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Therapeutische Umschau. Revue therapeutique 1989-Sep

[Food allergies].

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M J Lentze

Cuvinte cheie

Abstract

Food allergy in childhood presents with different clinical manifestations depending on the age of the affected child. Whereas toddlers and children with food allergy or pseudo-allergy present with similar symptoms as adults, two different forms have been identified in the newborn and infant period. One can occur as allergic colitis in breast or bottle fed infants. In breast fed infants the bloody mucoid stools are produced because of an allergic reaction of the colonic mucosa to foreign proteins which are delivered to the baby via breast milk. In bottle fed infants the given foreign protein itself can trigger the allergic reaction. The clinical, endoscopical and histological appearance is similar to that of ulcerative colitis. Elimination of foreign proteins from the diet of the mother or in bottle fed infants from the child is the therapy of choice. The second manifestation of food allergy in this age group is the cow's milk protein intolerance with predominantly gastrointestinal symptoms such as vomiting, diarrhea and failure to thrive. The diagnosis is based on the clinical picture alone. The usual laboratory tests don't discriminate enough and can therefore not confirm the diagnosis. Elimination of the affecting protein and replacement by a semi-elementary diet are recommended for therapy. The prevention of allergies by dietetic means has become of great importance since it was possible to identify newborns at risk for allergies. The prolonged breast feeding and the late introduction of solids later than the sixth month of life is the preventive measure. "Hypoallergenic" formulae are not recommended because not enough solid data are available to confirm their preventive effect.

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