A personalized approach to the management of breastfed infants with functional gastrointestinal disorders and cow’s milk allergy. The role of nutritional recommendations for a nursing mother

Abstract

Introduction. Functional gastrointestinal disorders (FGID) in infants are a complex of symptoms from the gastrointestinal tract that cannot be explained by structural or biochemical disorders. To alleviate the symptoms of functional disorders, a set of measures is required, first of all, psychological support for the mother and, of course, rational feeding, which includes maintaining breastfeeding, optimizing the nutrition of the nursing mother. Despite the abundance of professional information on this issue, previous studies demonstrate a low level of women’s awareness of nutrition during breastfeeding. The aim of the work is to determine the effectiveness of recommendations on nursing mother’s nutrition in the complex treatment of breastfed children with FGID and allergy to cow’s milk proteins.
 Materials and methods. Seventy five mother–child pairs were included in the study. 1–4 months infants exclusively breastfed during the study were divided into two groups: 1 — FGID infants (n = 51) and 2 — infants with suspected cow’s milk allergy (CMA) n = 24. In addition to the comprehensive treatment of the child, mothers of both groups were given recommendations on the nursing woman’s nutrition. Mothers of children from group 2 were assigned a diagnostic dairy-free diet for a period of 1 month. 
 Results. On the 2nd visit, when analyzing the symptoms of the FGID in group 1, the number of children with symptoms of regurgitation of more than 2 episodes per day decreased by 28% (p < 0.001), crying for more than 3 hours per day — by 52% (p < 0.001). Children of group 2 with a clear positive effect from the diagnostic dairy-free diet therapy of the mother (n = 20) were diagnosed with Allergic and alimentary gastroenteritis and colitis (K52.2 — 10th revision of ICD-10), the continuation of the dairy-free diet for the mother and the supervision of an allergist were prescribed. The survey of women showed that all nursing women were interested in nutrition issues during lactation, 92% of the surveyed mothers searched for this information on the Internet. At the same time, only 12% of women considered this information to be sufficient. Evaluating the presented materials on nutrition, the overwhelming majority of respondents replied that they helped them to adjust their diet and expand nutrition, as well as to maintain breastfeeding.
 Conclusion. Thus, an integrated approach in the management of FGID infants and gastrointestinal manifestations of food allergies, including the use of nutrition recommendations developed in the National Medical Research Center of Children’s Health for nursing women, allows achieving a positive effect on the side of symptoms both in FGID and CMA patients, and also contributes to the improvement of the psycho-emotional state of a woman and prolonged breastfeeding.