Severe Reactions to Cow's Milk in Very Young Infants at Risk of Atopy

Abstract

Cow's milk (CM) allergy (CMA) is a disease of infancy, usually appearing in the first months of life. Symptoms triggered by CM at first introduction are not completely defined. The aim of this study was to investigate the prevalence of severe reaction to CM and clinical manifestation triggered by CM administration in the first few months of life. Particularly sensitizing appears to be the exposure to CM formulas in the neonatal nursery. The little doses of allergens are more sensitizing than larger ones. These data provide clear evidence of the immunological effects of oral antigen administration during the neonatal period, therefore babies at risk of atopy should receive in their first day's colostrum and/or formulas appropriate for atopy prevention.In this prospective study we evaluated 27 babies in order to ascertain the prevalence of CM induced severe reactions.

Immunogenicity of Hydrolysate Formulas in Children (Part 1). Review of 202 Reactions

“…Such data explain also why babies who appar ently never received CM native pro teins, but were surely fed a HF supple ment in their very first days of life, at the age of few months when still excl usi ve ly BMfed ex per ien ced ana phylaxis after a few ml of the same for mu la [7] as the babies fed whole CM in the Ma ternity [78]. How ever, we face the crude reality that 5060% if not 100% of HR children receive a CM formula in the nur sery without our knowledge [78]. In our hospital, and surely others too, also ba bies who are meant to be BMfed receive a pi rate bottle during the night if they cry [2,78].…”

“…The sensitization seems to have occur red in the very first days of life as a conse quence of some feeds in the Maternity Hospi tal. [78] with the PWHF, which was giv en again at the 6th month for CMA prophylax is. Although we cannot exclude that the infants were the victims of pirate bottles, nor we analyzed BM samples for the presence of CM proteins, the following points are in favour of this as sump tion: 1) The mothers totally avoided CM and dairy products during lactation, there fore a sen sitization through BM can be ruled out; 2) The babies were healthy during breast fee ding and did not show any symptom or sign sug gestive of CMA; 3) high levels of IgE antibodies and strongly positive SPTs to the HF were present in the babies [77].…”

“…Reaching thus the infant's gut, they are again hy drolyzed, ab sorbed, and enter into the APC where they ex perience their hun dredth transfor ma tion, yet CM pept ides are still immunogen i c [80] despite the pre s ence of se cretory IgA in BM [103]. Such data explain also why babies who appar ently never received CM native pro teins, but were surely fed a HF supple ment in their very first days of life, at the age of few months when still excl usi ve ly BMfed ex per ien ced ana phylaxis after a few ml of the same for mu la [7] as the babies fed whole CM in the Ma ternity [78]. How ever, we face the crude reality that 5060% if not 100% of HR children receive a CM formula in the nur sery without our knowledge [78].…”

“…How ever, we face the crude reality that 5060% if not 100% of HR children receive a CM formula in the nur sery without our knowledge [78]. In our hospital, and surely others too, also ba bies who are meant to be BMfed receive a pi rate bottle during the night if they cry [2,78].…”

Neonatal Cow Milk Sensitization in 143 Case-Reports Role of Early Exposure to Cow's Milk Formula

“…A major cause of sensitization to CM in genetically predisposed neonates is the (in) advertent administration of CM in neonatal nurseries. Neonatal care should include 49-100% of such infants given supplements of CM or hydrolysate formulas (HFs) during the first 3-4 days of life [1][2][3][4][5]. Among these babies CM allergy (CMA) was more frequent [6], until to 100% of infants, none of them had symptoms at the first CM administration [3].…”