Cow’s milk allergy affects one percent of European children in the first two years of life. Together with the egg one it is the most frequent in this age group. However, the numbers say that this is still a rare problem, if all diagnoses were completed correctly. Which is not always the case. With a double effect. An incidence of the disorder higher than the actual one. And too many children who do not consume milk, yogurt and cheese in a period of life in which these foods also play an important role in the growth process.
Food allergies: a sticker at the restaurant will tell us if the food is safe
by Claudia Carucci
Cow’s milk allergy: the importance of a correct diagnosis
The topic of overdiagnosis of milk protein allergy – not to be confused with lactose intolerance: whose reaction does not involve the immune system and is directed against a sugar – is not new. This is confirmed by the data reported in an article published in the journal Clinical and Experimental Allergy, indirectly. The researchers – coordinated by Robert Boylepediatric allergist at Imperial College London – have highlighted how prescriptions for special infant formulas have increased in recent years in countries such as England, Norway and Australia.
Rates ten times higher than expected
“With rates that are more than ten times higher than would be expected for the number of children actually suffering from a milk allergy.” Overestimated data, the result according to experts of an excess of diagnosis. To determine them, the tendency to limit the evaluation to some suspicious symptoms, but not sufficient to ascertain an allergy to cow’s milk. Indications that alone – excessive crying, regurgitation of milk, diarrhea – in many cases instead lead specialists to lead to the exclusion from the diet of a precious food for the development of a child. Hence the idea of starting a dialogue between independent experts – without any constraint with companies that produce special milks – to take stock of the situation and make proposals to limit the diagnoses.
Atopic dermatitis, if there is goat milk in the creams or lotions, the risk is a food allergy
by Giulia Masoero Regis
When a child is allergic
To determine the immediate reaction after ingestion of a food are almost always the IgE, antibodies that are activated against the non-tolerated component of a food. In the case of cow’s milk, the proteins in question are three: casein (the most reactive), alpha-lactalbumin and beta lactoglobulin. Symptoms to watch out for, as summarized in another paper published in the journal Jama Pediatrics, are substantially uncertain growth, frequent crying, urticaria, angioedema, gastrointestinal (colic, blood in the stool, vomiting with bile) and respiratory disorders (rhinitis and asthma, although rare). But these are “spies”, which taken individually are never enough to complete the diagnosis. This is why – once the reproducibility and specificity of the symptoms have been found, always in the minutes following the ingestion of milk – it is necessary to investigate further. The reference for parents is the pediatrician of free choice.
You need the contact prick test
Once the child has been examined and the family (allergic) history reconstructed, the first step involves the prick test, in which a drop of food is placed in contact with the skin to check for the presence of a skin reaction. Only in selected cases it may be necessary to evaluate the presence in the blood of the immunoglobulins typical of allergy sufferers, which may however not be present in cases of so-called non-IgE-mediated allergy: characterized by an onset of symptoms not always corresponding to the ingestion of milk, from which the possible negativity to the prick test. For the certainty of the diagnosis, in any case, the oral provocation test is necessary, which involves the administration of the “suspect” food under the supervision of the doctor: both to evaluate the symptoms that appear immediately afterwards and to deal with any complications (sometimes even serious).
Artificial milk, too much advertising on the web: the complaint from WHO and pediatricians
by Tina Simoniello
How to deal with a positive test?
The first choice therapy for all food allergies is the elimination of the food from the diet. However, the exclusion diet almost always has a beginning and an end. Within three years of life, 9 out of 10 children solve the problem and can go back to consuming cow’s milk, its derivatives and products that contain it as an ingredient. Not before having the patient again subjected to the prick test and oral provocation test. Meanwhile, experts recommend, “breastfeeding should still be continued”.
More allergic if you haven’t taken mother’s milk
Breastfeeding by the mother is in fact always to be considered as an extra protection against food allergies. And the longer it is, the better. To this it should be added that, although rare, these disorders are almost always found in infants fed from the first days with artificial milk. Another indication that emerges from work: a mother who feeds her child is not required to exclude milk, yogurt and cheese from her diet. If breastfeeding is not a solution, however, milk must be replaced by “pushed hydrolysates”: products of cow or vegetable origin (rice, soy) that can only be purchased in pharmacies and parapharmacies, in which proteins are broken down into such small peptides not to be recognized by the immune system.
Heart door
Breastfeeding protects women’s hearts from heart attacks
by Federico Mereta
The diet: how it changes before and after 12 months
A choice to be recommended within the first year of life, always under the supervision of a pediatric nutritionist who can also evaluate the overall quality of the diet. The risk, in fact, is represented by some possible imbalances. Hence the call for caution in the use of replacement formulas, which can “alter the taste of the child”, “cause a deficiency in some micronutrients” and “encourage an excessive intake of free sugars used in place of lactose: with the risk resulting from tooth decay, overweight and obesity “.
No to vegetable “milks”
In the most serious forms, but always on the advice of a pediatrician allergist, it is also possible to resort to mixtures of free amino acids, more digestible. On the other hand, all those drinks of vegetable origin that we often call milks, but which are not such are excluded: based on almond, rice and soy. Infants over one year old who are allergic to milk and need a breast milk substitute should instead take “calcium-fortified formulas or even donkey or mare’s milks, which have low cross-reactivity with cow’s milk.”