If the baby is allergic to cow protein. What does Dr. Komarovsky say about allergies in babies? Recovery prognosis

At all times, milk was considered one of the most popular products, because it contains a lot of useful trace elements and vitamins. It is not surprising that today in stores you can find a huge range of dairy products for every taste.

But for many people, milk is contraindicated. This is most often the result of an allergy to cow's milk protein. Such an ailment can manifest itself in many ways, because milk contains dozens of different antigens, all of which can cause adverse reactions organism.

Allergy to milk protein in adults

Adults are not as susceptible to milk allergy as children, but it is more difficult to diagnose because it presents with a variety of symptoms, and if the allergen is not known in advance, then the allergy can be easily confused with other ailments.

The onset and severity of symptoms in adults depends on several factors:

• The degree of sensitivity to milk protein;
• The amount of the allergen that has entered the body;
• The ability of the body to resist the allergen;
• The general state of human health.

There are 3 stages in the development of an allergic reaction:

• Immune;
• Biochemical;
• Clinical.

Let's take a closer look at these stages.

immune stage

The first contact of antibodies occurs immune system and allergen. Antibodies try to cope with foreign substances, as a result of which the body becomes sensitized, that is, the body acquires hypersensitivity to the action of the allergen.

The essence of sensitization is to prepare the internal organs for the negative effects of foreign substances on them.

Biochemical stage

In the body, reactions begin to take place due to the presence of foreign particles. This stage develops when there is a second contact of the allergen with antibodies. In the area where contact has occurred, lymphocytes and antibodies accumulate, and together they try to isolate antigens.

During this, substances such as histamine and serotonin are formed in the body. They provoke initial signs allergies (skin rashes, fever, inflammation).

Clinical stage

The reaction begins from the tissues of the body. The degree of reaction is affected by the amount of the allergen, the body's ability to fight it and the general state of affairs with human health.

Clinical reactions can occur both instantly and with a delay of up to several days.

Symptoms of manifestation

Symptoms of milk protein allergy in adults:

Allergy to milk protein in children older than one year

While the child has symptoms of a reaction to milk protein, pediatricians recommend completely eliminating dangerous allergen from the child's diet.

Cow's milk can be replaced with other products such as:

Most often, an allergy to food disappears when a child reaches the age of three, when all body systems are formed.

If an allergy occurs to a particular substance, then such an allergy is not related to the immaturity of the organism and will manifest itself in each case of interaction of the organism with the allergen.

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Allergy to milk protein in children under one year old

For a newborn child, everything except mother's milk, any mixture is the coarsest food. In infants, the mucous membrane of the digestive tract is loose, immature, not protected by natural microflora, well passable for allergens.

Only by the age of 2 in children, the walls of the stomach and intestines acquire the ability to resist the introduction of pathogenic agents.

Milk allergy and lactose intolerance

There are two reasons why milk intolerance manifests itself:

• Intolerance to lactose contained in milk;
• Milk protein intolerance: casein, globulin, albumin.

The enzyme lactase is responsible for the processing of lactose, if there is a lack of lactase in the body, then the reaction to milk immediately follows from the immune system. Lactase is produced from the cells that make up the small intestine and is responsible for dissolving the sugar found in dairy products.

Lactase deficiency can be the result of inflammatory processes and infections.

Allergy to milk allergic reaction on proteins that are present in milk, and not on lactose. People with a milk allergy can tolerate lactose if it is separated from the milk proteins.

AT infancy the body may react to milk due to lactose intolerance, because at this age the child mainly feeds on mother's milk.

Let's bring comparative analysis symptoms of lactose deficiency and cow's milk protein allergy:

As seen, characteristics may be similar. When they appear, you need to carefully monitor the condition of the child.

Causes of the disease

When the allergen is cow's milk protein, the body may react to one or more of the 25 proteins found in milk.

Factors causing a reaction for milk protein:

• Heredity. The patient's immune system may simply not be able to cope with the production of the required number of enzymes for the digestion of milk;
• Bad ecology;
• There were pathologies during pregnancy(premature birth, constant stress and etc.);
• Parental lifestyle, attention to healthy lifestyle family life;
• Avitaminosis;
• Frequent use of immunostimulants.

Possible causes of an allergy specifically to cow's milk protein:

Allergens, along with the blood, enter all parts of the body, therefore, it is not known which organs can be affected due to an allergy to cow's milk protein. The process can be aggravated by the course of other diseases, such as SARS, various infections, etc.

Allergy to cow protein can be manifested by a violation in the work:

• Gastrointestinal tract;
• Skin lesions;
• Respiratory system.

If problems in the gastrointestinal tract in infants are caused by an allergy to cow's milk, then the body may react as follows:

The skin is also prone to manifestations of milk allergy.

Symptoms:

Problems with the respiratory system are quite rare, but they are still useful to know.

The following symptoms appear:

How to determine that this is a reaction to milk?

The doctor necessarily conducts a visual examination, draws attention to the condition of the skin, is interested in the general condition of the patient.

The more detailed the patient describes the clinical picture of the disease, the more likely the doctor can help.

Do not try to diagnose yourself, your loved ones, especially children.

Remember, only a certified pediatrician can correctly diagnose a child. Parents do not need to self-medicate and give the child all kinds of medicines.

Digestive system baby not formed, and there is a risk of even more harm to the health of the baby.

In order to properly diagnose a disease, you must:

• Get tested for lactose intolerance. Manifestations of lactase deficiency are easily confused with an allergy to cow's milk protein;
• Pass medical tests.

Testing for lactose intolerance

The very test for lactase deficiency is adherence to a lactose-free diet (with symptoms in an infant, the mother adheres to the diet).

Lactose is a constituent of all dairy products, including milk, butter, cheeses and cream.

Present in all derivatives of dairy products:

If after a few days the manifestations of the disease disappear, it can be said for sure that the cause is lactase deficiency.

If it is an allergy to protein, then for recovery it is necessary that the contact of the allergen with the body stops completely, and this long process and in a few days, as a rule, it does not pass.

Analyzes

If the symptoms remain, then a set of tests is carried out to identify the allergen, among them:

• General urine analysis. The level of protein should be increased, the presence of erythrocytes in the urine is possible;
• Blood test(general and biochemical);

If allergic reactions occur in the body, then there should be many immune complexes in the blood:

• Determination of the amount of immunoglobulins IgE, IgG;
• Determination of the degree of sensitization of the body to milk proteins.

Scarifying tests

Apart from laboratory tests in allergology, the use of skin scarification tests.

During their implementation, shallow scratches 0.5–1.0 cm long are made on the skin of the forearm or back, on which one drop of a different allergen is applied.

Near each scratch, a brief designation of the allergen that was applied is inscribed with a pen.

In the case of an allergy to milk, various proteins, fats and carbohydrates that are part of it are used separately as allergens.

After a certain time, an inflammatory shaft is formed around one or more scratches, which is larger in size than around the other scratches. This means that the body shows an allergic reaction to this component of milk.

What if the baby is allergic to milk?

In this case, you need to follow a few rules:

• Mom needs to follow a hypoallergenic diet and breastfeed the baby for as long as possible, because mother's milk contains everything necessary for normal development baby;
• Dairy products should be excluded and products that may contain milk proteins in one form or another (ice cream, pastries, etc.):
  • when the allergy is mild, the mother can consume sour-milk products in small volumes: kefir, fermented baked milk, sour cream;
  • when the allergy is severe, the mother will have to completely abandon not only the “milk”, but most likely also products such as eggs and fish;
• The same principle applies to the feeding situation:
  • completely eliminate the "milk" - if the allergy is pronounced;
  • use dairy products possible with subtle symptoms. This is due to the fact that during the fermentation of dairy products, the protein is broken down into amino acids, the processing of which is much easier for the body to cope with.

What to do if an artificial person is allergic to milk?

Many formulas for complementary foods contain milk protein. If the child is allergic to it, then it is necessary to switch to mixtures of hydroisolated proteins or amino acids.

There is an option to use a mixture based on goat's milk, but here you need to be very careful in order to diagnose allergy symptoms in time if they appear. There are also soy mixtures on the market, they are allowed only after six months and provided that the child is not allergic to soy.

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Therapeutic measures to eliminate the problem

The main thing in treatment is to exclude contact with the allergen. In this situation, the symptoms should go away on their own, and all that remains so that the allergy no longer causes inconvenience is to carefully monitor your and your child's diet.

There is also a more radical way - drug treatment. There are several types of drug treatment available.

The use of antihistamines

Such drugs reduce the production of histamine, prevent the recurrence of the disease, accelerate the process of destruction of histamine in the tissues.

In acute form of allergy (anaphylactic shock, lesion large areas skin), you can use such means as:

• Suprastin(available in tablets, allowed to use from 1 month, average price 120 rubles );
• Tavegil(available in tablet form, as a syrup, solution for injection,
  price 110 - 250 rubles) ;
• Loratadine 20 rubles ).

For allergies without complications, you can use:

• Telfast(available in tablets, average price 130 rubles );
• Tsetrin(available in tablets, average price 150 rubles );
• Claritin(available in tablet form and as a syrup, price 210 - 600 rubles).

The use of enterosorbents

This is required element treatment. Such drugs well remove allergens from the body, prevent further intoxication and slagging of the body, and also improve the intestinal microflora.

These include:

• Enterosgel(average price 400 rubles );
• Activated carbon(average price 30 rubles );
• White coal(average price 120 rubles );
• Smecta(average price 200 rubles );
• Sorbex(average price 100 rubles ).

The use of external agents

Non-hormonal ointments and creams against allergies

The active ingredients of such drugs reduce inflammation, relieve itching, prevent the development skin reactions, soften the skin and relieve irritation.

These include:

• Fenistil-gel(average price 400 rubles );
• Bepanthen(average price 320 rubles );
• Dermadrin(average price 120 rubles );
• Epidel(average price 800 rubles ).

Hormonal anti-allergic ointments and creams

These drugs are also called corticosteroids. They are necessary for strong reactions to skin, as well as in cases where non-hormonal ointments do not give the desired result. They have powerful anti-inflammatory, anti-allergic and immunosuppressive effects.

These ointments and creams include:

• Triderm(average price 750 rubles );
• Hydrocortisone ointment(average price 30 rubles );
• Gistan(average price 140 rubles );
• Advantan(price 500 - 1300 rubles );
• Prednisolone ointment(average price 20 rubles );
• Sinaflan(average price 30 rubles ).

For babies, such ointments are absolutely contraindicated for up to four months, but even after that they must be used with very great care.

Doctors may also prescribe the following drugs to relieve allergy symptoms:

• Salbutamol- relieves shortness of breath, narrows blood vessels in the bronchi, causes muscle relaxation, average price 120 rubles ;
• Claridol- relieves swelling and suppresses cough, can cause a sedative effect, average price 80 rubles ;
• Xylometazoline- stops the secretion of mucus from the nose, as it has a powerful vasoconstrictor effect, the average price 50 rubles ;
• Olopatadin- relieves itching of the eyelids, eliminates tearing and redness of the eyes, average price 350 rubles .

Before using any of the above drugs, a consultation with your doctor is required.

Folk remedies for milk allergy

Exist great amount folk ways in the fight against manifestations of allergy to milk. Consider the most effective of them.

Baths with beneficial herbal decoctions

Allergy often manifests itself on the skin, and traditional healers recommend regularly taking baths with useful herbal decoctions. For this, herbs that have anti-inflammatory, antipruritic effects are better suited.

These include:

• Chamomile- to prepare chamomile decoction, take 300 g of dry grass, pour 5 liters of water, boil and leave for 2 hours to infuse, then use immediately;
• Mint- brew 100-200 g of dry chopped peppermint herb 2-3 liters of boiling water and insist in a warm place under the lid for 30 minutes, then strain and add to the water for a general bath.
  The duration of the procedure is 10-15 minutes. Course - 10-12 baths;
• Sage- condensed condensate is used to prepare the bath clary sage. The drug is added at the rate of 200 ml per 100 liters of water. The duration of the procedure is 8-15 minutes. It is recommended to take baths every other day or according to the scheme “two days in a row with a break for the third”. Course - 12-18 baths;
• Calendula- finely chop 1 kg of leaves, flowers and stems of the plant and pour a mass of 3-4 liters of cold water. Let it brew for 5-10 minutes, then put on fire and cook for 5 minutes. Remove from heat and insist 10 minutes. Strain and add to bath water.

Other recipes

Recipes for babies

For babies, a decoction of dill seeds is more suitable.

It will help you deal with digestive issues.

To prepare such a decoction, you need to pour half a teaspoon of seeds with boiling water and let it brew.

After the broth has cooled, give 3-5 drops to the child.

Gradually, a single dosage is increased to a spoon.

You need to be careful when using traditional medicine methods in the treatment of children. Infusions from some medicinal herbs are contraindicated in children under three years of age, and their use may lead to new health problems. Such herbs, for example, include a series.

Tired of dermatitis?

Peeling of the skin, rash, itching, ulcers and blisters, cracks - these are all unpleasant symptoms of dermatitis.

Without treatment, the disease progresses, the area of ​​\u200b\u200bthe skin affected by the rash increases.

It has the following properties:

• Relieves itching after the first application
• Restores, softens and moisturizes the skin
• Eliminates rash and peeling of the skin in 3-5 days
• After 19-21 days completely eliminates plaques and traces of them
• Prevents the appearance of new plaques and an increase in their area

Prevention

In the case of a milk allergy, the best solution is not to eat foods that contain milk protein.

This, by at least, will protect against the most allergic reaction.

It is also necessary before buying any product to carefully study its composition for the content of allergens in it.

It is important to know that even after several years of preventive treatment against milk protein allergy, milk should not be contacted.

And if at the first contact there may not be a violent allergic reaction, then with repeated contacts, it can appear immediately.

This will happen because by the first contact in the body there will not be the required amount of antibodies, but after a while, the immune system will definitely develop new antibodies, they will come into contact with the allergen, and, as a result, the allergy will manifest itself.

So that the children infancy milk allergy was not necessary:

• Expectant mother scrupulously approach the issue of nutrition during pregnancy;
• No intoxication during pregnancy (alcohol, cigarettes, etc.);
• In the first months of breastfeeding, mothers can potentially avoid hazardous products, due to which allergies may occur;
• During feeding, replace milk in the mother's diet with fermented milk products;
• Pass periodically preventive treatment from possible allergies.

If a child still shows symptoms of an allergy to milk protein, you need to carefully monitor the situation and take timely measures to avoid difficulties, such as various pathologies. internal organs or dermatological problems.

Forecast

Nowadays, more and more people are suffering from milk protein allergy. Unfortunately, many of them are children. But now, with the development of medicine, it has become much easier to determine what exactly caused the allergy, and therefore its treatment is much more successful than before.

According to various studies, almost half of all children, upon reaching the age of one year, get rid of this disease, and almost 90% recover by 3-4 years.

Rarely, a milk protein allergy persists for life. But even then, people have a reasonable hope for allergists, because every year more and more drugs are invented that can really help with this problem.

The benefits of cow's milk are mentioned in many scientific sources. This is also confirmed by experience - since childhood, many children have been told by their parents that cow's milk is the key to good and good health. Unfortunately, an allergy to cow protein is considered a common occurrence, which appears most often in infants and children under 2 years of age. How to determine such a disease, why does it appear and how can an allergy to milk in a baby be eliminated?

Pediatricians do not recommend using pure cow's milk for feeding babies and young children. Its composition is fundamentally different from women's milk- its fat content is much higher, it contains 4 times more calcium and 7 times more phosphorus, 2-3 times more protein. The body of a child who was recently born is not able to cope with so many micro and macro elements. As a result, an allergic reaction occurs - the body's response to an excess of substances that cannot be absorbed.

Types of allergy to cow's milk protein

Allergy to cow's milk protein in infants can be of two types - true and false

1. The appearance of a true allergy is typical when using even a small amount of cow's milk. Protein compounds of milk are perceived by the body as potentially harmful agents, regardless of their quantity. In some cases, it is possible for a baby to be allergic to cow protein even with normal breastfeeding - this is possible provided that the mother ate a lot of dairy products before feeding.

2. A false allergy occurs when the child has received excess amount cow's milk. In this case, an allergy occurs due to the peculiarities of the work of the pancreas of a newborn - due to the lack of special enzymes responsible for the processing of milk, it is impossible to assimilate the entire amount of the product, as a result of which an allergic reaction occurs.

Note that the appearance of an allergy to cow's milk protein is a rather rare phenomenon that can appear only in certain groups of children with a number of predisposing factors.

Which babies can get allergies

We noted above that an allergy to dairy products in infants may appear if there are certain predisposing factors. According to statistics, at the moment such an allergic reaction occurs in 5-10 percent of children under 1 year old. In the future, when growing up, the indicator decreases, and closer to preschool age, almost every child is able to easily absorb cow's milk. All this is due to the peculiarities of the immune system, which is fully formed by the age of 7-9.

Factors that can trigger an allergic reaction

1. Availability genetic predisposition. In particular, the likelihood of a disease is high if the mother had hay fever, allergic dermatitis, or other allergic reactions.

2. Bad ecological situation- the presence of harmful production in the district where the child grows up, the negative sanitary situation in the room where the child is.

3. Significantly increases the risk of allergies if the mother has bad habits during pregnancy.

Above we have listed the causes of true allergies - false form can occur even if the child has not been exposed to any negative factors.

Symptoms of cow's milk protein allergy

The symptoms of an allergy to cow protein in infants are extensive - there are manifestations from the digestive, respiratory systems, as well as skin integuments. The following phenomena are characteristic of the digestive system: the presence of undigested milk in the feces, pain in the child's stomach, due to which the child becomes restless, often cries, flatulence is possible, a slight increase in temperature, intestinal peristalsis, vomiting after eating.

Quite often, the symptoms of an allergy to milk protein in a baby are perceived as ordinary intestinal colic - parents begin to react only when a rash appears in the child. That is why, in order to eliminate the likelihood of developing a chronic form of the disease, it is necessary to immediately contact a pediatrician in case of repeated occurrence of such symptoms after taking cow's milk.

On the part of the skin, the following symptoms are possible:

1. A milky scab appears, manifesting itself in the form of clearly defined spots covered with peeling. They occur in the face, chest or behind the ears.

2. Children's eczema - the appearance of a symptom in infants up to 6 months is characteristic in case of an allergic reaction to milk. First, rashes appear in the form of small blisters, which then turn into erosive spots that heal after a few days.

3. Another characteristic feature is the presence of spots of atopic dermatitis. The most possible localization is in the area of ​​the elbow bends. It is a bright red, flaky patches that cause severe itching.

4. In some cases, urticaria may appear.

5. One of the most severe symptoms is Quincke's edema, which can be localized on any surface, including internal organs. The occurrence of such edema in the lungs or larynx is dangerous, since they can lead to asphyxia and death of the child.

Like any other allergy, in a baby, an allergy to milk protein also affects the respiratory system. There are characteristic signs of the presence of an allergen - the child often sneezes, coughs, in some cases allergic rhinitis may appear. In the absence of timely treatment, the development of bronchial asthma is possible.

How to identify a milk protein allergy

Note that the symptoms of milk allergy in infants can be confused with the clinical picture of another disease. That is why it is strictly forbidden to make a diagnosis on your own, based only on your own assumptions. The symptoms we

listed above can only be a signal to parents that it is necessary to seek help from an allergist.

Diagnostic studies include the collection of anamnesis, blood tests, feces, as well as special allergic tests. If the baby is allergic to protein, doctors will be able to detect this based on the diagnosis - in the end this will allow the correct treatment to be prescribed.

How to cure milk protein allergy

We examined how cow protein allergy manifests itself, now we will consider how it can be cured. The most effective method of how an allergy to milk in infants can be eliminated is the exclusion of cow's milk from the child's diet. This is the easiest, most efficient and safest way. It is not required to take antihistamines, it is not necessary to carry out special therapy for the development of body resistance to protein.

Proper treatment involves the exclusion of dairy products from the diet of not only the child, but also the mother. In addition, it is desirable for a child to replace regular milk with hydrolyzed milk, and at the age of 6 months, milk of plant origin (for example, soy) can be given. Such a diet will be more expensive than using regular cow's milk, but there are no other, more acceptable methods. In some cases, goat milk can be used, but there is a high chance that the allergy will reappear.

It can also be carried out ancillary treatment aimed at eliminating the manifestation of symptoms of an allergy to cow protein. In this case, special remedies can be used to eliminate redness, rashes, severe itching and problems with the digestive system.

One of the first allergens that a newborn baby encounters is cow's milk protein. It causes a reaction in every twentieth baby.

There are certain ways by which you can identify that the baby is suffering from an allergy to cow's milk, and improve his well-being.

Causes of intolerance

An allergy is an immune response to foreign substances.

But digestive system the baby is still so immature that sometimes it does not have enough enzymes to fully break down the protein. Separate links of the protein chain are perceived by immune cells as foreign, as a result of which the baby develops an allergy to cow's milk protein.

Factors that increase the risk of developing intolerance in a newborn:

• Heredity;
• Unfavorable ecological situation;
• Complicated course of pregnancy (threat of miscarriage, fetal hypoxia, preeclampsia, and so on);
• Artificial feeding;
• The nature of the nutrition of a nursing mother.

By the age of 2-3, when the child's digestive system is mature enough to resist allergens, many children outgrow the milk protein allergy. But some of them are allergic to dairy products throughout their lives.

Milk allergy symptoms

Symptoms of allergy to cow's milk protein in infants are diverse.

All manifestations of allergy to milk protein can be combined into several large groups:

1. From the gastrointestinal tract: diarrhea (sometimes interspersed with blood or mucus), colic, profuse regurgitation after eating, increased gas formation, lagging behind in weight from their peers, bleeding, dehydration;
2. On the part of the skin: milk scab (crusts on the head), atopic dermatitis, urticaria, eczema, Quincke's edema;
3. From the respiratory system: allergic rhinitis, shortness of breath, cough, wheezing.

When they occur, there is real threat the health and life of the newborn, and he needs immediate medical attention.

Way out

The allergist makes a diagnosis after examining the child, interviewing the mother and receiving test results. To identify allergies, you need to take a blood test for allergens, a stool test and a skin prick test.

The strategy for dealing with allergies is determined by the way the child is fed. If the baby is breastfed, the mother is prescribed a special diet.

She will have to give up not only milk, but also all products with its content (butter, cream, cottage cheese, kefir, fermented baked milk, condensed milk, and so on). A noticeable improvement in the condition of the newborn should occur in 14-30 days.

If the baby is fed with an adapted mixture, it is necessary to exclude the usual mixtures that are made on the basis of cow's milk. The baby is switched to either goat milk formula (NANNIE, Goat) or hydrolysate formula.

Feeding with goat's milk formula cannot be 100% guaranteed to get rid of allergies, because the baby may also have a reaction to it. Another disadvantage of these mixtures is their high cost compared to conventional ones.

In hydrolysate mixtures, the protein molecules are already partially broken down, so they are easier to digest. Depending on the severity of allergy manifestations, a mixture with partial or deep protein hydrolysis is selected.

On the packaging of such mixtures there is always a mark "hypoallergenic". After six months of using them, you can make a second attempt to return to the usual baby food based on cow's milk.

Conclusion

The main weapon in the fight against allergies is the correct diagnosis. After identifying the allergen and excluding it from the baby's diet, the child's condition will improve much. It is highly likely that with age, the manifestation of such a factor as an allergy to cow's milk protein in infants will weaken or disappear altogether.

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Allergy or lactase deficiency?

To properly get rid of local symptoms and eliminate the risk of secondary food allergies, you need to understand what kind of ailment babies suffer from. Children under 4 years of age experience some problems with the absorption of milk protein, and with allergies with mild manifestations, this is normal. But in addition to insufficient fermentation (this is the reason that causes partial indigestion of milk protein), there is a more serious problem - lactase deficiency.

This is an extreme dairy protein intolerance. The body of a child 1 year old and younger with insufficiency cannot absorb not only fermented milk products, but also sheep, cow, even mother's milk. There are simply no enzymes in his gastrointestinal tract that could cope with the breakdown of a complex milk peptide, which can be manifested by vomiting, diarrhea. A peptide is a component of a protein, which is then broken down into amino acids. In addition to it, the mixtures contain milk sugar. Both peptides and milk sugar are contraindicated for a baby with lactase deficiency.

The diet of a baby with this problem excludes all dairy products, the child is transferred from breastfeeding to artificial. Read more about the diet for children with lactase intolerance - below.

In the video, Dr. Komarovsky talks about cow's milk:

Reaction to mother's milk

Subject to the rules of breastfeeding, a child cannot develop an allergy to mother's milk. When symptoms appear, the influence of two reasons is likely:

1. Artificial additives, vegetable or dairy are added to food;
2. The child is lactose intolerant.

When adding additional elements to the diet, you should immediately exclude them and seek the advice of a doctor. If the case is in lactase deficiency, which causes rejection, the child is registered with a local pediatrician and must be fed with a special diet, since the disease itself will not go away.

Symptoms of the disease

Allergy to cow's milk protein or other dairy product manifested by several symptoms of varying severity. They include both skin rashes and problems of the digestive system or respiratory tract. How does milk allergy manifest itself? Easiest to notice skin manifestations:

• red rashes (atopic dermatitis);
• rash with small dots (urticaria);
• milk scab;
• swelling of the neck and head region (Quincke's edema).

Quincke's edema is the most dangerous. This is an instant allergic reaction that develops within half an hour to an hour and can be fatal. Edema is primarily affected by the respiratory organs. At the first stages of tumor growth, the respiratory lumen is closed, the small allergy sufferer has nothing to breathe. To relieve swelling, ventilate the lungs at the time of the peak of swelling and save the life of a child with allergies, it is necessary to call an ambulance. Numerous skin rashes are also dangerous. They can easily harm the still fragile body of the baby, especially if he has not reached the age of 1 year.

An allergy to cow's milk, goat's or sheep's milk also manifests itself in the form of specific respiratory problems:

• narrowing of the airways;
• hoarseness when breathing;
• cough;
• runny nose;
• sputum.

Most of these symptoms pose a serious threat to the baby. If symptoms that manifest as a dairy allergy prevent him from getting enough oxygen, an ambulance is the only solution.

It is important to know how an allergy to cow's protein manifests itself in infants, symptoms when affecting the gastrointestinal tract:

• diarrhea;
• constipation;
• vomit;
• too frequent spitting up;
• underweight (determined by the development table and the words of the doctor).

Digestive problems are the most harmless for a child, the main thing is that each one goes away. But there are facts that are rarely noticeable (even a mother may not reveal them), but they serious reason see a doctor. When blood clots appear in the stool, with a strong underweight, a doctor's examination is mandatory.

How to distinguish allergies from other body problems

Allergy to sour-milk products is not a necessary prerequisite for negative manifestations. To distinguish the reaction of the body to an allergen from a chronic or temporary illness, you need to know which disease symptoms it is similar to.

With problems of the respiratory type, the cause is not caused by allergies, but by the presence of bronchitis, asthma, or a common cold. To distinguish the disease, it is best to consult a doctor, but at home, you can also try to separate the ailments. infectious and others respiratory diseases characterized by the appearance of temperature, weakness, runny nose in newborns.

Poisoning or intoxication of the body with harmful substances can often be confused with a reaction to an allergen. Only a specialist can check what exactly is wrong with the child.

The easiest way is for the mother, who introduced complementary foods to the baby gradually. A newborn without symptoms of the disease suddenly begins to cough - it means that the new complementary foods are to blame. Having determined its expiration date and other characteristics, it is easy to understand whether the matter lies in poisoning or in the wrong approach to allergens.

In the video, an allergist-immunologist talks about an allergy to milk:

Reasons for the appearance

Allergic reactions of the body rarely appear just like that. They are based on either a hereditary predisposition or a problematic environment.

The behavior of the mother and her genes mainly affect the development of allergies. If in the family (from the side of the father too) allergies were noticed with a reaction to milk protein, then the disease is genetic and incurable. It can only be compensated by symptomatic treatment. If the allergy to dairy products developed gradually, then the point is too early complementary foods or nutrition of the wet nurse. If she consumed a lot of sweet milk ingredients, seafood, then the risk of a negative reaction to allergens increases.

If the child was taken away from the mother early and switched to artificial feeding, then with a probability of 30% he will develop an allergic predisposition.

Wheat allergy or other problems are more likely to appear. Possible further negative reaction to milk and eggs. The program developed by Komarovsky will help reduce the risk.

The harmful effect of a dairy product on a child can be caused by the ingress of chemicals into it. This happens when treating an animal that then produced milk. Feeding cereals, kefir, cottage cheese allows such a reason.

Often, the reaction to milk in children under one year old is especially strong, and disappears when they reach 4 years old, but can turn into other manifestations: intolerance to eggs, etc. Finally, the primary allergy disappears at the age of 5 years.

What to replace milk

Dairy products make up most human diet in the first 2 years of life. How to replace milk, it is still impossible to give too many cereals, meat and herbal products? When it appears backlash for cow's milk in infants, it seems to mothers that now it will be very difficult to make up a child's nutrition. However, milk allergy has one peculiarity.

Except in cases of lactase deficiency, a child cannot be cross-allergic to cow's, sheep's or goat's milk at the same time. The cross state is characterized by the fact that a person has intolerance to several related products. This does not happen with milk and dry mixes, since each animal product contains its own protein. In cows it is casein, and in goats and sheep it is another substance. Only reactions to powdered milk, which contains cow protein, are likely.

If an allergy to goat's milk is noticed, then the possibility of intolerance to sheep's or cow's milk is extremely small. The milk of some animals is simply replaced by another.

How to feed a child with lactase deficiency? It's harder to find a way out here. It does not allow you to eat any products with dairy components. Allergy to milk in children is more gentle, but for children with insufficiency, special fermented mixtures are being developed. At the extreme stage of the development of the disease, a mixture with one of the types of amino acids is used - the end product of the breakdown of the substance. Just in case, wheat flour is excluded, which can also be an allergen.

When compiling a diet, it should be taken into account that the mixtures replace only part of the dairy products. They cannot underlie other fermented milk products. Then the child needs to be distracted by other types of food: vegetable purees, canned meat for children, which are easy to give after a year. The main thing is that the composition does not include predominantly egg white.

In order to avoid the development of allergies, you need to follow a few simple rules feeding the child and transferring him to adult food:

1. Maximum breastfeeding. Usually, other types of food begin to be fed at about 4 months, but to completely eliminate the likelihood of acquired allergies, experts advise starting to enter only at 8 months. One of these specialists is the allergist Komarovsky. He does not offer treatment for allergies, but seeks ways to relieve symptoms.
2. When switching to a new diet, start with fermented milk products or dietary mixtures. They include only partially fermented dairy products (peptides and sugars) in their composition. Such content is digested much easier and is necessary for the transition to a new food.
3. You need to enter only one product at a time, it is better - one new food in 3-4 days. Then it will be easier to track down what caused the food allergy and whether it is a reaction to other types of food.

The main rule is how to make proper diet the baby is the care and attention of the mother. Until the child has reached the age of 4 years, the problem is especially dangerous.

Proper introduction of complementary foods and a full check of the baby for allergies - the only way recognize an allergic reaction and reduce the risk of it occurring. You need to understand that the reaction can even be to milk porridge. The later the child is weaned from the mother's breast and transferred to artificial or sour-milk nutrition, the better.

We must not forget that even with the right balance of nutrition, breastfeeding and constant supervision of the child, he may suddenly develop an allergy. In this case, you can not ignore the symptoms, you must urgently contact pediatrician and call an ambulance.

po-detski.ru

Today, an allergy to cow's milk protein affects about 5-8% of all infants. There is an allergy to this protein and its intolerance. The first case is a special reaction of the immune system, the second is the difficulty of digesting certain foods and has nothing to do with the immune system.

An allergy to cow protein in infants most often does not threaten life and does not belong to severe pathologies, but it significantly complicates the life of parents. In half of the children, such a reaction to cow's milk disappears by the age of one, and after reaching the age of five, almost 90% of children get rid of this pathology. Lifelong intolerance to cow's milk is very rare.

Allergy to cow protein in infants: symptoms

Symptoms of bovine protein allergy in infants can develop in two ways: immediate - within a couple of hours, or delayed - over several days. Signs of such a violation are:

1. Redness and eruptions on the buttocks, cheeks and forearms.
2. Nasal congestion, rapid breathing, runny nose, coughing, sneezing.
3. Vomiting, colic, belching, diarrhea with foam, flatulence.

Especially severe symptoms from the digestive system are observed in children of the first weeks of life. They may experience vomiting, bloating, and diarrhea after drinking milk, with traces of thick mucus. In addition, there is a capriciousness and irritability of the child, a violation of sleep and appetite. If a re-admission milk does not occur, all symptoms begin to disappear after three days.

With the continuation of feeding the child with dairy products, the signs of allergy will increase. Itchy dermatoses, swelling and redness appear on the skin. Since the itching with an allergic rash is very severe, scratching may occur and secondary infection may occur.

One of the most serious manifestations of an allergy to cow's milk protein is anaphylaxis. This condition is characterized by a rapid sudden onset and development. After taking milk, the child's skin turns pale, swelling of the throat and face and spasm of the muscles of the larynx begin. In parallel with this, a convulsive syndrome appears. In the absence of urgent medical care the consequences can be severe.

Causes of cow protein allergy in infants

There are up to 20 varieties of cow's milk proteins, most of all here are caseins. Most often, the reaction is caused by several types of such proteins. Some children also develop beef allergies. However, when cooking with high temperatures meat protein becomes inactive, but milk protein retains its activity even when boiled.

There are several reasons for the development of an allergy to cow protein in infants:

1. Genetic hereditary tendency to the appearance of allergic reactions. It does not matter what kind of reaction the baby's relatives have: food allergies, hay fever, bronchial asthma, and more.
2. Artificial feeding. Especially often, an allergy to milk protein appears with a rapid transition from breast milk to artificial nutrition or with the sudden introduction of a new product into the diet.
3. Incorrect dilution of infant formula.
4. Diseases and stressful situations. The transition to a new formula or the introduction of milk (as well as other new products) into the diet should not coincide with vaccinations, colds, extreme heat, dysbacteriosis and other stressful situations in the baby's life.
5. Lactase. The cause of an allergy to cow protein in infants is an incorrect reaction of the immune system to this product. This pathology must be differentiated from lactose deficiency, accompanied by similar symptoms.

Diagnosis of protein allergy in infants

To determine if a child is allergic to cow protein, you need to visit a pediatrician who will prescribe a set of necessary examinations. An important role in the diagnosis of protein allergy in infants is given to such data as the manifestation of an allergy in a baby and the presence of certain diseases in his relatives (atopic dermatitis, bronchial asthma, hay fever, urticaria, and others). The doctor also pays attention to how the child is gaining weight.

To diagnose a protein allergy, a prick test, or allergy test, is usually performed. As a result of this study, the presence of immunoglobulin E proteins in the blood is revealed.

In some cases, against the background of the absence of dairy products in the diet, a provocative test is performed. But this type of diagnosis requires close attention of doctors and stay in the hospital.

grudnichki.com

Causes of milk allergy

There are two reasons that contribute to the development of allergies in childhood:

1. Complete or relative lactase deficiency - this condition develops in the body of those babies who, from birth, do not produce enough special enzyme lactase, which is involved in the breakdown of milk lactose. As a result of such incomplete breakdown of animal protein, substances are formed that can be perceived by the body as harmful (foreign).
2. Intolerance to the protein itself, contained in cow's (goat's, sheep's, etc.) milk.

For artificial feeding of children with this pathology, special mixtures prepared on a dairy-free basis or using vegetable milk (soy, rice, oat, coconut, etc.) should be used.

Main symptoms

As a rule, a reaction of any type does not develop after one use of a dairy product. A true allergy does not appear immediately, but after re-entering the digestive system of cow's or other milk. The process of allergization of the body takes at least 1 hour, in some children the first symptoms of food allergies may appear after 1-2 days. This should be taken into account when taking an anamnesis at a doctor's appointment.

Common symptoms of milk allergy in babies are:

1. Skin manifestations - rashes, peeling, areas of redness, diaper rash, itching.
2. Appetite disturbance - a decrease in the volume or frequency of feedings, a complete refusal of the baby to eat.
3. Dyspeptic disorders - frequent regurgitation immediately after feeding, periodic vomiting.
4. Intestinal symptoms - frequent stools with sour smell, diarrhea, intestinal colic, bloating.
5. Stopping weight gain, underweight.
6. Pathology of the respiratory system - increased production of nasopharyngeal mucus, swelling of the airways, leading to difficulty breathing for the baby.
7. A rare form of milk allergy is an anaphylactic reaction.

Casein Allergy Diagnosis

Recognizing the cause of an allergy on your own is quite difficult, without special knowledge. Only an allergist can help in diagnosing the causative factor. He will be able to establish the final verdict after collecting all the complaints, a detailed examination of the baby, conducting additional studies and specific tests.

Common symptoms of food allergies are skin manifestations - rash, irritation, dryness of certain parts of the body. To identify causal relationships between skin rashes and milk allergy, it is enough to keep a food diary, exclude milk and mixtures based on it from the child's diet. It is also possible for trained medical staff"provocative test".

If the baby has other symptoms (intestinal, respiratory), diagnosis between different types of allergens is possible only with the help of special surveys(skin tests, determination of immunoglobulin E to various products).

In favor of an allergy to milk in infants, a hereditary history also testifies. Most members of the same family can clearly trace food intolerance to dairy products or various kinds of allergic reactions when they are consumed.

Principles of treatment of food allergy to milk

To prevent the development of allergic reactions in young children, highly adapted formulas are made on a dairy-free basis, using soy or hydrolyzed protein.

Preventive mixtures include: "Nutrilon hypoallergenic 1, 2", "NAS hypoallergenic 1, 2". With therapeutic purpose highly adapted mixtures are used: Alfare, Frisopep, Nutrilon-Pepti TSC, etc. Lactose-free products for artificial feeding help to cope with lactase deficiency.

As the child grows older and with the introduction of complementary foods, products made from milk and dairy components should be avoided. Also, with a delay from the usual deadlines, ingredients with a high percentage of allergenicity should be given - eggs, fish, cottage cheese, nuts.

With obvious skin rashes and itching, it is reasonable to use external ointments that reduce these manifestations, as well as antihistamines. Preference should be given to drugs with a minimal effect on the central nervous system (desloratadine).

Sorbents help to eliminate protein from the digestive tract. Their use should not exceed 2-3 days, so as not to provoke constipation in the child.

Forecast

Over time, a milk allergy in a baby can go away on its own. In the process of growing up, the baby gradually differentiates and improves its digestive organs and enzymes, the immune system, which allows the body to completely break down milk sugar into glucose and galactose. A fully digested protein is not able to stimulate an atypical immune response.

Relative lactase deficiency, in certain cases, can be compensated after puberty, but complete lactose intolerance remains with the child for his entire life. These children need additional calcium supplements to skeletal system could develop fully.

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What causes the development of milk allergy?

About 5% of babies are lactose intolerant. Allergy to milk casein in young children develops regardless of what kind of feeding they are on. However, according to statistics, children who receive breast milk are much less likely to suffer from hypersensitivity, in addition, the severity of clinical manifestations in infants who feed on mixtures is higher.

An allergic reaction develops as a response to ingestion in the gastrointestinal tract food products containing a foreign protein. Cow's milk contains more than 25 types of protein, the most active of which are casein, alpha- and beta-lactoglobulins, and albumin.

Due to the fact that certain groups of enzymes may be absent in the stomach of a small child, animal proteins that enter the gastrointestinal tract are not broken down into monomeric components. Thereby useful material cannot be completely absorbed through the mucous membrane. The baby's body perceives them as foreign cells and reacts with an allergy to protein.

Reactions are of two types. True hypersensitivity develops even with the use of a small amount of milk due to a lack of degrading enzymes. Pseudo-allergic reaction occurs due to overuse a product when the stomach cannot cope with the processing of such an amount of milk.

Allergy to cow protein in infants appears in two cases:

• when the baby is breastfed, and the mother ate a dairy product;
• when feeding with a formula based on powdered milk.

The best food for a newborn in the first six months of life is breast milk, which contains all the necessary substances for the baby, and is also easily digested. Any foreign proteins easily penetrate through the insufficiently formed gastric mucosa and small intestine, therefore, can lead to an allergy to milk protein in infants.

The likelihood of an increased reaction of the body in a child increases in the presence of predisposing factors:

• A tendency to allergies is observed in one of the parents.
• During the period prenatal development the baby was exposed to the adverse effects of the environment or harmful substances.
• Mother had pathological conditions when carrying a baby, such as toxicosis, preeclampsia or fetal hypoxia.

Symptoms

Antigens are carried in the bloodstream various bodies, therefore, there are no unequivocal signs of how an allergy in infants to cow's milk manifests itself. After all, pathology can affect both the skin and be expressed in dyspeptic disorders.

Symptoms of hypersensitivity can become more pronounced in the event of acute respiratory viral infections, weakening of the protective reaction, infectious pathology and in stressful situations.

Milk allergy in infants is characterized by specific symptoms from some systems.:

• gastrointestinal tract;
• skin;
• respiratory system.

Malfunctions in the gastrointestinal tract that occur as a response to an allergy to cow's milk in infants:

• Diarrhea. The baby has loose stools, in which there are food particles, as well as curdled milk.
• Vomit. It looks like profuse regurgitation, accompanied by crying and anxiety.
• The admixture of blood in the feces indicates a serious course of allergy symptoms.
• Abdominal pain. The baby signals anxiety, crying or whims about discomfort in the intestines. This symptom must be differentiated from colic.
• Children after a year may indicate that they are disturbed by discomfort in the epigastrium. This condition is typical for allergies, because upon contact with a foreign protein, histamine is released, which leads to hypersecretion of hydrochloric acid.

How else is an allergy to milk manifested in a baby?

It can occur on the skin, which is expressed by the following symptoms:

• Atopic dermatitis - a rash in the popliteal region, on the elbows, cheeks, forehead, chin.
• Milk scab - often appears in children on artificial feeding and is manifested by the formation of dense white crusts on the scalp.

Respiratory symptoms are rare. It can be manifested by the secretion of mucus from the nasal passages, sneezing, coughing, shortness of breath. AT exceptional cases bronchial asthma develops.

Diagnostics

How to determine an allergy to milk in a baby? With such a question, you need to contact the pediatrician. After examining the child, the doctor will ask some questions about situations when a reaction occurs, and also ask if there are allergies in the family.

To establish whether an allergy is a response to the intake of cow's or goat's milk, laboratory and clinical tests should be performed in infants:

• Fecal analysis.
• A blood test for the content of antibodies to allergens.
• Skin tests.

Allergy to cow's milk protein in infants is similar to lactase deficiency, the presence of the latter can be determined using an analysis to detect stomach enzymes.

Treatment

The key to preventing the recurrence of an increased reaction of the body to cow's milk protein is a special lactose-free diet recommended for allergies. With artificial feeding, the baby needs to choose a dairy-free mixture, which is based on protein hydrolysates.

To combat hypersensitivity to casein and albumin, drugs are also used:

• antihistamines - remove external signs reactions, have a hyposensitizing effect (Suprastin, Loratadin);
• corticosteroids - prescribed for severe symptoms (hydrocortisone);
• enterosorbents - effective in the development intestinal disorders, remove toxins (activated carbon, Enterosgel).

When a baby does not tolerate lactose protein, mothers have a question whether a child can be allergic to goat's milk, whether it will be possible to give it to a baby and thereby compensate for the missing nutrients contained in dairy products. Hypersensitivity sometimes develops to goat's milk, but this happens much less frequently.

Forecasts

Unfortunately, the number of children with allergies is increasing every year. However medical diagnostics makes it possible to establish the cause of hyperreactivity of the body and choose ways to get rid of it.

According to statistics, by the end of the first year of life, about half of children suffering from milk allergy completely get rid of this problem. And by the age of three, the pathology remains in no more than 10-15% of babies.

Can allergies be prevented?

To avoid the occurrence of an allergy to cow's protein in infants, as well as to reduce the severity of hypersensitivity symptoms, some rules should be followed:

• Watch your diet during pregnancy, give up foods that can cause allergies.
• Remember that nicotine and alcohol not only have negative impact on the fetus, but can also cause hypersensitization of the body - increased sensitivity to certain substances.
• When breastfeeding during the first months, a young mother should be excluded from the menu of foods that may develop allergies. Read more about the nutrition of a nursing mother →
• If you have problems digesting milk protein in an infant, switch to a lactose-free or fermented milk formula.

A developing allergy to milk protein negatively affects the state of the body, because of which the baby may experience symptoms of various pathologies from the internal organs. Dermatological problems also appear quite often.

If hypersensitization has not been eliminated, then the likelihood of developing bronchial asthma increases, as well as suppression of the infant's immune system. It is for this reason that it is important to detect allergies in a timely manner and take measures to get rid of it.

Allergy to cow's milk protein

Allergy to cow's milk protein (another good article)

Allergy to cow's milk protein occurs in 2 - 6% of children in the first year of life. The constant search for optimal approaches to the diagnosis and treatment of this pathology leads to the regular appearance of new reviews, guidelines (or guides, from the English guide) and other publications. This guide, dedicated to the development of a clear algorithm for the diagnosis and treatment of cow's milk allergy, was presented in 2009 working group in Pediatric Gastroenterology under Emilia-Romagna.

Allergy to cow's milk protein (CMP) affects 2 to 6% of children under one year of age. About 50% of children recover from CMPA within the first year of life. 80-90% - during the first five years.

At the same time, it should be noted that parents begin to suspect an allergy to cow's milk proteins in children approximately 4 times more often than it actually occurs. So, in many children, parents suspect CMPA, based on symptoms such as skin rashes, sleep disturbances, persistent nasal congestion, seborrheic dermatitis or positive results of non-specific studies. In addition, parents often prescribe an unnecessary diet to their children without adequate medical and dietary supervision.

These incorrect dietary restrictions can cause nutritional imbalances, especially in the first year of a child's life. So accurate diagnosis cow's milk protein allergy (CMP) is important not only to avoid the risk of rickets, decreased mineralization rate, anemia, growth retardation and hypoalbuminemia, but also due to immediate clinical reactions or severe gastroenteropathy leading to malabsorption.

Allergy to cow's milk protein: when to suspect?

Children with an allergy to cow's milk proteins are characterized by a burdened atopic history.

Cow's milk allergy should be suspected in children who present with immediate allergic reactions such as: acute urticaria/angioedema, wheezing, rhinitis, dry cough, vomiting, laryngeal edema, acute asthma with severe respiratory failure, anaphylaxis.

Allergic reactions of the delayed type (or the so-called late symptoms allergies), causing the need to diagnose for CMPA are: atopic dermatitis, chronic diarrhea, blood in the stool, iron deficiency anemia, gastroesophageal reflux disease (GERD), constipation, chronic vomiting, colic, low weight gain (refusal to eat) , enterocolitis syndrome, protein-losing enteropathy with hypoalbuminemia, eosinophilic esophagogastroenteropathy.

The diagnosis of "allergy to cow's milk proteins" is based on the details of the anamnestic signs (Fig. 1), the results of a skin allergy test (prick test) and the detection of serum specific IgE to cow's milk proteins, the positive effect of the elimination diet and the reaction to a food provocative test.

Clinical manifestations of cow's milk protein allergy (CMP) can be divided into IgE-mediated clinical reactions (symptoms appear within 30 minutes after ingestion of cow's milk) and non-IgE-mediated reactions (onset hours and days after protein ingestion). cow's milk), with a predominant reaction from the skin and gastrointestinal tract. However, immediate and delayed type allergic reactions can be combined in atopic dermatitis and in eosinophilic esophagogastroenteritis. (Fig. 1)

Allergy to cow's milk protein: prick tests and food challenge

Prick tests (allergy skin tests) are one of the most accurate laboratory methods confirmation/exclusion of cow's milk allergy: Approximately 60% of children with a positive prick test are indeed allergic to cow's milk proteins. The value of negative skin test results is considered even higher: over 95%. Additionally, a prick test with a diagnostic preparation made from a cow's milk substitute can be applied.

However, in a small proportion of children negative results prick tests and serum IgE still develop clinical reactions characteristic of allergy to cow's milk proteins. Therefore, in such patients, despite a negative IgE test, with a strong suspicion of allergy to cow's milk protein, a food provocative test should be performed to prove the absence of clinical allergy.

Thus, the food challenge test, open or blind, remains the "gold standard" for verifying food allergies (including allergies to cow's milk proteins) when the diagnosis is in doubt. A food provocative test should be carried out under the supervision of a doctor in a ward intensive care, especially in the case of a positive prick test or serum IgE to cow's milk and in infants, due to the risk of immediate allergic reactions.

Hydrolyzed formulas and other milk substitutes: diet for CMPA

To replace cow's milk in the diet of children with allergies to its proteins, mixtures based on hydrolyzed protein, soy, rice, and milk from other domestic animals can be used. Unfortunately, any of the listed products can also cause allergies.

Thus, about 10% of children with an allergy to cow's milk protein (CMP) react to mixtures prepared on the basis of hydrolyzed proteins (the so-called hydrolyzed mixtures).

Even more often, clinical manifestations of allergies in children under 6- one month old cause formulas based on soy (in older children, the incidence of allergic reactions to hydrolyzed protein and soy proteins are comparable). Soy mixtures provoke mainly gastrointestinal symptoms.

Rice is also a fairly allergenic product and, according to available data from Australian researchers, often provokes enterocolitis syndrome in Australian infants. In addition to Australia, rice-based formulas for feeding children allergic to cow's milk have also been used in Italy. Extensive long-term research promises to bring definitive clarity to the question of whether rice-based formulas can be used for cow's milk allergy as a viable alternative to this product. To date, it is believed that rice mixtures can be used in individual cases, taking into account the taste and cost of the mixture.

The milk of other mammals is insufficiently dietary adequate. In particular, goat's milk causes clinical reactions in more than 90% of children allergic to cow's milk proteins. donkey milk- 15%, and has a high cost.

Food home cooking as an alternative to milk, it can be allowed for children from 4 months.

Separately, it should be noted mixtures based on amino acids. Amino acid-based mixtures do not cause allergies, however, their use is limited due to the high cost and extremely specific taste.

Algorithm for the diagnosis and treatment of suspected allergy to cow's milk proteins

If an allergy to cow's milk proteins is suspected, pediatricians and parents are forced to solve the problem of not only confirming / excluding this diagnosis, but also the further nutrition of the child. To facilitate this task, the Emilia-Romagna group, according to the symptoms and type of infant diet, proposed three different algorithms for diagnosis and further management of patients. They are reflected in Fig. 2,3,4

These approaches apply to children of the first year of life.

Babies with mild to moderate allergy symptoms (cow's milk formula feeding)

Rice. 2. Babies with mild to moderate allergy symptoms (cow's milk formula feeding)

Diagnosis and treatment algorithm for suspected allergy to cow's milk proteins: explanation for Fig. 2

The pediatrician should suspect cow's milk protein allergy on a free diet only in the most severe cases. Mild allergic reactions can be difficult to interpret because they may be the result of causes unrelated to an allergy to cow's milk proteins.

With a relatively late onset of gastrointestinal symptoms, other pathology (i.e. infections) must be ruled out before testing for allergic reactions is initiated. In moderate atopic dermatitis, the suspicion of cow's milk protein allergy is not justified in the absence of a clear relationship between cow's milk consumption and the onset of symptoms. However, if any of the above symptoms are clearly associated with cow's milk formula, then it is recommended to eliminate cow's milk from the diet and follow the course of action for severe reactions(Fig. 3)

In infants with symptoms of allergic reactions of immediate type (vomiting, angioedema, wheezing, rhinitis, dry cough) or delayed type (moderate/severe atopic dermatitis, diarrhea, blood in the stool, iron deficiency anemia (IDA), gastroesophageal reflux disease (GERD) , constipation), an allergy to cow's milk protein may be suspected. In addition, this diagnosis should be considered in infants not responding to therapy.

If an allergy to cow's milk proteins is suspected, the infant is prescribed an elimination diet for 2-4 weeks, excluding cow's milk protein (for 4 weeks - in the presence of gastrointestinal signs). Infants should be fed hydrolyzed milk formulas or soy formulas (the last recommendation is for children over 6 months of age in the absence of gastrointestinal symptoms).

If the allergy symptoms subside at the same time, a food provocative test (FPT) with cow's milk proteins is necessary to verify the diagnosis. If PPP is positive, the child must be on an elimination diet, after which the test can be repeated after 6 months (for GERD - a shorter interval), and in any case, after 9-12 months of age. If the food challenge test is negative, a free diet is prescribed.

If there is a high likelihood of developing IgE-mediated reactions of the immediate type, in infants who do not respond to therapy with hydrolyzed protein formulas (hydrolyzed formulas) or soy, a food challenge test can be performed after a 14-day amino acid formula diet.

Cow's milk substitutes are used in children under 12 months of age. In older children allergic to cow's milk proteins, due to the availability of an adequate diet, formulas based on hydrolysed protein or amino acid formulas are rarely required.

Infantile colic (more than 3 hours of crying per day, 3 days for three weeks) is definitely not considered as a consequence of an allergy to cow's milk.

Children with severe cow's milk protein allergy (cow's milk formula feeding)

Rice. 3. Children with severe cow's milk protein allergy (cow's milk formula feeding)

Diagnosis and treatment algorithm for confirmed allergy to cow's milk proteins: explanations for Fig. 3

Immediate allergic reactions include: laryngeal edema, acute dyspnea with severe respiratory failure, anaphylaxis.

Delayed type allergic reactions: chronic diarrhea or chronic vomiting with low stature, intestinal bleeding with iron deficiency anemia(IDA), protein-losing enteropathy with hypoalbuminemia, biopsy-proven eosinophilic gastroenteropathy.

If any of these symptoms are due to a suspected allergy to cow's milk proteins, the infant is placed on a milk-free elimination diet. Substitutions may include soy formula (in children over 6 months), hydrolyzed formula, or amino acid blend. The initiation of treatment with hydrolyzed or soy mixtures should be under medical supervision, due to possible clinical reactions. If an amino acid formula is used, it should be used for 2 weeks, after which the infant should be switched to soy or hydrolysed formula.

In children with late severe signs of gastrointestinal distress, low growth/weight, anemia, hypoalbuminemia, or eosinophilic esophagogastroenteropathy, it is recommended to start the elimination diet with an amino acid formula and then switch to a hydrolyzed formula. The effect of the diet should be checked within 10 days for enterocolitis syndrome, 1-3 weeks for enteropathy and 6 weeks for eosinophilic esophagogastroenteropathy.

In children with anaphylaxis and confirmed positive IgE tests or severe gastrointestinal reactions, a food challenge is not needed to verify the diagnosis. It should be performed no earlier than 6-12 months from the last reaction. Children should follow an elimination diet until the age of 12 months, and with enterocolitis syndrome - up to 2-3 years.

Children with severe allergic symptoms of any plan must be hospitalized in a specialized hospital.

Hydrolyzed protein formula or amino acid formula is used in children under 12 months of age and in older children with gastrointestinal symptoms. In children older than 12 months with anaphylaxis, the need to use cow's milk substitutes in the diet does not always arise.

Breastfed baby and suspected allergy to cow's milk proteins

(Fig. 4) Algorithm for dealing with suspected non-IgE mediated reactions to cow's milk proteins in breastfed infants

Algorithm for the diagnosis and treatment of breastfed children with suspected allergy to cow's milk proteins: explanation for Fig. 4

In children who are fully breastfed, the symptoms of cow's milk protein allergy (atopic dermatitis, vomiting, diarrhea, blood in the stool, GERD, etc.) are almost always not IgE mediated. Therefore, with moderate symptoms of these disorders, it is not recommended to exclude milk from the mother's diet. To date, there is no evidence for the significance of eliminating eggs or cow's milk from the mother's diet, for example, in infants with blood in their stools (proctocolitis).

From the diet of mothers whose children have moderate symptoms, cow's milk protein, eggs and other products should be eliminated only if a clear clinical reaction is noted. In addition, the infant must be hospitalized in a specialized hospital. The maternal elimination diet should last for 4 weeks. If there is no improvement, the diet should be discontinued. If the symptoms have improved, it is recommended that the mother take a large amount of cow's milk for 1 week. If symptoms return, the mother should continue the elimination diet with additional calcium intake.

The infant can be weaned according to the recommendations common with healthy children, but cow's milk should be avoided until 9-12 months of age, and for at least 6 months from the start of the diet.

If the volume of breast milk is insufficient, then a mixture based on hydrolyzed proteins or a formula based on soy (after 6 months of age) is used for supplementary feeding. If the symptoms do not worsen after the mother restarts cow's milk, the eliminated foods can be gradually introduced into the diet in turn.

Allergy to cow's milk protein in children: a summary

1. The definitive diagnosis of cow's milk protein allergy is based on a food challenge test performed after a 2-4 week elimination diet.
2. A diagnostic food challenge (DPT) is not performed for immediate-type allergic reactions or delayed-type allergic reactions (gastrointestinal symptoms with anemia, decreased growth or hypoalbuminemia) if the causative role of cow's milk is obvious. If it is necessary to conduct a food provocation test, it can be performed no earlier than 6-12 months after the reaction and no earlier than 12-24 months of life, according to the symptoms.
3. Diets given in baby food(including maternal breastfeeding) should be balanced. Children who are allergic to cow's milk protein are given additional calcium.
4. Children with mild atopic dermatitis and a negative history of reactions to cow's milk do not require a diet.
5. Soy formula should not be used in infants less than 6 months of age with allergic symptoms and older infants with gastrointestinal symptoms.
6. Children with gastrointestinal symptoms and anemia, short stature and hypoalbuminemia should receive amino acid based formulas followed by a switch to hydrolyzed formulas.
7. Hydrolyzed protein formulas and amino acid formulas are used in infants up to 12 months of age and in older children with severe gastrointestinal symptoms.
8. In children older than 12 months with anaphylaxis, it is not always necessary to use cow's milk substitutes.

Allergy to cow protein in infants is an infrequent and, in principle, harmless phenomenon. However, babies with such an allergy constantly experience difficulties with feeding, parents must constantly look for some way out and solve the problem of feeding the baby.

The article considers the following questions:

Why and how does cow protein allergy manifest?

Cow's milk contains many components that can potentially cause an allergic reaction, but cow's protein is the most common allergy.

At normal process Digestion of food that enters the stomach, and then into the intestines, breaks down into enzymes, which are individually absorbed into the body. And the unformed digestive system of a newborn is sometimes not able to separate milk into enzymes. This situation is called "allergy to cow protein". The situation is also aggravated by the fact that the infant's digestive system is practically, since the walls of the gastrointestinal tract in the child have not yet formed and strengthened.

When does cow protein allergy occur?, At what age? Usually, infants aged from birth to one and a half years are susceptible to this disease. And, as a rule, the symptoms of cow protein allergy go away on their own when the child is 3-5 years old. At this time, the child's digestive system is sufficiently normalized and the body begins to produce the necessary substances on its own in order to resist pathogenic elements. Very rarely, allergies persist for life.

As usual, infants whose mothers had a difficult pregnancy or the course of pregnancy was constantly complicated by stress, bad ecology and other harmful influences are especially susceptible to the appearance of such an allergy.

Allergies can be caused by an early transition from breastfeeding to artificial, or improper introduction of complementary foods. It can also manifest itself due to the heredity of this disease.

It should be noted that Allergy to cow protein manifests itself in two types- true and pseudo-allergy. A true bovine protein allergy means that your baby's body cannot tolerate ANY amount of protein. Pseudo-allergy is a condition when an allergic reaction occurs only after the baby has “overeaten” milk, that is, a certain amount of milk enzymes is still normally digested in his tummy, but his body no longer wants to accept an excess amount of milk.

Allergy to cow protein - symptoms

How to identify an allergy to cow protein? This allergy manifests itself in several ways:

Digestive organs. You can recognize an allergy to cow protein by the appearance of pain in the abdomen, vomiting and diarrhea in the baby. Also stool baby may contain undigested milk or blood. The child develops dysbacteriosis, the number of bacteria of Escherichia coli and enterococci grows in the body.

Skin. On the skin, an allergy to cow's milk protein is manifested by diathesis, eczema, redness, hives and the so-called "milk scab" - a thin crust white color appearing on the child's head. Diathesis and eczema usually appear on the elbows and under the knees, as well as on the baby's face and cheeks. Severe itching and the appearance of blisters on the skin indicates eczema in a child. Urticaria is also characterized by the appearance of small blisters on the skin, which are similar to those that appear if you burn yourself with nettles. In severe cases, Quincke's edema may occur.

Respiratory system. These may be coughing or sneezing, a runny nose, wheezing in the child's chest, hoarse voice, occasionally swelling of the larynx. However, pediatricians say that an allergy to cow protein rarely manifests itself with such symptoms.

Signs of an allergy to cow protein can appear both immediately after the indigestible component enters the baby's body, and after a few days.

How to treat an allergy to cow protein

Before proceeding with treatment, you need to correctly diagnose. Even if the baby has the symptoms described above, parents should contact the pediatrician, as there are some childhood diseases that coincide in symptoms with cow's milk protein allergy, for example, lactose deficiency.

First of all, the pediatrician prescribes the refusal to feed the baby with products containing lactose for a week. As a rule, the disappearance of symptoms indicates that the child has lactose deficiency. One week of dairy-free eating is not enough to cure a protein allergy.

How to feed a baby with cow protein allergy

So what should you do if your child is allergic to cow protein?

Most allergy symptoms can be relieved by simply optimizing baby nutrition. If the child eats breast milk, then all dairy products are excluded from the mother's diet, including condensed milk, butter and pastries based on it, cream, milk soup.

If the child is on, then it is necessary to find a mixture for him based on goat's milk, not cow's milk. But in this case, you must first do a test for the digestibility of goat's milk by the baby's body. Feed the baby baby(sometimes you have to switch to hydrolysates) you need at least six months. Then you can again introduce mixtures containing cow's milk into the diet and observe the reaction of the baby's body. If signs of allergy to cow protein reappear, then the child is again transferred to goat milk mixtures.