A 3-month-old child was diagnosed with an allergy to milk protein; before that, doctors had been convincing for 2 months that the skin was “blooming”. What to do?

A 3-month-old child was diagnosed with an allergy to milk protein; before that, doctors had been convincing for 2 months that the skin was “blooming”. What to do?

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answers (2)

Answer 1
January, 2021

We faced the same when the baby was 2.5 months old. Try a mixture based on Cabrita goat milk, which an allergist advised us at one time. This is an adapted milk formula based on goat's milk, such a protein is easier and softer for the baby to digest. I looked at the company's website, they have very strict checks on the quality of the mixture in production in Holland. It suits us very well! Allergy disappeared, there are no rashes, no regurgitation, colic also bypassed))

Answer 2
January, 2021

Cow's milk protein allergy (CMPA) is a pathological reaction caused by the ingestion of foods containing cow's milk proteins (CMP), which is based on immune mechanisms.

The initial symptoms that occur in the first days and weeks of a child's life are often not specific enough and do not have the nature of a specific pathology. These include skin manifestations such as flushing of the skin, persistent diaper rash, small papular rash.

The diagnosis is made on the basis of examination by specialists and additional studies:

Determination of the level of specific IgE is a diagnostic method

IgE-mediated PA.

The following test systems are currently used in clinical practice:

  • colorimetric method using paper discs as a solid support;
  • fluorimetric method using a cellulose sponge as a solid phase matrix;
  • chemiluminescent method using biotinylated allergens and solid phase with avidin particles;

The most recognized analytical test system in the field of laboratory diagnostics of allergies is currently the UniCAP Systems method, which has high sensitivity, specificity and reproducibility.

Skin testing (skin scarification tests, pretests) confirms the presence of sensitization and is effective in the diagnosis of IgE-mediated CMP allergy.

The diagnostic elimination (dairy-free) diet is

a universal method that allows to confirm the diagnosis in both IgE-mediated and non-IgE-mediated forms of CMPA

such a diagnostic measure as "diagnostic product administration" has been developed.

It is recommended to carry out a etiological treatment - exclusion from the diet of all products containing cow's milk proteins, as well as beef. When breastfeeding the child, a dairy-free diet is prescribed for the mother. In cases of mild manifestations of CMPA, a dairy-free diet is recommended as monotherapy.

Formulas based on cow's milk

and complementary foods containing CMP or other, unmodified, dairy animal proteins should be excluded from the child's diet (e.g. goat's, sheep's milk). Compliance with the elimination diet should be accompanied by monitoring of indicators of the child's physical development.

The minimum periods of exclusion from food are recommended by international documents, and are at least 6 months, in the presence of severe reactions - at least 12-18 months.

For children with CMPA who are bottle-fed, it is recommended to use specialized formulas based on highly hydrolyzed milk protein or amino acids in their nutrition.

If, when taking a formula based on highly hydrolyzed protein, the condition does not improve within 2 weeks, it is recommended transfer to food based on amino acids.

Given the lack of registered second-generation antihistamines for use, childrendimetindene can be prescribed in a short course of pits under the age of 6 months (dosage regimen for patients from 1 month to 1 year, 3-10 drops per dose 3 times a day).

It is recommended that external therapy be carried out differentially, taking into account pathological changes in the skin. The goal of external therapy is not only to relieve inflammation and itching, but also to restore the water-lipid layer and the barrier function of the skin, as well as to ensure proper and daily skin care.

  • topical glucocorticosteroids
  • Topical calcineurin inhibitors (topical immunomodulators) include pimecrolimus in 1% cream and tacrolimus in 0.03% and 0.1% ointments
  • Moisturizers and emollients are part of the current standard of treatment for atopic dermatitis

The above measures and drugs are selected based on the clinical picture of the disease, the severity of the course. To select treatment tactics, you should consult a pediatrician, dermatologist, allergist.

The material was compiled on the basis of clinical recommendations of the Union of Pediatricians of the Russian Federation

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