Diagnostic Approach and Management of Cow's‐Milk Protein Allergy in Infants and Children

Abstract

In breast-fed infants, the mother should start a strict CMP-free diet. Non-breast-fed infants with confirmed CMPA should receive an extensively hydrolyzed protein-based formula with proven efficacy in appropriate clinical trials; amino acids-based formulae are reserved for certain situations. Soy protein formula, if tolerated, is an option beyond 6 months of age. Nutritional counseling and regular monitoring of growth are mandatory in all age groups requiring CMP exclusion. REEVALUATION: Patients should be reevaluated every 6 to 12 months to assess whether they have developed tolerance to CMP. This is achieved in >75% by 3 years of age and >90% by 6 years of age. Inappropriate or overly long dietary eliminations should be avoided. Such restrictions may impair the quality of life of both child and family, induce improper growth, and incur unnecessary health care costs.

Alergia a la leche y al huevo: diagnóstico, manejo e implicaciones en América Latina

“…Las manifestaciones clínicas (dermatitis atópica, asma, rinitis alérgica, urticaria, angioedema, anafilaxia) pueden deberse a un mecanismo mediado por IgE que se caracteriza por reacciones inmediatas, es decir, durante las primeras dos horas posteriores al consumo de la leche, o mecanismos no mediados por IgE, en los cuales la reacción se debe a activación celular (síntomas gastrointestinales, síndrome de Heiner) y se caracterizan por ser reacciones tardías, o sea, aquellas que ocurren entre 48 horas y una semana después del consumo; además, hay que tener en cuenta que pueden ocurrir ambos mecanismos en un mismo paciente, situación que no es infrecuente (50 % de los casos), especialmente cuando sufren de dermatitis atópica o tienen síntomas gastrointestinales (16,17).…”

Complementary Feeding, Peculiarities of Introduction. Clinical Cases

“…), орехи (миндаль, грецкие, лесные и др.). Основным аллергеном для детей раннего возраста является белок коровьего молока, гиперчувствительность к которому, по данным ESPGHAN (2010, 2012), встречается в 2-3% случаев [21,22], а по данным EAACI (2014) -в 4,2% [23].…”

Food allergies. Recommendations on supplementary feeding introduction in patients with food allergies and risk group children: what and when?

“…For a child allergic to CMP, a diet is formed that completely eliminates cow milk proteins [3,[5][6][7][8]. In case of breastfeeding, this is achieved by prescribing a milk-free diet to the child's mother.…”

“…Feeding with infant formulas has a great significance in developing a CMP allergy in infants, leading to excessive intake of foreign protein that provokes an increase of reactive sensitivity of cells and tissues against immature intestinal barrier and the immune response. However, breastfed children may also develop clinically significant CMP allergies due to the penetration of food proteins in breast milk [3,6,7]. Prognosis for CMP allergies largely depends on the form of FA.…”

“…The so-called group of eight foods that commonly cause allergic reactions includes cow milk, eggs, soy, peanuts, nuts, wheat, seafood, and fish [2,3,5]. The allergen of leading clinical significance in the early childhood is cow milk protein (CMP) [3][4][5][6][7][8]. The peak incidence of true CMP allergy occurs in the first year of life, accounting for 2-3% of infants [6].…”