What are the signs of lactose intolerance in children. How is lactose intolerance diagnosed in kids. What causes lactose intolerance in children. How can lactose intolerance be managed in children.

Understanding Lactose Intolerance in Children

Lactose intolerance is a condition where the body struggles to break down or digest lactose, a sugar found in milk and milk products. This digestive issue can affect both children and adults, leading to various uncomfortable symptoms after consuming dairy products.

Unlike a milk allergy, which involves an immune system response, lactose intolerance is related to the digestive system’s inability to process lactose effectively. This distinction is crucial for proper diagnosis and management of the condition.

What Causes Lactose Intolerance in Children?

The primary cause of lactose intolerance is a deficiency in lactase, an enzyme produced in the small intestine. Lactase is responsible for breaking down lactose into simpler sugars that the body can absorb. When there’s insufficient lactase, undigested lactose moves through the digestive system, leading to various symptoms.

Several factors can contribute to lactose intolerance in children:

• Digestive diseases or infections
• Injury to the small intestine
• Genetic predisposition (family history of lactose intolerance)
• Premature birth (often a temporary issue)
• In rare cases, congenital lactase deficiency (present from birth)

Identifying Risk Factors for Lactose Intolerance

While lactose intolerance can affect anyone, certain factors may increase a child’s risk of developing this condition:

1. Premature birth
2. Ethnic background (more common in African American, Jewish, Mexican American, American Indian, and Asian American populations)
3. Family history of lactose intolerance

It’s important to note that the onset of symptoms can vary based on ethnicity. White children typically begin showing symptoms after age 5, while African-American children may experience symptoms as early as 2 years old.

Recognizing Symptoms of Lactose Intolerance in Children

Symptoms of lactose intolerance usually appear 30 minutes to 2 hours after consuming foods or drinks containing lactose. The severity and duration of symptoms can vary depending on the amount of lactose consumed and the individual child’s lactase production.

Common symptoms include:

• Upset stomach or nausea
• Abdominal cramps
• Bloating
• Abdominal pain
• Gas
• Loose stools or diarrhea
• Vomiting (more common in teenagers)

Is lactose intolerance dangerous for children?

While lactose intolerance can cause discomfort, it is not typically dangerous. However, persistent symptoms can lead to nutritional deficiencies if dairy products are completely eliminated from the diet without proper substitution. It’s crucial to work with a healthcare provider to ensure your child receives adequate nutrition while managing lactose intolerance.

Diagnosing Lactose Intolerance in Children

Proper diagnosis of lactose intolerance is essential for effective management. Healthcare providers typically begin with a physical examination and a detailed health history. To confirm the diagnosis, several tests may be recommended:

1. Lactose Tolerance Test

This test evaluates how well the body absorbs lactose. After fasting, the child drinks a liquid containing lactose, and their urine is checked for glucose levels. However, this test is less commonly used now due to the availability of more specific tests.

2. Hydrogen Breath Test

The hydrogen breath test is currently the most widely used method for diagnosing lactose intolerance. The child drinks a lactose-rich solution, and their breath is analyzed at regular intervals to measure hydrogen levels. Elevated hydrogen levels indicate lactose intolerance.

3. Stool Acidity Test

This test is primarily used for infants and young children. It measures the acidity of the stool, which increases when lactose is not properly digested. The presence of lactic acid, glucose, and other fatty acids in the stool suggests lactose intolerance.

4. Small Bowel Biopsy

In some cases, a small sample of the small intestine may be taken for analysis. This is typically done when other tests are inconclusive or if there’s suspicion of other intestinal issues.

Managing Lactose Intolerance in Children

While there is no cure for lactose intolerance, the condition can be effectively managed through dietary adjustments and, in some cases, supplementation. The goal is to minimize symptoms while ensuring the child receives adequate nutrition, particularly calcium and vitamin D, which are abundant in dairy products.

Dietary Modifications

The primary approach to managing lactose intolerance involves limiting lactose intake. However, this doesn’t necessarily mean eliminating all dairy products from the child’s diet. Many children with lactose intolerance can tolerate small amounts of lactose without experiencing symptoms.

Some strategies for managing lactose in a child’s diet include:

• Gradually introducing lactose-containing foods to determine tolerance levels
• Consuming lactose-containing foods with other foods to slow digestion
• Opting for lactose-free or lactose-reduced dairy products
• Choosing aged cheeses, which typically contain less lactose
• Incorporating non-dairy sources of calcium and vitamin D into the diet

Lactase Enzyme Supplements

Over-the-counter lactase enzyme supplements can be helpful for some children. These supplements provide the lactase enzyme that the body lacks, allowing for better digestion of lactose-containing foods.

Is it safe for children with lactose intolerance to consume small amounts of dairy?

Many children with lactose intolerance can tolerate small amounts of dairy without experiencing symptoms. Gradually introducing dairy products and monitoring reactions can help determine an individual child’s tolerance level. This approach allows for some nutritional benefits of dairy while minimizing discomfort.

Nutritional Considerations for Lactose Intolerant Children

Ensuring adequate nutrition is crucial when managing lactose intolerance in children. Dairy products are significant sources of essential nutrients, particularly calcium and vitamin D, which are vital for bone health and overall growth.

Alternative Sources of Calcium and Vitamin D

For children who need to limit or avoid dairy, there are numerous alternative sources of calcium and vitamin D:

• Fortified non-dairy milk alternatives (soy, almond, oat)
• Leafy green vegetables (spinach, kale, collard greens)
• Calcium-fortified juices
• Canned fish with soft bones (sardines, salmon)
• Tofu processed with calcium sulfate
• Nuts and seeds (almonds, sesame seeds)

It’s important to work with a healthcare provider or registered dietitian to ensure that a child’s diet meets all nutritional requirements while managing lactose intolerance.

Long-term Outlook for Children with Lactose Intolerance

Lactose intolerance is a manageable condition that doesn’t typically impact a child’s overall health when properly addressed. With appropriate dietary modifications and potential use of lactase supplements, most children with lactose intolerance can lead normal, healthy lives.

Can children outgrow lactose intolerance?

In some cases, particularly when lactose intolerance is caused by a temporary condition like premature birth or intestinal infection, children may outgrow the condition. However, when lactose intolerance is genetic or develops later in childhood, it’s typically a lifelong condition. Regular reassessment of tolerance levels is recommended, as some individuals may find their ability to digest lactose improves over time.

Supporting Children with Lactose Intolerance

Managing lactose intolerance in children requires a team approach involving the child, parents, healthcare providers, and potentially school staff. Here are some strategies to support children with lactose intolerance:

• Educate the child about their condition and how to manage it
• Work with school staff to ensure appropriate dietary accommodations
• Encourage open communication about symptoms and dietary needs
• Explore lactose-free alternatives for favorite foods
• Teach label-reading skills to identify hidden sources of lactose
• Consider joining support groups or connecting with other families managing lactose intolerance

How can parents help their lactose intolerant child navigate social situations involving food?

Social situations involving food can be challenging for children with dietary restrictions. Parents can help by:
– Communicating with hosts or event organizers in advance about dietary needs
– Packing safe snacks or alternatives for parties or outings
– Teaching the child to politely decline foods that may cause discomfort
– Encouraging the child to focus on non-food aspects of social gatherings
– Helping the child develop confidence in managing their dietary needs

Advances in Lactose Intolerance Research and Treatment

While lactose intolerance is a well-understood condition, ongoing research continues to explore new management strategies and potential treatments. Some areas of current research include:

• Development of more effective lactase supplements
• Investigation of probiotics that may improve lactose digestion
• Exploration of genetic factors influencing lactase persistence
• Studies on the potential of prebiotics to enhance lactose tolerance

These research efforts aim to improve the quality of life for individuals with lactose intolerance and potentially develop new treatment options in the future.

Are there any promising new treatments for lactose intolerance on the horizon?

While there are no imminent cures for lactose intolerance, researchers are exploring several promising avenues:
– Gene therapy to restore lactase production (still in early experimental stages)
– Microbiome modulation to enhance lactose digestion
– Development of more targeted and effective enzyme supplements
– Personalized nutrition approaches based on genetic and microbiome profiles

As research progresses, it’s possible that new management strategies or treatments may become available, potentially offering more options for children and adults with lactose intolerance.

Lactose Intolerance in Children

What is lactose intolerance in children?

Lactose intolerance is when the body can’t easily break down or digest lactose. Lactose is a sugar found in milk and milk products.

If your child is lactose intolerant, your child may have unpleasant symptoms after eating or drinking milk products. These symptoms include bloating, diarrhea, and gas.

Lactose intolerance is different from having a food allergy to milk.

What causes lactose intolerance in a child?

Lactose intolerance happens when the small intestine doesn’t make enough of a digestive juice, or enzyme, called lactase. Without enough lactase, the body can’t break down or digest lactose.

Lactose intolerance can happen to both children and adults. Some common causes include:

• Digestive diseases or infection

• Injury to the small intestine

• Family history of lactose intolerance. In these cases, over time the body may make less of the lactase enzyme. Symptoms may occur during the teen or adult years.

• A baby being born too early, also called a premature baby. This type of lactose intolerance is often a short-term problem that goes away.

In very rare cases, some newborns can’t make any lactase from birth.

Which children are at risk for lactose intolerance?

Lactose intolerance can happen to anyone. But your child is more at risk for lactose intolerance if your child:

• Is a baby who was born too early (premature). This type of lactose intolerance is often a short-term problem that goes away.

• Is African American, Jewish, Mexican American, American Indian, or Asian American

• Has a family history of lactose intolerance. Symptoms may occur during the teen or adult years.

What are the symptoms of lactose intolerance in a child?

Symptoms often begin to appear in white children after age 5. They appear in African-American children as young as 2 years old.

Symptoms begin about 30 minutes to 2 hours after having foods or drinks containing lactose. Each child’s symptoms may vary. Symptoms may include:

• Upset stomach or nausea

• Cramps

• Bloating

• Belly (abdominal) pain

• Gas

• Loose stool or diarrhea

• Vomiting, happens more often to teens

How severe your child’s symptoms are will depend on how much lactose your child has had. It will also depend on how much lactase your child’s body makes.

The symptoms of lactose intolerance may look like other health conditions. Always see your child’s healthcare provider for a diagnosis.

How is lactose intolerance diagnosed in a child?

Your child’s healthcare provider will give your child a physical exam and take a health history.

Your child may need to be tested. The most common tests used to check how lactose is absorbed in the digestive system include:

• 
  Lactose tolerance test. This test checks how lactose is absorbed by your child’s digestive system. After fasting, your child drinks a liquid that has lactose. The urine is checked for glucose levels. The hydrogen breath test is done more commonly.

• 
  Hydrogen breath test. Your child drinks a liquid that has a lot of lactose. The breath is then checked at regular times to measure the amount of hydrogen. High levels of hydrogen mean your child is lactose intolerant.

• 
  Stool acidity test. This test is used for babies and young children. It checks how much acid is in the stool. If your child is not digesting lactose, the stool will have lactic acid, glucose, and other fatty acids.

• Occasionally, a small bowel biopsy (sample) is sent for testing

How is lactose intolerance treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

No treatment will help your child’s body make more lactase. But you can manage your child’s symptoms with a diet that limits lactose. Your child may not have to stop eating all foods with lactose. Your child’s healthcare provider may also suggest your child take lactase enzymes. They are sold over the counter.

Here are some tips for managing lactose in your child’s diet:

• 
  Start slowly. After a week of limiting foods with lactose, try adding small amounts of milk or milk products back to your child’s diet. Watch to see if your child has any symptoms. Note which foods your child can handle and which foods your child should not eat.

• 
  Have milk and milk products with other foods. You may find your child has fewer symptoms if your child has milk or milk products with meals. Have your child try eating cheese with crackers. Or let your child have milk with cereal.

• 
  Choose dairy products with naturally lower levels of lactose. These include hard cheeses and yogurt.

• 
  Look for lactose-free and lactose-reduced milk and milk products. These can be found at many food stores. They are the same as regular milk and milk products. But they have the lactase enzyme added to them.

• 
  Ask about lactase products. Ask your child’s healthcare provider if your child should take a lactase pill or lactase drops when having milk products.

Talk with your child’s provider about what products or diet changes may help your child. You may also find it helpful to see a registered dietitian.

Calcium

Children and teens who are lactose intolerant may have little or no milk in their diet. But milk and dairy products are a major source of calcium. If your child is lactose intolerant, be sure that your child gets enough calcium. Calcium is needed for growing and repairing bones throughout life. Calcium may also help prevent some diseases.

The amount of calcium your child needs will vary by age:

Many nondairy foods are high in calcium, including:

• Green vegetables, such as collard greens, turnip greens, broccoli, and kale

• Fish with soft, edible bones, such as salmon and sardines

Other nondairy foods that are good sources of calcium include:

• Tofu

• Orange juice with added calcium

• Soy milk with added calcium

• Breakfast cereals with added calcium

Always talk with your child’s healthcare provider. Your child’s provider may prescribe a calcium supplement if your child can’t get enough calcium from diet alone.

Vitamin D

Vitamin D is needed for the body to absorb calcium. It’s important that your child’s diet has enough vitamin D. Sources of vitamin D include eggs and liver.

Children under 1 year old should have a vitamin D supplement of 400 IU a day. Children over 1 year old should have 600 IU of vitamin D a day.

What are possible complications of lactose intolerance in a child?

Lactose intolerance won’t hurt your child’s body. The symptoms are unpleasant, but they are not serious.

How can I help my child live with lactose intolerance?

Lactose intolerance can cause unpleasant symptoms. But in most cases, you don’t need to remove all foods with lactose from your child’s diet. By watching your child’s symptoms, you can find out which foods they can handle. You can also tell which foods your child should stay away from.

When foods are removed from your child’s diet, you must replace them with other foods that offer needed nutrients. Also make sure that your child has enough calcium and vitamin D. Read nutrition labels on foods. The bottom section of the label contains information on calcium and vitamin D.

Talk with your child’s healthcare provider about what products or diet changes may help your child. You may also find it helpful to see a registered dietitian.

When should I call my child’s healthcare provider?

The symptoms of lactose intolerance may look like symptoms of other disorders. Have your child checked by a healthcare provider if your child has:

• Loose stool or diarrhea

• Swelling or bloating

• Belly pain

• Other GI (gastrointestinal) symptoms

Key points about lactose intolerance in children

• Lactose intolerance is when your child’s body can’t easily break down, or digest, lactose. Lactose is a sugar found in milk and milk products.

• It happens when the small intestine doesn’t make enough of a digestive juice, or enzyme, called lactase.

• Your child may have uncomfortable symptoms, such as bloating, gas, and an upset stomach after eating or drinking milk or milk products.

• Have your child see a healthcare provider for a diagnosis.

• You can manage your child’s symptoms by limiting foods that have lactose.

• Children and teens need calcium and vitamin D for bone growth and health. Read food labels so you can check that your child gets the right amount of these nutrients.

• Ask your healthcare provider for help if you have concerns about developing a lactose-intolerant dietary plan

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.

Lactose intolerance: babies, kids & teens

What is lactose intolerance?

Lactose intolerance is when the gut can’t break down lactose. This problem happens because there isn’t enough lactase in the small intestine.

Lactose is a sugar present in all breastmilk, dairy milk and other dairy products. It makes up 5-7% of breastmilk, infant formula and dairy products.

Lactase is an enzyme. Enzymes break down the nutrients in food so the body can use them.

Lactose is important for your baby’s health and development. It provides around 40% of your baby’s energy needs and helps them absorb calcium and iron.

Causes of lactose intolerance

There are 3 main causes of lactose intolerance.

Lactase non-persistence (hypolactasia)
This happens when your child’s lactase enzymes gradually start to decrease. This is genetic and very common – about 70% of people have this type of lactose intolerance. Symptoms can start after the age of 5 years, but they’re usually more noticeable in teenagers and young adults. Children can usually still tolerate small amounts of lactose in their daily diets.

Congenital lactase deficiency (alactasia)
This happens when babies are born with no lactase enzymes at all. This is genetic and extremely rare. Babies with this kind of lactose intolerance have severe diarrhoea from the first day of life and fail to thrive. They need a special diet from the time they’re born so they can grow and develop well.

Secondary lactose intolerance
This can happen if a child’s digestive system is upset by infections like gastroenteritis, which can temporarily damage the lining of the stomach and small intestine. This kind of lactose intolerance is short term and usually improves after a few weeks.

Conditions like coeliac disease can also lead to secondary lactose intolerance. Once these conditions are being managed properly, lactose intolerance should be less of a problem.

Common symptoms of lactose intolerance

Symptoms of lactose intolerance in babies, children and teenagers include:

• wind
• stomach pain and bloating
• diarrhoea
• rumbling tummy.

Babies with lactose intolerance might also have symptoms like:

• nappy rash
• crankiness or irritability
• trouble settling
• attachment problems during breastfeeding
• failure to gain weight.

Even if your baby has these symptoms, it doesn’t always mean that they’re lactose intolerant. Some or all of these symptoms can be common in healthy breastfed infants.

If you think your baby or child has the symptoms of lactose intolerance, you should talk with your GP.

Sometimes lactose intolerance is confused with food allergies. Food allergies involve your immune system, but food intolerances don’t. Also, common food allergy symptoms include vomiting, blood or mucus in poo, hives and facial swelling – these aren’t symptoms of lactose intolerance. If your child has symptoms like these, see your GP.

Assessment and diagnosis of lactose intolerance

These are the 2 main tests that your doctor might recommend if your child has symptoms of lactose intolerance.

Hydrogen breath test
For this test, your child drinks a standard amount of lactose. Then the amount of hydrogen gas in your child’s breath is measured. Lactose-intolerant children have higher levels of hydrogen in their breath.

Elimination diet
This involves removing foods containing lactose from your child’s diet to see whether symptoms improve. If the symptoms come back once the foods with lactose are reintroduced, lactose intolerance is most likely the cause of the problem.

It’s best to speak to your GP or a dietitian before starting your child on an elimination diet. They’ll ensure that your child’s diet continues to give your child the nutrition they need for growth and development, even while you’re eliminating things from it.

Treatment: lactose intolerance in babies

The treatment for lactose intolerance in babies often depends on the cause. And no matter what’s causing your baby’s lactose intolerance, it’s important to soothe and comfort your baby when they’re showing symptoms.

Congenital lactase deficiency
If your baby has congenital lactase deficiency, your GP, paediatrician or dietitian will guide your child’s treatment.

Secondary lactose intolerance
For a breastfed baby with secondary lactose intolerance caused by gastroenteritis, you should be able to keep breastfeeding.

Weaning off breastmilk isn’t usually recommended. This is because breastmilk has so many nutritional benefits and lactose is good for your baby’s growth. Your child can usually tolerate a small amount of lactose, and gradually increasing it can help your child’s body produce more lactase.

If your baby is formula fed or you’re considering giving them formula, consult your GP or a dietitian before using or changing to a low-lactose or lactose-free infant formula. If your child is under 6 months, avoid using soy-based infant formula.

Talk to your GP if you’re thinking of using Lacteeze drops in expressed breastmilk or Lacteeze tablets. There’s some debate about the effectiveness of these treatments. Also talk to your GP if you want to try replacing breastmilk or alternating breastmilk with formula, or you’re generally worried about your baby’s nutrition.

Treatment and management: lactose intolerance in older children and teenagers

If your older or teenage child is diagnosed with lactose intolerance, you can reduce the amount of lactose in their diet. But you don’t need to get rid of products with lactose completely, especially if your child eats only small amounts of them with other foods during the day.

Your child can usually eat:

• cheeses with very low lactose content – brie, camembert, cheddar, colby, edam, fetta, gouda, havarti, mozzarella, parmesan, halloumi, Swiss and Tilstat
• yoghurt – the bacteria in yoghurt breaks down the lactose so it’s usually fine for your child to eat
• calcium-fortified soy products – soy yoghurt, soy milk, soy ice-cream and soy cheese
• lactose-free cow’s milk
• butter and cream – these contain only small amounts of lactose and are usually fine to eat
• bread, cereals, fruit, vegetables, meat and other protein foods
• full-fat milk – the fat in full-fat milk gives your child’s body longer to digest lactose.

Your child should be careful about eating:

• milk ice-cream and milk desserts
• cream cheese, processed cheese and cheese spread
• muesli bars
• instant mashed potato and vegetables with added milk or white sauces.

You or your child should check the ingredients in:

• biscuits, cakes and cake mixes
• soups
• mayonnaise
• milk chocolate.

Lactose overload in babies

Lactose overload isn’t the same as lactose intolerance – that is, it isn’t a problem with the production of lactase. Rather, lactose overload happens when a baby consumes large amounts of lactose at one time and can’t break it all down.

Lactose overload can happen when mothers have a natural oversupply of breastmilk in their baby’s early weeks. It can also happen when breastfed babies switch to the second breast before the first breast has been well drained.

And it can happen when bottle-fed babies drink a lot of milk, but this isn’t common.

If your baby has symptoms of lactose overload, check your breastfeeding position and breastfeeding technique. Good attachment can help your baby drain the first breast before moving to the second. If over-feeding is causing the overload, try not to feed more often than every 3 hours.

Nutritionist told how to recognize lactose intolerance – Gazeta.Ru

A nutritionist told how to recognize lactose intolerance – Gazeta.Ru | News

January 13, 2022, 18:48

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You don’t need expensive genetic tests to determine if you have lactose intolerance. This was told to Gazeta.Ru by a nutritionist, an expert on the Doctor TV channel, Natalia Nefedova. In her opinion, you can understand that you have lactase deficiency on your own.

“By the age of 30, you will still understand whether you have intolerance or not,” said Natalia Nefedova. “There will be bloating, nausea and diarrhea after eating dairy products and especially milk, because there is less lactose in yogurts and cheeses.”

The nutritionist added that lactose intolerance can manifest itself at any age, but many people can “go their entire lives drinking milk. ”

But the widespread opinion that “cow’s milk is for calves, not people” is not true, Natalya Nefedova noted. According to her, if a person does not have an allergy to milk proteins or lactose intolerance, he can consume regular milk without replacing it with vegetable analogues.

At the same time, even with lactase deficiency, you can drink milk and eat dairy products if you “swallow a tablet with the lactase enzyme.”

Previously, Gazeta.Ru told how to make vegetable milk on your own.

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Gastroenterologist explained how to test products for people with lactose intolerance

Lactose, or milk sugar. According to statistics, about 40 percent of Russians are prone to intolerance to this enzyme. Why is there such a reaction to milk? And what to do with it? Read in the material of the TV channel “Saint Petersburg”.
Why lactose intolerance occurs? Globally, we divide lactase deficiency into 2 types. The first is genetic, or primary lactase deficiency. It most often develops with age, but we are born with a predisposition. And secondary lactase deficiency. It occurs in people with some diseases, ”said Ekaterina Pazenko, a gastroenterologist and candidate of medical sciences.

What foods contain lactose

Cheese, cottage cheese, kefir – these are the products that contain lactose in its natural form. For example, 100 grams of cheese, depending on the variety, can contain up to 6 milligrams of milk sugar. However, there are other foods that contain the so-called “hidden lactose”.

These include sausage, some types of sausages, chocolate, cakes. Read the label before using the products to understand the ingredients. “But these products contain a small amount of lactose, so some patients with lactase deficiency tolerate them well and can be eaten,” the specialist added.

How to tell if you are lactose intolerant

One way to detect lactose intolerance is to do a hydrogen test. The essence is simple – a special device compares samples of exhaled air before and after drinking a solution with lactose. And if you don’t want to resort to laboratory diagnostics, but do you still need to check the state of the intestinal microflora?

If, after drinking a glass of milk, bloating or abdominal pain occurs after 1-2 hours, lactase deficiency is suspected. To establish a diagnosis, it is necessary to exclude milk and dairy products from the diet for 2-3 weeks. “If the symptoms have completely disappeared, we can say with a fairly high degree of probability that you have a lactase deficiency,” said the gastroenterologist.