Managing cows' milk allergy in children

Ludman, Siân; Shah, Neil; Fox, Adam

doi:10.1136/bmj.f5424

Cited by 47 publications

(59 citation statements)

References 27 publications

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“…2012; Ludman et al. 2013). Typically such formulae contain a large proportion of smaller sequences as illustrated by the peptide-length distribution (Fig.…”

Section: Resultsmentioning

confidence: 99%

Clustering analyses in peptidomics revealed that peptide profiles of infant formulae are descriptive

Lambers¹,

Gloerich

Hoffen³

et al. 2014

Food Science & Nutrition

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Prompted by the accumulating evidence on bioactive moieties of milk-derived peptides, novel methods were applied to compare the peptide composition among commercially available hydrolysate formulations and to determine batch-to-batch variations of protein hydrolysate products. Despite the availability of general methods to measure, for example, the degree of hydrolysis and peptide mass distribution at a high level, the objective of this study was to more qualitatively compare peptide sequences and composition. By a comprehensive approach combining peptidomics technologies and multivariate clustering analyses, the peptide profiles of different hydrolyzed milk protein formulations were compared. Moreover, peptide profiles of various hydrolysate batches that had been produced over a period of 5 years were included. Coupling of identified peptide sequences to the position in their corresponding milk proteins produced numerical datasets that subsequently were utilized for multivariate data analyses. These analyses revealed that batch-to-batch variation in the peptide profiles of a specific extensively hydrolyzed casein preparation was low. Moreover, extensive multivariate evaluations revealed that the peptide profiles of different commercially available hydrolyzed milk protein formulations provided a descriptive and distinct signature. Overall, the described methodology may contribute to the field of peptide research as observed dissimilarities in peptide profiles of similar products may be related to differences in their overall functionality.

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“…2012; Ludman et al. 2013). Typically such formulae contain a large proportion of smaller sequences as illustrated by the peptide-length distribution (Fig.…”

Section: Resultsmentioning

confidence: 99%

Clustering analyses in peptidomics revealed that peptide profiles of infant formulae are descriptive

Lambers¹,

Gloerich

Hoffen³

et al. 2014

Food Science & Nutrition

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“…If a child on AAF can tolerate eHF challenge, it is safe to move the infant to an eHF. If a response to either a CMP or eHF challenge test is observed, the infant should be kept on the therapeutic formula that resolved the symptomatic manifestations of CMPA 5,8,43 .…”

Section: Volume 58 • Number 1 Cow's Milk Protein Allergy In Turkeymentioning

confidence: 99%

Consensus statement on diagnosis, treatment and follow-up of cow's milk protein allergy among infants and children in Turkey

et al. 2016

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The present paper aims to provide experts' consensus on diagnosis and management of cow's milk protein allergy (CMPA) among infants and children in Turkey, based on review of available evidence-based guidelines, publications and experts' clinical experience. The experts agreed that CMPA diagnosis should be based on symptomatic evaluation and diagnostic elimination diet as followed by implementation of an open challenge test after disappearance of symptoms and confirmation of CMPA diagnosis in re-appearance of symptoms. For breastfed infants, differential diagnosis involves withdrawal of cow's milk-containing products from the mother's diet, while calcium supplements and appropriate dietary advice are given to mothers to prevent nutritional deficiency. For infants not breastfed exclusively, cow's milk-based formula and any complementary food containing cow's milk protein (CMP) should be avoided. The first line treatment should be extensively hydrolyzed formula (eHF) with use of amino acid-based formula (AAF) in severe cases such as anaphylaxis, enteropathy, eosinophilic esophagitis and food protein induced enterocolitis along with cases of multiple system involvement, multiple food allergies and intolerance to eHF. Introduction of supplementary foods should not be delayed in CMPA, while should be made one by one in small amounts and only after the infant is at least 17 weeks of age. Infants who are at-risk can be identified by family history of atopic disease. Exclusive breastfeeding for 4-6 months (17-27 weeks) is recommended as the best method of infant allergy prevention. There is no evidence that modifying the mother's diet during pregnancy and/or breast-feeding and delaying solid or even potentially allergic foods beyond 4-6 months in infants may be protective against allergy among at-risk infants. When exclusive breastfeeding is not possible, at-risk infants should get a partially or extensively hydrolyzed formula (pHF or eHF) to prevent allergy until risk evaluation by a health professional. In conclusion, the present consensus statement provides recommendations regarding diagnosis, prevention and management of CMPA in infants and children in Turkey, and thus expected to guide physicians to optimize their approach to CMPA and decrease burden of the disease on infants and their caregivers.

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“…Cow's milk allergy is the food allergy presenting the highest natural tolerance acquisition rate: more than 80% of children presenting with milk allergy bring out their allergy by the age of 5 years, and non-IgE-mediated subtype even earlier than IgEmediated [29]. However, children with higher CM-IgE titer, especially for casein, and low levels of CM-specific IgG4 are associated with persistent allergy.…”

Section: Milkmentioning

confidence: 95%

“…Cow milk (CM) allergy is the most frequent food allergy in childhood, with a prevalence of 2-3% of the infants [29][30][31][32]. Cow's milk allergy is the food allergy presenting the highest natural tolerance acquisition rate: more than 80% of children presenting with milk allergy bring out their allergy by the age of 5 years, and non-IgE-mediated subtype even earlier than IgEmediated [29].…”

Section: Milkmentioning

confidence: 99%

Immunotherapy for Food Allergies: A Myth or a Reality?

Praticò

Leonardi

2015

Immunotherapy

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Food allergy is a worldwide issue, with an estimated prevalence of 2-10%. An effective treatment is not available for people affected and the only management is the avoidance of the allergen. Oral immunotherapy and sublingual immunotherapy have been tested by several authors, in particular for milk, egg and peanuts allergy, with significant results in term of desensitization induction. The achievement of tolerance is by the contrary doubtful, with different results obtained. In this review, we reviewed protocols of oral and sublingual immunotherapy for food allergy published in literature, mainly against milk, egg and peanut. At present, immunotherapy does not represent the gold standard in the treatment of food allergy, even if it can desensitize patients.

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Managing cows' milk allergy in children

Cited by 47 publications

References 27 publications

Clustering analyses in peptidomics revealed that peptide profiles of infant formulae are descriptive

Clustering analyses in peptidomics revealed that peptide profiles of infant formulae are descriptive

Consensus statement on diagnosis, treatment and follow-up of cow's milk protein allergy among infants and children in Turkey

Immunotherapy for Food Allergies: A Myth or a Reality?

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