lactase can be used per 10 – 13 grams of lactose consumed. Hence we recommend a dose of 4,500 FCC with each lactose-containing meal. For very sensitive lactose-intolerant consumers (needing a 100% conversion) 9000 FCC per meal is recommended. Over time, consumers will quickly establish an effective dose.
After drinking milk or having any dish containing milk/ dairy, if you have gas and bloating sensation in stomach and abdomen, pain or cramps, gurgling sounds, nausea and loose stools, you are likely to have Lactose Intolerance.
60 to 70% of Indian population have decreased Lactase Enzyme in their small intestine. This is due to genetic makeup. As we grow from teenager to adult and subsequently into older individuals, the lactase concentration in our intestine decreases.
Lactase helps to break lactose present in milk and dairy product into glucose and galactose. In absence of sufficient lactase, lactose travels further in our intestine, instead of getting broken down. It reaches large intestine “colon”. In colon they get broken down and converted by bacteria. This action causes more production of gases, and more liquid passes into the large intestine. This is what causes gas, cramp/pain, gurguling sound and diarrhea.
Can I also have Lactose Intolerance when I am suffering from some other gastrointestinal disease condition?
If you are suffering from gastrointestinal diseases like irritable bowel syndrome, inflammatory bowel disease, you may have intolerance to milk and dairy products.
After gastroenteritis, you may suffer from milk and lactose intolerance, as there is deficiency of lactase enzyme. It takes four to six weeks for normal lactase levels to be restored.
No. There are people who are allergic to milk and dairy foods. But the symptoms of a dairy allergy are often different from those of lactose intolerance. In the case of an allergy, the body reacts to the protein in milk, rather than to the sugar. Plus, allergies involve the body's infection-fighting system, called the immune system. Lactose intolerance does not.
If you realise, you are having symptoms of lactose intolerance, you can try milk and dairy with Lactase enzyme. You can consult to your family doctor for the guidance, as there may be chance you may be having other gastrointestinal conditions.
Diagnosis of Lactose Intolerance is done mainly by patient’s history and symptoms. There are test too diagnose the lactose intolerance. The test is called hydrogen breath test. This may take about 2 hrs. The patient will be asked to consume lactose-containing drink/milk. The same may cause cramping, bloating, gas, or diarrhea. 15 to 20 minutes after drinking the lactose drink, patient is asked blow into apparatus every 15 minutes for two hours. The air the patient breathes into these apparatus is tested frequently for the presence of hydrogen. Normally, very little hydrogen is detected in breath. But in lactose intolerance due to lactase deficiency, hydrogen and other gases are produced, as undigested lactose in the colon is fermented by bacteria.
Treatment differs depending on how severe the problem is. But in general, treatment can include:
- Eating less dairy food. Total avoidance is not recommended, as you may develop nutritional deficiency.
- Finding non-dairy sources of nutrients (such as calcium and vitamin D) and protein
- Taking an enzyme supplement that will help you break down dairy foods. In India, Yamoo tablets are available, which contains lactase enzyme. Yamoo is being used by many lactose intolerant patients in India and they are now able to use milk and dairy in their diet.
Yamoo tablet contains Lactase enzyme 4500 FCC. When taken along the milk and dairy products, there is reduction in symptoms of boating, gas, abdominal cramps and dairrhea, as lactose gets digested by lactase. Yamoo helps you to enjoy milk and dairy products.
Consume one or two Yamoo chewable tablets with milk and dairy products. One tablet can digest or neutralise approximately 18 gms of lactose, i.e around 300 to 400 ml of milk. If you consume more milk and dairy take two tablets.
It is extremely safe and comes under the category of food supplement. Lactase enzyme is naturally present in our small intestine. Hence when replacement is given in lactose intolerance, it will be safe as any food product. The source of Yamoo is Aspergillus oryzae . Lactase from Aspergillus Oryzae has high activity throughout the GI tract; even in stomach where pH is less. Regulatory bodies like FSSAI (India) EFSA & USFDA, approve & recommend Aspergillus oryzae as a source for Lactase.
Yes, it can be taken in pregnancy as it is food supplement. It is safe.
Yamoo chewable tablets are available in your nearby chemist shops. It has been made available all across India. You can also procure Yamoo online from this site and other sites like Amazon & 1 mg