In the last decades, the prevalence of food allergies in childhood has increased significantly. Among them, the cow's milk protein allergy (APLV) It is one of the highest incidence, and one of the main challenges for specialists in pediatric gastroenterology and allergology.
With the aim of spreading the latest news and advances in the cure of this food allergy, the "First Day of Child Health and Nutrition: Nutrinfant Symposium-Workshop" was held on November 20, where different issues related to the APLV, both IgE-mediated and non-IgE-mediated.
IgE-mediated and non-IgE-mediated allergy: how do they differ?
The mechanisms involved in the process of a food allergy are varied, and in this way we could talk about:
IgE-mediated allergies, when the body creates defenses to protect against the allergenic substance.
Allergies not mediated by IgE, where IgE antibodies do not come into play but other different mechanisms.
In both cases there is a reaction in which the immune system participates. Hence the term "intolerance" is not well used to refer to allergies not mediated by IgE, since the immune mechanism does not come into play in food intolerance (for example, lactose intolerance).
The symptoms of a food allergy are very varied. In general, in cases of IgE-mediated allergy they occur immediately, while in a non-IgE-mediated allergy they are late, something that makes the diagnosis of allergy difficult since it is difficult to establish a relationship between the intake of the causative food and the reaction.
In Babies and more How to know if my baby could be allergic to cow's milk proteinsAPLV not mediated by IgE: the importance of an accurate diagnosis
During the "First Day of Child Health and Nutrition", Dr. Josefa Barrio, a pediatrician at the University Hospital of Fuenlabrada, explained what it is APLV not mediated by IgE, as well as the associated table of food protein-induced enterocolitis (Food Protein-Induced Enterocolitis; FPIES).
The FPIES It is a potentially serious condition, whose main symptom is vomiting, sometimes accompanied by diarrhea, paleness and decay. However, until relatively recently I was under diagnosed, since there are no well-established criteria for doing so.
And is that unlike IgE-mediated allergies, in which a prick test (skin puncture) or a blood test (RAST) is enough, non-IgE-mediated allergies are based exclusively on the medical history.
In Babies and more, cases of allergy to cow's milk protein continue to appear because of the "pirate bottle"If there is doubt about the medical history, sometimes it may be necessary to perform an oral challenge test to the milk to confirm the diagnosis. This should always be done in a hospital and under strict medical control.
Once the allergy is diagnosed, the child should wear a cow's milk protein-free diet, and in case of breastfeeding, the doctor is likely to recommend the mother to follow this diet to avoid the presence of cow's milk proteins in breast milk.
Is non-IgE mediated APLV cured?
Experts point out that the prognosis of spontaneous cure of non-IgE-mediated APLV is usually very good, except for exceptional cases. In addition, it occurs in a short space of time, that is, most children exceed it between two and three years.
IgE-mediated APLV: higher prevalence but good cure prognosis
During the Conference, Dr. Luis Echeverría, a pediatrician at the Allergy and Pulmonology Unit of the Severo Ochoa University Hospital, explained more details about the IgE-mediated APLV and the success of oral immunotherapy treatments.
The Symptoms associated with IgE-mediated allergies are immediate onset., or at most within the first hour after intake. Its manifestations are very varied, being able to present cutaneous reactions, respiratory symptoms, edema ... or even anaphylactic shock.
Dr. Luis Echeverría said that, although there is an increase in the prevalence of this type of APLV, the prognosis for long-term cure is very good, reaching 90 percent spontaneous tolerance.Is IgE-mediated APLV cured?
For children who have not reached milk tolerance spontaneously by three or four years of age, there are oral immunotherapy programs With a great success rate.
In Babies and more Early exposure to allergen food, key to the cure of food allergiesThe oral immunotherapy treatment would go through expose the child to the allergen food in a controlled manner and under medical supervision, until tolerance is reached. In this way, a new way of healing food allergies is opened that has nothing to do with the traditional current carried out to date, consisting of avoidance diet:
"Oral immunotherapy with cow's milk proteins is a Proactive treatment option for children with IgE-mediated allergy to cow's milk, achieving high desensitization rates, but with frequent adverse effects during the procedure, most of them being of mild severity "
How should the diet of a baby with APLV be?
Either in the case of IgL-mediated APLV, as in the case of non-IgE-mediated APLV, until the child reaches tolerance should follow a diet free of milk, dairy products and derivatives.
But not only is it enough to eliminate milk from the child's diet, but it is very important to take care of their diet to "ensure adequate growth", as stated by Dr. José Manuel Moreno Villares, co-director of the Department of Pediatrics at the University of Navarra Clinic, during the Day.
In Babies and more 80 percent of people do not consume the calcium and vitamin D they need (and it is worrisome)Thus, the substitute formulas that the baby with APLV should take must be safe and effective to achieve proper nutrition and growth, and would go through:
Hydrolyzed formulas, which consist of infant formulas with digested protein in small portions (small peptides) that do not trigger an immune response (allergy).
Soy formulas, for those older than six months who do not present enteropathy.
Elementary Formulas
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