The most common reason for contacting an allergist with infants is food hypersensitivity, in particular, a reaction to antigens in cow's milk. Today's conversation is devoted to this problem.
The urgency of the problem
In the last decade, this type of hypersensitivity in babies up to 12 months of age has acquired new features:
- very early appearance;
- high prevalence;
- combined manifestations of allergies with symptoms from the digestive tract.
Cow's milk protein antigens are considered to be the strongest allergens. Milk contains more than 40 allergens.
The most dangerous are:
- caseins;
- bovine serum albumin;
- beta lactoglobulin;
- alpha lactalbumin.
Risk factors for food hypersensitivity to cow's milk proteins:
- hereditary predisposition;
- artificial feeding;
- eating a large amount of dairy products by a nursing mother;
- diseases of the gastrointestinal system in newborns;
- early introduction of complementary foods with the inclusion of dairy products.
How is cow protein allergy characterized in infants?
For young children, symptoms in the form of a skin rash - atopic dermatitis are characteristic. Most often, at the age of 2 to 3 months, mothers may notice reddening of the baby's cheeks. Redness can disappear and intensify.
Subsequently, bubbles appear at the site of the rash, which burst, and a weeping surface is formed, covered with crusts. The baby is very worried about itching. With an advanced form of allergy, the rash can cover the entire body of the child.
In some special cases, an allergic immune reaction to milk in a child can manifest itself as hives - the appearance of itchy blisters on the body. Against the background of urticaria, allergic edema of the face, eyelids, lips may appear.
Do not forget that in babies, allergic processes can mimic the pathologies of the gastrointestinal system. These manifestations complement the skin symptoms. Gastrointestinal manifestations include vomiting, intestinal colic, stool dilution, and increased gas production.
In children of the first month of life, the process of allergic inflammation in the tissues of the esophagus can be accompanied by severe pain and refusal of breast milk, resembling a picture of pylorospasm.
Why does cow's milk antigens become allergic?
These processes are associated with a decrease in the protective functions of the immune system to food allergens.
Even in the prenatal period, the type of response of the immune system is laid. In the presence of hereditary prerequisites, a Th-2 type of immune response is formed.
Allergens can cross the placenta, and also enter the fetus with amniotic fluid.
In children, due to physiological characteristics, there is an immaturity of the digestive tract. An increased antigenic load on the intestinal wall can trigger the formation of an allergic reaction.
Specific immunoglobulins E of the mother, starting from the 20th week of pregnancy, are able to cross the placenta.
Diagnostics
- Allergic anamnesis. An allergist, during a conversation, finds out the presence of close relatives of the first degree of relationship with established diagnoses of allergic diseases. Also, the doctor will pay attention to the peculiarities of pregnancy and childbirth, the type of feeding, the timing of the introduction of complementary foods.
- Keeping a food diary.
- Allergy tests - skin scarification and prick tests.
- Laboratory tests - detection of specific E antibodies to cow's milk antigens.
Treatment
The main method of therapy for food hypersensitivity is diet therapy.
If a small patient is breastfed, mothers are given a special diet with the exception of dairy products. Mothers are also advised to avoid foods with a high allergenic ability - chocolate, coffee, spices, mushrooms, nuts, strawberries, sausages, canned food. Pasta, gluten-containing cereals and sugar are limited.
Children receiving milk formulas are prescribed medicinal formulas-hydrolysates.
What are hydrolyzate mixes?
Highly hydrolysis mixtures are obtained by enzymatic degradation of the substrate - whey or casein to peptides. Peptides have a low molecular weight, which means that by hydrolysis it is possible to reduce the allergenicity of the mixture hundreds of times. Parents will find it helpful to familiarize themselves with the classification of hydrolyzate mixtures.
Classification of highly hydrolysis mixtures
According to the substrate undergoing hydrolysis, all mixtures are divided into casein and whey.
Casein is the least allergenic and is used for severe cases of allergy. Casein mixtures include "Pregemestil", "Frisopep AS", "Nutramigen". Whey blends are more nutritious and chemically valuable. These include "Alfare", "Nutrilon Pepti Allergy".
According to the degree of decomposition of the substrate mixture are divided into:
- highly hydrolyzed - "Alfare", "Neocate", "Frisopep";
- partially hydrolyzed prophylactic mixtures - "NAS GA", "Frisolak GA".
By chemical composition, the mixtures are divided into lactose-free, low and high lactose. There are also mixtures containing long chain and medium chain triglycerides.
For severe food allergies with disruption of the digestive tract, casein-free lactose-free mixtures are prescribed. Medium-chain triglycerides significantly increase the absorption of fats.
What you need to know if your toddler is prescribed protein hydrolysate formulas?
- Mixtures-hydrolysates are introduced very slowly, for at least 10 - 14 days. On the first day, no more than 10 ml of the mixture is given.
- Blends have a bitter taste and should be given before the previous blend.
- A change in the color and odor of feces in a newborn is possible, the stool may become liquefied.
- In the first days of the introduction of the mixture, there is increased gas formation and bloating.
Soy blends
If you have an allergic reaction to cow's milk antigens it is possible to use soy mixtures:
- Nutrilak Soy;
- Soybean Semp;
- "Frisosoy";
- Enfamil Soya.
These blends contain soy protein isolates. It is not recommended to introduce soy mixtures before 5 months of age.
Goat milk formulas
Goat milk has a reduced content of casein, beta-lactoglobulin, and alpha-lactalbumin has a different structure. New Zealand produces Nenny and Nenny the Golden Goat blends. The mixtures are well absorbed and have hypoallergenic properties.
"Amalthea" - instant dry goat milk, recommended for use in women during lactation and childbearing in order to prevent allergic diseases in the baby.
Introduction of complementary foods
Complementary foods are administered as prescribed by a doctor.
Start with monocomponent vegetable purees or lactose-free gluten-free cereals. From six months, you can enter canned meat puree from rabbit, horse meat, turkey, excluding beef and veal.
From 8 months of age, vegetable and cereal dishes with the addition of meat puree are introduced. The kid can be given apples, currants, cherries, yellow plums baked or in the form of compotes.
Until one year old, the child is not given cottage cheese, eggs and seafood.
Diet prophylaxis
Children from the risk group for the formation of allergic reactions to cow's milk protein are recommended hypoallergenic prophylactic mixtures. For example, "NAS Hypoallergenic", "Nutrilon GA", "Hipp GA". The mixtures are based on partially hydrolyzed peptides.
Breastfeeding is the main factor in preventing the development of food allergies by providing immunity from antigens. It is advisable to continue natural feeding for at least six months in order to reduce the risk of allergic processes.
Nuts, peanuts, chicken eggs, milk, seafood are excluded from the diet of a nursing mother. Cow's milk is injected after a year, chicken eggs after 24 months, nuts and seafood are not recommended until 3 years of age.
Memo to parents
Cow's milk protein antigens are considered to be the strongest allergens. For young children, manifestations of food hypersensitivity to cow's milk proteins are typical in the form of a skin rash - atopic dermatitis. What parents need to know:
- An increased antigenic load on the intestinal wall can trigger the formation of an allergic reaction.
- The main treatment for food allergies is diet therapy.
- Highly hydrolyzed mixtures are obtained by enzymatic degradation of the substrate - whey or casein to peptides. Peptides have a low molecular weight, and by hydrolysis it is possible to reduce the allergenicity of the mixture hundreds of times.
- Breastfeeding is the main factor in preventing the development of cow's milk allergy in infants, providing immunity from food antigens.
- Children from the high-risk group for the formation of allergic processes are recommended hypoallergenic prophylactic mixtures.
Article rating:
