Monday, September 20

Allergy to cow’s milk proteins, can it be cured?


Allergy to the proteins in cow’s milk is a problem that mainly affects children. It is, in fact, the most common food allergy among children under two years of age: it affects up to 2.5% of that population. That is, one in every forty boys and girls.

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This is ensured by the protocols of the Spanish Association of Pediatrics (AEP), prepared in collaboration with the Spanish Society of Clinical Immunology, Allergology and Pediatric Asthma (SEICAP).

In most cases, the cause lies in a genetic predisposition. Those from cow’s milk are usually – especially in developed countries – the first foreign proteins to enter the diet of infants, and that is why this allergy appears or is detected at such an early age, before the others.

The positive is that most children with this allergy they overcome it – that is, they heal – spontaneously. In general, they acquire tolerance to cow’s milk proteins, and therefore can resume (or start) a normal diet, when they reach between three and five years of age.

Types of allergies

This age difference has to do with the fact that there are two main types of allergies to cow’s milk proteins: one in which an antibody present in the blood called Immunoglobulin E (IgE), and the other in which it does not intervene. They are known as IgE-mediated allergy and non-IgE-mediated allergy.

IgE-mediated allergy to cow’s milk proteins is the most serious. Reactions and symptoms appear at a few minutes or up to an hour later that the child ingests cow’s milk. For its part, non-IgE-mediated allergy generates later reactions: they can appear hours or even days later.

Most children with this last type of allergy – the non-IgE-mediated one – stop having it when they are three years old, as explained by one Article from the United for Milk Allergy community. In contrast, the average age at which children with IgE-mediated allergies can adopt a normal diet is five years.

How to detect allergy to cow’s milk proteins

The most common symptoms, and that can appear immediately after the ingestion of cow’s milk, are: hives and hives, wheezing, cough or difficulty breathing, swelling of the lips, tongue or throat, tingling or itching sensation around the mouth and vomiting.

After a few minutes or hours, other effects of the allergy may occur, such as diarrhea, pain or cramps in the abdomen, watery eyes, or runny nasal discharge. In extreme cases, even a anaphylaxis, a serious and life-threatening reaction.

If the existence of this allergy is suspected, it is necessary to consult the doctor to confirm it and take the appropriate measures. The first one is an elimination diet, that is, free of cow’s milk protein. In its protocols, the AEP stresses that “this diet must be strict.”

The pediatricians’ document clarifies, however, that in cases where the child continues to feed through breastfeeding “there’s no need eliminate “cow’s milk protein” from the mother’s diet.

To replace breast milk or start mixed breastfeeding, given the impossibility of the child to drink cow’s milk (and also from other animals such as goat and sheep, which have similar proteins), experts suggest the use of extensively hydrolyzed formulas, soy, rice or elemental formulas.

Pediatricians emphasize the importance that family members and caregivers of the child understand the scope of the avoidance diet, since cow’s milk proteins can be found as “hidden ingredient“in multiple foods.

For this reason, special care must be taken when reading product labeling, and also when preparing food, to avoid any inadvertent contamination.

Active allergy treatments

In most cases, as noted, these allergies disappear spontaneously over time. And until recently the avoidance diet it was the only recommended treatment to avoid its negative effects.

However, in recent years new treatments, which involve a most active role in the search to overcome the problem. Above all, to avoid possible allergic reactions to the accidental intake of cow’s milk or any of its derivatives.

And not only for that: they are also important and recommended due to the fact that, in some cases, allergy to cow’s milk proteins – especially the one mediated by IgE – persists into adulthood.

The most important of these treatments is oral immunotherapy or oral tolerance induction (ITO). It consists of administering, in a controlled manner, daily doses of allergy-causing proteins: starting with a very small amount and gradually increasing, gradually, until reaching a maintenance dose, which must be continued for a period of time. extended time.

Thus, thanks to the ITO, experts estimate that up to 80% of patients with this non-remitting allergy could incorporate into your diet cow’s milk proteins, at least in a low quantity.

And patients with the most sensitive cases could at least access a protective dose, which would reduce the risk of anaphylaxis or other serious reactions.

For the rest, a consensus about age from which it is convenient to apply these immunotherapy treatments. A study carried out by scientists from the Miguel Servet hospital in Zaragoza, showed that they can be implemented with a very high efficiency (98%) from the moment of diagnosis, even in babies under one year of age.

The doubt It is based on the fact that the introduction of cow’s milk in such young children (the average age of the babies in the study of the Zaragoza doctors was five months) could attempt against breastfeeding.

Both the AEP and the World Health Organization recommend that children be fed exclusively by breastfeeding for at least six months of life. And that it be extended “as long as possible”, accompanied, after the initial semester, by solid foods.

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