Food allergies involve abnormal reactions to dietary proteins, such as cow's milk protein, chicken egg protein, and soy protein. Infants are more likely to develop an allergy because their gastrointestinal tract is still immature. The intestine acts like a sieve with slightly larger holes here and there. This allows larger pieces of undigested protein to enter the bloodstream. This is usually harmless. However, in allergic infants, these proteins are recognized as "invaders." In response, the immune system produces antibodies that attack them. This leads to allergic reactions.
Problems such as spitting up, colic, diarrhea, crying, eczema, asthma, bronchitis, and inconsolable crying can indicate a food allergy. It's especially important to consider this if allergies run in the family. However, spitting up can also be caused by drinking too quickly or too much, and diarrhea by a limited (and therefore unhealthy) diet. Don't be too quick to assume an allergy, as you'll be imposing unnecessary restrictions on your child. If your baby exhibits some of the above symptoms and you're sure it's not due to something else, discuss it with your child's child health clinic or dietitian.
Breastfeeding is the most natural food for infants. Breast milk contains immune substances that may protect your baby against food allergies (including cow's milk allergies). Therefore, it's best to exclusively breastfeed your child for the first six months. Breast milk may contain traces of cow's milk protein. Using a cow's milk-free formula during breastfeeding is advisable to eliminate any risk of developing a cow's milk allergy. If you don't breastfeed or are unable to breastfeed for any reason, an infant formula based on predigested (hydrolyzed) whey protein offers a solution. This means it doesn't contain whole proteins, but rather, the proteins are essentially chopped into small pieces. If these small protein fragments enter the bloodstream through the intestines, your child's immune system won't recognize them as cow's milk protein. The body won't produce antibodies, thus preventing an allergic reaction.MEDICAL BACKGROUNDA food allergy is an immunologically mediated reaction to a food. The clinical symptoms are caused by reactions between consumed food components and specific antibodies (immunoglobulins) and/or T lymphocytes.
The final symptoms are preceded by a sensitization phase, during which antibodies are formed that react upon subsequent contact with the allergenic food substance.
A food allergy usually involves an atopic or anaphylactic (type I) reaction to a protein or protein-containing food. The antibody that plays the most important role in this is IgE. The best-known and most frequently described allergenic product is cow's milk.CAUSES OF FOOD (COW'S MILK PROTEIN) ALLERGYThe exact causes of food allergies are still unknown. While the factors involved are known, the exact interrelationships are unclear.
Genetic factors: children born to one or two atopic parents have a higher risk of developing an allergy. This is likely related to certain immune system traits that are passed on.
Suboptimal protein digestion: in infants, protein digestion is not yet optimal. Due to relatively low activity of protein-splitting enzymes and a relatively high pH in the stomach, protein may not be properly digested, and large protein molecules may pass through the intestinal wall and enter the bloodstream.
High intestinal permeability: it is known that the intestinal wall in infants is more permeable. This increases the chance that large protein molecules can pass through the intestinal wall.
Low concentration of secretory IgA: local defense in the intestine is provided by IgA. IgA is capable of coating food components with a protective "coat," preventing their absorption. In addition, IgA prevents the rest of the immune system from being attacked, which reduces the chance of an allergic reaction.SYMPTOMS OF FOOD (COW'S MILK PROTEIN) ALLERGYFood allergies can cause a wide range of relatively non-specific symptoms. In infants, gastrointestinal and skin symptoms are most commonly seen. These can manifest as vomiting/nausea/spitting up, poor appetite, diarrhea and/or constipation, diaper rash, atopic dermatitis, and urticaria.NUTRITIONAL POLICY FOR FOOD (COW'S MILK PROTEIN) ALLERGYIf a breastfed infant reacts to allergens in the mother's diet, the mother should limit or eliminate these allergenic foods from her diet. Allergens include dairy products, citrus fruits, eggs, nuts, and fish.
If the mother is not breastfeeding and the infant is allergic to cow's milk protein, infant formula based on cow's milk protein cannot be given. A commonly used alternative in the past was a soy-based formula. However, 10-35% of infants with a cow's milk protein allergy also develop an allergy to soy protein. An allergic reaction leads to damage to the small intestinal wall and increased permeability. If soy protein is given now, the large molecules of soy protein can also pass through the intestinal wall and cause an allergic reaction. Therefore, it is better to switch to a protein hydrolysate-based formula (free amino acids and short-chain peptides) as soon as a child exhibits an allergic reaction to cow's milk protein. The intestinal wall can then heal, and the risk of an allergic reaction is minimal.
However, using a protein hydrolysate does not completely eliminate the possibility of an allergic reaction. If an infant also has an allergic reaction to a protein hydrolysate—a very rare occurrence—an infant formula based on free amino acids offers a solution. |
