Newborns are also allergic to milk?One article is done to identify and respond!

*For medical professionals for reading reference

Summary:

The intestinal wall structure of the newborn is loose, the intestinal mucosal cells are high, and it is prone to leakage of large molecular antigen. Moreover, the normal fungus of the intestinal cavity is not established, and the immune system is not complete. Milk protein allergies (CMPA) will occur. For children with milk protein allergies, including newborns, food avoidance is the only effective method for disease management [1]. It should be noted that breast milk is the best source of nutrition for babies. Breastfeeding should be adhered to. If CMPA is diagnosed, the mother needs to avoid sensitized food and pay attention to the supplement of calcium and vitamin D.

1. Newborn CMPA Overview

Newborn digestive tract functional development is not mature, the intestinal wall structure is relaxed, the normal flora of the intestinal cavity has not been established, and the immune system is not complete. In addition, genetic and environmental factors are also one of the risk factors of allergies in newborns [3].

Gastrointestinal tract and skin symptoms are the most common symptoms of CMPA in newborns. About 90%of newborn will have gastrointestinal symptoms, mainly vomiting, blood and bloating. The tolerance performance is similar [2,4]. Therefore, clinically, when the newborn has early feeding tolerance, it will also consider whether there are food allergies. In addition, CMPA will also show respiratory suspension and superfluous reactions, but this is rare in full moon [5,6].

Gastrointestinal symptoms details

The occurrence of premature milk protein is more late than the full moon, and often occurs after 32 weeks of tire age, and the smaller the fetal age, the later the onset may be [7]. However, not all premature infants' onset time is relatively late. Some literature reports show that a 33+2 weeks of a 33+2 weeks of premature babies CMPA will be ill 2 days after birth. It has a certain relationship with the mother's intake of milk protein [8].

The feeding method also has a great impact on the occurrence of newborn milk protein. Formula milk and ordinary milk contain protein that can easily cause allergies of the body, with a number of more than a dozen. The most important allergies are α-casein and β-milk globulin. They have good stability. Dehydration and other treatment, still retain the biological activity of antigen [9,10]. There is evidence that the risk of pure breastfeeding baby food allergies is low [11], and breastfeeding should be encouraged, but it should be noted that food protein includes milk protein, peanut protein, egg protein, etc. will also pass to the baby through milk, so pure Baby -fed babies also have the risk of food allergies [12].

2. Newborn CMPA recognition process

ESPGHANEACCI (ESPGHANEACCI) recommends that food allergies should follow the following diagnostic process [13,14]:

This process is also applicable to the diagnosis of newborn CMPA.

History screening is the first step in diagnosis. Reference to allergies, family history, and feeding history. When children have symptoms and food intake, they may consider suspected CMPA. Because SIGE is low in newborns and it is difficult to sample sampling of newborns, laboratory examinations are not suitable for newborns allergic diagnosis [4].

Food avoidance 2-6 weeks+stimulation test is a gold standard for diagnosis of food allergies. Considering the complexity of open food stimulation test operation processes and certain risks. The results of adverse reactions to an oral food stimulus test for infants and young children showed that the incidence of adverse reactions was 56.1%, of which severe allergic reactions reached 21.7%[15].

Oral food stimulus test may also increase the risk of allergies again, so it is not recommended to conduct in newborns. Diagnostic food avoidance is the most commonly used method at present. Symptom relief after food avoidance can help diagnose newborns CMPA. The guide recommends the alternative formula for the avoidance of amino acid formula for 2-6 weeks as a diagnostic food. [16,17]. The amino acid formula is 100%Food -free recipe for allergen, which completely avoids allergens, effectively relieves symptoms, and diagnose one step as soon as possible [18].

3. Nutrition management of newborn CMPA

Breast milk is the best source of nutrition for babies. For the newborn CMPA diagnosed, breastfeeding should be adhered to. At the same time, the mother avoids milk and dairy products. Due to the severe symptoms of premature babies CMPA, which are often severe, and severe consequences such as circulating failure, low response, NEC, etc., you can also consider directly replacing it to amino acid formula milk. At the same time Re -introduction of breast milk, the mother still needs to avoid milk and dairy products [19].

For the diagnosis of newborns CMPA, children should also avoid allergenic foods at least 6 months or to September to December [13,20], and the younger age, the longer it is recommended to avoid [21]. Immune cells are memory, and the high -sensitivity period is at least 6 months [22]. Therefore, after food allergies occur, allergens are still needed for 6 months to avoid recurrent allergies. Deep hydrolyzed formula (EHF) has a residual peptide chain and is still sensitive; nearly 30%of children are not resistant to EHF, and children with mild moderation may also be intolerance for EHF [23].

Therefore, the use of EHF during high allergies may cause repeated symptoms and prolonged diseases. As mentioned earlier, β-milk globulin is a common allergens for milk protein allergies. The amino acid formula does not contain β-milk globulin, 100%non-allergen, suitable for all children with milk protein allergies. It is currently the first choice for the treatment formula [18].

The osmotic pressure is one of the attention of newborn feeding. Baby consumption of high osmotic pressure formula may damage its renal function, cause various gastrointestinal diseases, etc., and premature babies are more likely to be damaged by high -lyon pressure foods [24].

Many people worry that the penetration of amino acid formula is too high, and newborns or premature infants will be impatient. In fact, a survey of an osmotic pressure on breast milk and formula shows that the amino acid formula (taking Newcom as an example) osmotic pressure It is 340 MOSM/KG (310mosm/L), which is lower than that of parent milk enhancer and some premature infant formulas, so there is no need to worry about the osmotic pressure of amino acid formula [25].

The American Society of Pediatrics recommends that the penetration pressure of infant recipes should not exceed 450mosm/kgh2o (= 400mosm/L). The osmotic pressure of amino acid formula is within the scope recommended by authoritative agencies.

Multiple studies have shown that amino acid recipes can also improve premature inferial feeding problems and support normal growth and development. Calcium protein is a kind of antibacterial protein. When an intestinal inflammation reaction occurs, a retrospective analysis shows that children with food allergic feed on amino acid formula can alleviate intestinal inflammation by decreased the level of calcium protein levels [decreased in the level of calcium protein. [ 27]. Another research on another amino acid formula for extremely low birth weight shows that the amino acid formula can promote gastrointestinal maturity, improve gastrointestinal discomfort, improve nutritional conditions, and support growth and development [28].

Formulating feeding group in amino acid formula feeding group

The incidence of vomiting and stomach residues is significantly lower

The development of amino acid formula feeding groups is significantly better

Summarize

Because of its immature gastrointestinal tract and immune system, milk protein allergies will occur early. Early identification, early diagnosis, and early benefit. At present, for children with suspected milk protein, diagnostic food avoidance is an effective diagnostic solution. The latest guidelines should choose 100%unknown amino acid formula during the period of recommended food. For newborns who have diagnosed CMPA, allergenic foods should be avoided for at least 6 months or to 9 to December.

When choosing a formula during the food avoidance period, considering that the deep hydrolyzed formula has a residual peptide chain, it is still allergic, and the amino acid formula is 100%non -allergic. It is suitable for all children with milk protein. It is the first choice for the treatment formula. In addition, the amino acid formula osmotic pressure complies with the adoption pressure requirements of infant formula milk powder that the child science association is recommended. It is suitable for all children with allergies of milk protein, including newborns such as premature babies, which can be used with confidence. Feeding is not tolerant.

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