A newborn who is breastfeeding is diagnosed with galactosemia. What action should the nurse implement?

• A. Substitute a lactose-containing formula.
• B. Stop the infant breastfeeding.
• C. Add amino acids to breast milk.
• D. Give galactokinase with breast milk.

Answer: (B)

The important concept is that galactosemia means the baby cannot metabolize galactose, so any galactose in the diet must be removed. Breast milk contains lactose, which breaks down into glucose and galactose; continuing to feed breast milk will deliver galactose and risk toxicity to the liver and other organs. The correct action is to stop breastfeeding and feed a galactose-free, lactose-free formula (such as a suitable soy-based formula) so the infant receives nutrition without galactose. Substituting lactose-containing formula would keep introducing galactose, and adding amino acids or attempting to administer an enzyme won't address the ongoing galactose intake.