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Arch Dis Child. 1979 June; 54(6): 436–440.
PMCID: PMC1545434

Breath hydrogen test for detecting lactose malabsorption in infants and children. Prevalence of lactose malabsorption in Japanese children and adults.


The breath hydrogen test (BHT) was adapted for use in young infants and children. The diagnostic criterion of sugar malabsorption in the BHT was determined by oral administration of 0.5 g/kg of unabsorbable sugar (lactulose) to 21 healthy infants and children. A maximum increase in breath hydrogen less than 0.05 ml/min per m2 was observed in all subjects. A good correlation between results by the BHT and by the ordinary lactose tolerance test was obtained after oral administration of 2 g/kg lactose to 21 healthy infants and children, 2 congenital lactase-deficient infants, and 7 adults. Using this test, 80 healthy Japanese infants and children (aged between one month and 15 years) and 18 adults were examined for lactose malabsorption after a dose of 1 g/kg lactose. All infants and children under 2-years old absorbed lactose completely. The incidence of lactose malabsorption was 30% in 3-year, 36% in 4-year, 58% in 5-year, and 86% in 6-year-old children, 85% in schoolchildren, and 89% in adults. Thus the incidence of lactase deficiency gradually increases with age from 3 years, and about 90% of all normal Japanese adults are lactase-deficient.

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Selected References

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  • Bond JH, Jr, Levitt MD. Use of pulmonary hydrogen (H 2 ) measurements to quantitate carbohydrate absorption. Study of partially gastrectomized patients. J Clin Invest. 1972 May;51(5):1219–1225. [PMC free article] [PubMed]
  • Bond JH, Levitt MD. Quantitative measurement of lactose absorption. Gastroenterology. 1976 Jun;70(6):1058–1062. [PubMed]
  • Caskey DA, Payne-Bose D, Welsh JD, Gearhart HL, Nance MK, Morrison RD. Effects of age on lactose malabsorption in Oklahoma Native Americans as determined by breath H2 analysis. Am J Dig Dis. 1977 Feb;22(2):113–116. [PubMed]
  • Fernandes J, Vos CE, Douwes AC, Slotema E, Degenhart HJ. Respiratory hydrogen excretion as a parameter for lactose malabsorption in children. Am J Clin Nutr. 1978 Apr;31(4):597–602. [PubMed]
  • The lactose intolerance test and milk consumption. Nutr Rev. 1976 Oct;34(10):302–304. [PubMed]
  • Huang SS, Bayless TM. Lactose intolerance in healthy children. N Engl J Med. 1967 Jun 8;276(23):1283–1287. [PubMed]
  • Johnson JD, Simoons FJ, Hurwitz R, Grange A, Mitchell CH, Sinatra FR, Sunshine P, Robertson WV, Bennett PH, Kretchmer N. Lactose malabsorption among the Pima indians of Arizona. Gastroenterology. 1977 Dec;73(6):1299–1304. [PubMed]
  • Krasilnikoff PA, Gudman-Hoyer E, Moltke HH. Diagnostic value of disaccharide tolerance tests in children. Acta Paediatr Scand. 1975 Sep;64(5):693–698. [PubMed]
  • Krauss AN, Auld PA. Measurement of functional residual capacity in distressed neonates by helium rebreathing. J Pediatr. 1970 Aug;77(2):228–232. [PubMed]
  • Levitt MD. Production and excretion of hydrogen gas in man. N Engl J Med. 1969 Jul 17;281(3):122–127. [PubMed]
  • Maffei HV, Metz G, Bampoe V, Shiner M, Herman S, Brook CG. Lactose intolerance, detected by the hydrogen breath test, in infants and children with chronic diarrhoea. Arch Dis Child. 1977 Oct;52(10):766–771. [PMC free article] [PubMed]
  • Metz G, Blendis LM, Jenkins DJ. Letter: H2 breath test for lactase deficiency. N Engl J Med. 1976 Mar 25;294(13):730–730. [PubMed]
  • Newcomer AD, McGill DB, Thomas PJ, Hofmann AF. Prospective comparison of indirect methods for detecting lactase deficiency. N Engl J Med. 1975 Dec 11;293(24):1232–1236. [PubMed]
  • Newcomer AD, McGill DB. Breath H2 test for lactase deficiency. Am J Dig Dis. 1977 Aug;22(8):745–746. [PubMed]
  • Newcomer AD, Thomas PJ, McGill DB, Hofmann AF. Lactase deficiency: a common genetic trait of the American Indian. Gastroenterology. 1977 Feb;72(2):234–237. [PubMed]
  • Newcomer AD, McGill DB, Thomas PJ, Hofmann AF. Tolerance to lactose among lactase-deficient American Indians. Gastroenterology. 1978 Jan;74(1):44–46. [PubMed]

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