However, if untreated, the disorder is more likely to take a precipitous and fatal course ending in liver failure. There is also a high frequency of neonatal death from sepsis in untreated galactosemia infants, usually due to an Escherichia coli infection. For this reason, available literature advises doing immediate bacterial cultures on the blood, urine and cerebrospinal fluid of galactosemic neonates with clinical complications and administering antibiotics until results of the cultures are available. However, as a galactosemic infant is treated and the galactose level begins to decrease, the risk of infection with E. coli also decreases. In infants for whom treatment is delayed, severe symptoms may be avoided, but manifestations of mild residual brain damage may continue in the form of behavioral changes, impairment of visual perception, delayed mental development and sometimes epilepsy.
Cataracts are also likely to be present.
A child with galactosemia needs the same kinds and amounts of nutrients that a normal child needs for growth and development. However, the galactosemic child must have a diet which is free of galactose or any substance which yields galactose upon digestion. Since galactose is a component of lactose, a milk sugar, milk must be omitted from the diet in all of its forms. Parents of these children must learn to read food labels to determine contents of food products and become aware of foods which contain galactose. They should be instructed to look not only for milk, butter, cream or cheese in foods, but also for other forms of milk which contain lactose, such as non-fat dry milk, whey, or casein.