Pregnant Women

The role of lactose digestion in pregnant women is of special interest. Despite the nutritional value of milk during pregnancy, the lactase levels in some individuals in a number of racial and ethnic groups may be insufficient to hydrolyze commonly consumed amounts of lactose, resulting in lactose maldigestion and possibly milk intolerance. The Institute of Medicine report notes that "lactose intolerance among pregnant African American women may result in their subsequent avoidance of milk.'' Other populations may also experience lactose maldigestion and intolerance to milk during pregnancy.

Studies of lactose maldigestion in pregnant women, as measured by breath hydrogen response to 240 ml of low-fat (1%) milk, reinforce the Institute of Medicine's concern with lactose digestion among pregnant African American women. The prevalence of lactose maldigestion in early (13-16 weeks), late (30-35 weeks), and 8 weeks postpartum was 66, 69, and 75%, respectively, and that of nonpregnant control women was 80% (Table 3).

Accordingly, health care providers instructing African American women on the optimal dietary

Table 3 Lactose maldigestion3 in pregnant and nonpregnant African American women

African American women

% Lactose maldigestion

Early pregnancy (13-16 weeks)

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