Cow's milk protein allergy (APLV) is the most frequent food allergy in childhood, and a real problem for both the child and the parents, who have to be constantly alert to avoid eating something that can lead said protein (taking into account that numerous foods are made with milk).
The only treatment to date was avoid all exposure to dairy and foods that contain protein, and wait until now, normally beyond the year of life, to try what is called the "provocation tests", which consist of giving very small amounts of the allergen to assess the response, and if it is satisfactory, increase Little by little the amount.
A recent study, presented at the 41st Congress of the Spanish Society of Clinical Immunology, Allergology and Pediatric Asthma (SEICAP), has shown that in most cases, if the provocation is done much earlier, babies are cured earlier. The problem is that the treatment generates controversy because that means giving more and more cow's milk, at an age when many are still breastfed.
Start immunotherapy at the time of diagnosis
As we read in Heraldo, the research has been carried out by a team of allergist pediatricians at the Miguel Servet Hospital, in Zaragoza, recognized for his work and research in that field, and it is novel because instead of waiting six months since the last allergic reaction , as was done so far, suggests that The treatment is started as soon as the symptoms appear.
The objective is to overcome the allergy as soon as possible to avoid possible risks and consequences of an accidental allergic reaction, and to make the baby have a quality of life the same as that of other non-allergic children.
Positive results in 98% of cases
As in cases of provocation in children between 8 months and 4 years, the positive results (overcoming allergy) can be up to approximately 75% (according to this study whose sample, yes, it is small), in this research performed with 251 infants with an average age of 5 months, have shown that 98% of them manage to be tolerant to cow's milk proteins before 12 months of age.
In addition, something important must be taken into account: everything has been carried out with babies whose APLV was IgE mediated, which are the most dangerous, causing more allergic reaction and faster. That is, non-mediated IgEs are milder and symptoms appear beyond two hours after consuming the food. In addition, they are resolved earlier, while many mediated IgE APLVs can continue to affect children through adolescence.
How they provoke provocation
The treatment consists of starting with very low amounts of milk, offered on a regular basis, increasing gradually until reaching the amount that is considered appropriate for the child's age.
What is achieved in this way is to "force" the immune system to get used to food, and to stop reacting to its presence. Or what is the same, induce milk tolerance, in a treatment that can probably be done, in fact, with any other food that causes allergy.
But…
Let us say that a child is breastfed and that when the mother goes to work, she chooses to be offered bottles of artificial milk in her absence, and suffers an allergic reaction that ends up in diagnosis of APLV.
How to proceed? It is very possible that parents decide to avoid dairy products, obviously, and wait for the beginning of complementary feeding (or advance it if age is feasible), so that the child's feeding continues to feel tit and food (which is what was done so far).
In fact, it is not only the most frequent, but It is the most recommended option until 12 months: breast milk as the main food, supplemented with various foods, such as vegetables, fruits, meat, fish, legumes and even eggs, without any risk of allergy for not consuming dairy products. It is the most recommended, but that is the option that would not solve the allergy In that age.
The other possibility would be to choose to carry out the treatment and offer more and more artificial milk, until it consumed an amount such that the allergy was already overcome. The problem is that this consumption of milk in a bottle could end up displacing breastfeeding, especially if it is added with complementary feeding.
In this situation it could be more complicated to reach the recommendation of the WHO and the AEP, to breastfeed if possible until 2 years of age, and from that moment until the mother and / or the baby want, precisely to cause a mixed breastfeeding at an early age (remember that the study was done with children of 5 months of middle age) to overcome an allergy that, as I say, may not be a major problem if dairy products and processed foods are not offered Add milk in its composition.
In any case, everything depends on the message that parents receive. If they are encouraged to continue breastfeeding, according to official recommendations, or if they are encouraged to overcome the allergy before, at the risk of hindering breastfeeding. And it depends, obviously, on the final decision of each family, which are the ones with the last word. With impartial and truthful information, it is they who must decide how to proceed.
Photos | iStock
In Babies and more | How to know if my baby could be allergic to cow's milk proteins, Allergies in babies: Allergy to cow's milk proteins, Cases of cow's milk protein allergy continue to appear because of the "pirate bottle" "
