How do babies get food allergies

The rapid development of civilization has brought us more than one misfortune. "Food allergy" - many, when they hear this diagnosis, say: still, because what a muck you have to feed your children. Nitrates, dyes, modified products. But we will talk about something else: the products are good, and the body responds to them with reddening of the skin and a rash. As a rule, an allergic reaction is caused by food that is unusual, say, for the inhabitants of the Central Russian Upland - sea fish and shrimps, oranges and chocolate, nuts and spices. Although traditional milk, wheat and honey can cause allergies. It is not yet possible to establish the exact causes of the growing "coma" of allergic reactions. But you can stop its growth through proper nutrition.

Science and life // Illustrations

In allergy, the formation of an antigen-antibody complex causes the release of biologically active substances (BAS) - allergy mediators.

When preparing hypoallergenic diets for lactating women, it is necessary to ensure their high biological and nutritional value, sufficient content of vitamins, minerals and trace elements.

The division given in the table is conditional: regional, national, family and other peculiarities of children's nutrition are of great importance.

Highly allergenic foods include bright red and orange fruits and berries. Give your child green and yellow apples as complementary foods.

Science and life // Illustrations

Cross-reactions of pollen allergens, food products and phytopreparations ›

View full size

Many people suffer from hypersensitivity to food, but it is not always an allergy. Food intolerance is often caused by diseases of the gastrointestinal tract, insufficient activity of food enzymes, psychogenic aversion to certain foods, and other reasons. None of these cases involved an immune mechanism.

In the case of a true food allergy, the immune system perceives certain proteins not as useful food components, but as something alien, harmful to the body and develops protective antibodies against them. Proteins usually cause an allergic reaction, but sometimes other substances contained in food products act as allergens. When an allergen first enters the body, sensitization occurs - the immune system remembers it as a "stranger". And with any subsequent use of the product, an allergic reaction develops.

Manifestations of food allergies most often occur in early childhood and persist throughout life. Usually the skin reacts first: redness, itching, swelling appear. But there may also be abdominal pain, nausea, vomiting, intestinal upset (diarrhea, flatulence - increased gas formation, constipation). In addition, headache, irritability, nasal congestion, difficulty breathing up to an attack of suffocation and, as an extreme degree of severity, anaphylactic shock are not uncommon. It is important to know: an attack of a true allergy occurs even when the allergen enters the body in the smallest amount.

ONE IS POSSIBLE, THE OTHER IS NO

And now let's figure out the reason for this "injustice": why is it possible for one, and not for the other? We are all very different - not only our appearance is unique, but also biochemical processes, and how our body reacts to a new food component. And yet science establishes some patterns.

In the twentieth century, the external manifestations of allergies were called diathesis. In Greek it means "inclination". Addiction here is an abnormal reaction of the organism. If earlier this situation was stated, now it can be quantified: when analyzing blood, a specific (immune) protein is found in it, and the severity of the allergy can be determined by its quantity.

Predisposition to food allergies is often inherited. A hereditary relationship has been established in 50-70% of cases of allergic manifestations. An allergy to food products can form in a baby even in the womb with malnutrition of the expectant mother, as well as during breastfeeding. This is facilitated by overeating foods that have a pronounced allergenicity (fish, seafood, eggs, nuts, citrus fruits, chocolate, etc.). Transmission of the allergen to the fetus can occur in utero through the amniotic fluid when swallowed by the fetus or through its skin (it is very permeable).

In the immature body of premature babies, food allergies develop more often. The early transfer of the child to artificial feeding is also critical. Food allergies can be caused by improper introduction of complementary foods, inconsistency of food ingredients with the weight and age of the child. Do not overfeed your baby and introduce foods that have highly allergenic properties into the diet. The risk of developing allergies is higher if the child has an inflammatory disease. It is necessary to pay attention to the inadmissibility of the early use of medicines, especially antibiotics (the instructions for use of most drugs indicate whether they can be taken during pregnancy and lactation). Here is the last rule, expectant mothers often observe, but they don’t remember that during pregnancy you shouldn’t lean on chocolate. Especially if the mother herself had, as they used to say, "New Year's diathesis" - a reaction to tangerines and sweets eaten in excess during the holidays. So even in the womb, the child's body is subjected to sensitization.

SOMETIMES GOOD AND DANGEROUS FOOD

What in ordinary products can become dangerous? Most often, proteins of animal and vegetable origin become allergens, less often polypeptides - fragments of proteins. Some low molecular weight substances, in themselves not dangerous, turn into allergens by attaching to a certain protein. With a normal diet during the day, a person receives about 120 potential allergens. Milk, fish, eggs, animal and poultry meat, nuts, legumes, grains, vegetables and fruits - all of these common foods contain substances that can cause allergies.

Food allergens can change their antigenic properties during heat treatment in the direction of both their weakening and strengthening. But more often pasteurization, sterilization, freezing, pickling or salting products have little effect on the severity of allergenic properties. If the expectant mother is allergic to eggs, then she needs to limit the use of buns, mayonnaise, and cakes.

ALLERGY PORTRAIT

In each childhood, food allergies have different clinical manifestations. When breastfeeding, if the mother follows the diet, food allergies rarely develop in a child under 6 months old. Its very first manifestation is atopic dermatitis. It is first expressed in itching and redness of the skin around the mouth or around the anus of the child, in persistent diaper rash with careful care of his skin. Not only the skin responds to the onset of the allergen. With its further introduction, the whole body reacts: regurgitation, vomiting, frequent loose stools with mucus, bloating like intestinal colic and further skin damage may appear. Children often refuse food.

Small bubbles pour out on the skin, which quickly merge, burst with the development of weeping and further formation of crusts. Localization of skin lesions can be different, but more often it all starts with the face, neck. As the child grows, allergies can become chronic. The area of ​​skin lesions increases, areas of redness appear with fuzzy boundaries and rashes, accompanied by itching, peeling, scratching. The child becomes irritable, whiny, sleeps poorly, often refuses food. In the older age group in children with food allergies, skin manifestations can be urticaria, as well as angioedema angioedema.

Attentive parents quickly notice the connection between clinical manifestations and the introduction of a new product into the child's diet. But it happens that it is quite difficult to identify the allergen, then an allergist-immunologist comes to the aid of parents. He examines the child, noting the characteristic manifestations on the skin, mucous membranes, checks the safety of nasal breathing, examines the activity of all organs and systems. With its help, a family history is carefully collected and analyzed, the mother's diet is examined, the correctness and timeliness of the introduction of complementary foods and the composition of the mixtures used to supplement the child. In difficult cases, diagnostic tests are performed.

WHAT YOU CAN DO FOR YOUR CHILD

How do you determine what your child can and cannot eat? The most acceptable for children is an elimination test (from the Latin elimino - I take it out of the threshold, I delete it) test, when the suspected product is excluded from the diet for 1-2 weeks. Improvement in skin condition or disappearance of symptoms is a sign of his "guilt". Repeated use of a "suspect" food with a true food allergy will again evoke a past reaction. But it happens that in this way it is not possible to identify allergenic products, especially if there are several of them. Skin tests with allergens in young children are not performed, as children are afraid of such manipulations. And conducting provocative tests can cause serious complications. The doctor comes to the aid of laboratory diagnostics with a study of the patient's blood. Special diagnostic tests have been developed to detect the presence of specific antibodies in the patient's blood in allergic diseases. In practical medicine, enzyme-linked immunosorbent assay (ELISA), radioallergosorbent test (RAST), multiple allergosorbent test (MAST), immunochemiluminescent method, etc. are commonly used. The advantage of these tests lies in their informativeness and complete safety for the patient.

DIET

After identifying the cause of the food allergy, a diet is drawn up that excludes the use of the “guilty” product. This is the first and main step in the treatment of food allergies. Back in 1998, it was shown that the frequency of food allergy in children in the first 5 years of life is more than 6 times higher than other forms of allergy, such as inhalation to plant pollen or household allergens. Moreover, up to 30% of children with a proven immune mechanism of food allergy become more tolerant (able to tolerate) food by the age of three, and by the age of 12 this figure reaches 53% if reasonable individual hypoallergenic ("hypo" - low) diets are observed. Here is evidence that even genetically determined allergic manifestations can be avoided by eliminating contact with allergens. In cases where a food allergy develops in relation to infrequently consumed foods, such as strawberries, chocolate, crabs, the only effective method of treatment is the complete elimination of a particular food product and any others in which this product is included, even in the smallest quantities. The situation is more complicated with allergies to basic foods. They can be excluded only with proven allergies, with a mandatory replacement with another product of similar calorie content and with the same protein content, but not causing allergic reactions.

MILK FORMULA

An infant receiving formula milk does not have a variety of nutrition, and if an allergy to milk, more often cow's milk, occurs, it is excluded from the diet. In such cases, the child is transferred to hypoallergenic mixtures. Food should be selected with great responsibility. For the growth and development of the child, nutrients (proteins, fats and carbohydrates), vitamins and microelements are needed, which must be supplied to the body in sufficient and properly balanced amounts. It is best to use baby food based on protein hydrolysates. Soy-based baby food (soy milk) is currently recommended with great caution due to the high likelihood of developing an allergy to soy protein and is prescribed if a child is found to be deficient in the enzyme for digesting lactose - milk sugar.

Formulated infant formula based on milk protein hydrolysates contains already digested (hydrolyzed) proteins. Allergic reactions to them practically do not occur. The disadvantages of these mixtures are not very pleasant smell and color, leading to a change in color and consistency of baby feces to greenish and liquid, as well as their relatively high cost. But with food allergies, they become a saving substitute for intolerant milk. An example is the mixtures of the Dutch company Nutricia, a leader in the creation of mixtures for baby and medical nutrition. But there are products from other companies as well. The right choice will be made by the allergist.

Each jar indicates how to prepare baby food for a child depending on age, and a recipe for preparing a mixture is given, which is simple and consists in combining boiled water and powder in certain proportions.

Recent studies have shown that in many cases of food allergy, it is effective to replace cow's milk with goat's, which is due to the peculiarities of the physicochemical structure of its proteins. At present, products based on goat's milk have been developed for use not only as a substitute for women's milk, but also for cow's milk intolerance.

These goat-based breast milk substitutes are manufactured by Enfagroup Nutritional. In order to normalize the microflora and prevent constipation, these mixtures are additionally supplemented with prebiotics, compounds that restore the intestinal flora. Proteins have been added to the substitutes to improve the processes of brain maturation and the development of intelligence in an infant. In addition, these mixtures are enriched with an antioxidant complex containing selenium, beta-carotene, vitamin D3, taurine, inositol and choline, which enhances the child's body's resistance to various adverse environmental influences.

SUPPLEMENTING FOOD

After six months, not only with artificial, but also with breastfeeding, an insufficient amount of nutrients enters the body of a child with milk or milk mixtures for full growth and development. From this time on, it is recommended to introduce more solid food - complementary foods - into the diet. At first, it should be vegetable and fruit purees. At the same time, the child receives not only all the substances necessary for growth, but also new skills - he learns to chew and taste food. For children with a high likelihood of developing allergies, complementary foods are introduced carefully under the supervision of a pediatrician, one product per week and in small quantities. They start with foods that rarely cause allergies, such as fermented milk products, vegetable purees, cereals. When choosing a diet therapy, it must be remembered that the appointment of kefir for children with hypersensitivity to cow's milk proteins is unacceptable. Kefir has a high protein content (2.8 g per 100 ml), which increases the load on the urinary system of the child, and also causes microbleeding from the gastrointestinal tract. A new product is not introduced into the diet if the child is not completely healthy when teeth are cut, during vaccination. To be able to track the appearance of an allergic reaction, it is recommended to introduce a new product in the morning feeding, and not in the evening, especially at night. When prescribing an elimination diet, it is also necessary to exclude products that have cross-reactions with a food allergen: cow's milk - beef; tree pollen - apples, cherries, apricots, nuts; pollen of cereals - cereals, flour and flour products; eggs - the meat of various birds; quinoa pollen - beets, spinach, etc. If no improvement is observed within 10 days of the elimination diet, the list of recommended foods should be reviewed. Finding the "guilty" product is easier if parents keep a food diary, where they enter all the foods the child consumes, indicate the time of admission, the child's well-being during the day, and the time of onset of symptoms. The symptoms must be described in detail. All this information must be reported to the allergist-immunologist for careful selection of an individual hypoallergenic diet.

If the symptoms of food allergies do not disappear, the doctor prescribes medications, taking into account the age of the child, the severity of the skin process and the speed of the regression of the disease. In the diary, you need to write down what remedies and how quickly they helped to eliminate the symptoms.

Dry air enhances skin manifestations, so in the apartment where the child lives, it is necessary to maintain sufficient air humidity.

As a child with a food allergy grows, he eats and drinks a lot more different foods than in the infant period. In addition, he can already eat on his own, and does not always do this in the presence of his parents. Therefore, it can be difficult to trace the relationship between the development of symptoms and the consumption of any particular food.

SEVERAL RULES OF CONDUCT FOR PARENTS

Just drawing up a daily menu, even with the help of a doctor, will not solve the problem of feeding children with food allergies, you must ensure that it is also respected.

The child grows up, he understands better that after eating certain foods he becomes ill, he himself feels that something is wrong with him.

Try to explain to him in as much detail as possible what food is better not to eat. But you can’t foresee everything, there may be violations in the diet due to the use of an intolerable product in a hidden form (unknown filling, an integral part of the sauce, etc.). Be sure to have at home in a conspicuous place a list of products that are contraindicated for the child in order to exclude the possibility of feeding them out of forgetfulness or by an outsider if he is ignorant. It’s good to always have a supply of food in the house that the child tolerates well. When he goes to school or visits, you can give a well-tolerated product in a convenient package to replace the treat that is contraindicated for him. Living with food allergies is difficult for both the child and his parents, but we must try so that the disease does not interfere with the development of the child and his communication with peers, does not form in him a feeling of self-doubt, isolation. It is necessary to talk about this with children, and explain to close relatives and friends about food allergies. This will help to avoid excesses when someone “kind” thrusts a “forbidden fruit” into a child secretly from their parents and, bringing joy for a second, brings suffering for hours. Close contact with a knowledgeable allergist will help resolve the painful problem and eliminate the manifestations of food allergies.

Older children are more likely than younger children to experience non-immune food intolerance reactions (pseudo-allergic reactions). They usually depend on the amount eaten. Food intolerance is also associated with dyes, preservatives, various thickeners, stabilizers, flavors and the like. When buying products, always look for labels that list these ingredients. True, sometimes you have to wear a special magnifying glass, since manufacturers print such information in unacceptably small print and in the most “unreadable” places. If the patient has a non-immune food intolerance, thermally processed foods can be recommended if the raw food caused painful manifestations. The golden rule to follow is: "If in doubt, don't eat!" Food intolerance, unlike a true allergy, can manifest itself inconsistently and even disappear after the exclusion of an intolerable product from the diet for a long time. Stress, infections, physical overwork can exacerbate an existing food intolerance. Even playing sports after eating can provoke a pseudo-allergic reaction.

And one more rule: cook your own food, then there will be less fears about additives: homemade cutlet is better than sausage, porridge is better than potato chips, homemade bun is better than a pie from a stall.

In any case, the child must be shown to a doctor - an allergist-immunologist, who, after clarifying the nature of food intolerance, must issue a "Passport of a patient with an allergic disease." The passport contains the diagnosis, a complete list of intolerable foods and first aid measures in case of reactions to food, as well as the phone numbers of the doctor of the allergological office in which the sick child is observed.

"Passport" must always be carried with you, as well as the necessary medicines to provide assistance. It would be nice to buy a child and a mobile phone so that in case of an attack, he can contact you.

Allergy: myths and reality

Allergy is considered a disease of the 21st century. Some allergic reactions can be read in the writings of doctors of the 1st century BC. Over the millennia, humanity has accumulated a certain amount of information about allergies, and sometimes we think that we already know everything about it. However, some of this knowledge is just myths, stories passed from mouth to mouth and without any scientific basis.

Myths.

Myth #1.

"25% of people believe they have a food allergy."

Clinical studies show that only 6% of children and 2% of adults are allergic to certain foods.

Myth #2.

"Most allergic people react to sweets, tomatoes and strawberries. "

An allergy can be to any product. For most adults, the main allergen is peanuts. In the United States, 100 people die every year from a generalized allergic reaction to peanuts.

Myth #3.

"Food allergies are not dangerous."

In the event of anaphylactic shock or Quincke's edema, the count goes on for minutes. If you do not provide emergency medical care, as a result of bronchospasm, when air stops flowing into the lungs, the prognosis for the patient may be unfavorable. If you or your child have a food allergy, you must have Dexamethasone in ampoules in the medicine cabinet.

How does a food allergy manifest itself?

The leading clinical manifestations of food allergy are:

skin changes - 50-70% (rash)

Gastrointestinal manifestations - 30-60% (abdominal pain, changes in stool)

Respiratory syndrome - 20-30% (cough, runny nose, shortness of breath).

Young children rarely have isolated forms of food allergies. In most cases, food allergies are multi-organ in nature. This manifests itself in the form of constipation, a rash in the perianal region, colic, abdominal pain, which leads to refusal to eat and, as a result, to weight loss and anemia.

Initial symptoms occur in the first weeks or even days of a child's life. Most often, these symptoms are not specific enough and do not have the nature of a specific pathology. These include: skin manifestations (redness, persistent diaper rash, rash). Gastrointestinal symptoms can be expressed by profuse regurgitation, colic, constipation. At least 10-15% of cases of infantile colic are associated with food allergies. Refusal to take the product or anxiety about eating can also indicate an allergic reaction.

What is an allergen?

Cause-significant allergens are foods containing protein.

Major allergens in young children around the world:

The "big eight" allergens include: cow's milk, chicken egg, soy, peanuts, wheat, tree nuts, seafood and fish. It should be remembered that nuts include hazelnuts, walnuts, almonds, hazelnuts, pecans. And peanuts belong to another group of plants - legumes. Other common allergens include: chocolate, strawberries, honey, animal and bird meat, cereals. However, their causal role increases with age.

So, the main allergens in children under 3 years old are chicken eggs and cow's milk protein.

The development of food allergies in breastfed children occurs due to excessive consumption by the mother during lactation of products containing cow's milk protein and chicken eggs, as well as products with a high allergenic potential. Allergens are found in breast milk 1-6 hours after consumption, regardless of whether the mother has an allergic disease. Normally, this is of physiological importance for the formation of food tolerance in a child. But if there is a genetic predisposition to allergies, this can lead to sensitization, i.e. the accumulation of antibodies to this allergen and subsequently lead to the appearance of clinical symptoms of allergy.

So, if one or both parents in the family suffer from allergic diseases, a lactating woman should adhere to a hypoallergenic diet throughout the entire lactation period.

chicken eggs, have high allergenicity, not only protein, but also some proteins contained in the yolk. However, about half of children with hen's egg allergy are able to tolerate small amounts of egg whites in highly cooked foods (bread, biscuits). And among children over 5 years old who had an allergy to a chicken egg, most have a tolerance to a boiled egg. An allergy to a chicken egg can be accompanied by a cross-allergic reaction to the eggs of other birds and to chicken meat.

So, boiled eggs are less likely to cause allergic reactions in preschool children. And young children who are allergic to chicken eggs can eat foods containing intensely heat-treated egg white in small quantities.

Measles and mumps vaccines may contain trace hen egg allergens due to the use of chick embryos. This must be taken into account when vaccinating against these infections. The presence of a generalized allergic reaction to a chicken egg is an absolute contraindication for the use of these vaccines. In other cases, in the absence of a history of generalized allergic reactions to a chicken egg, a child can be vaccinated.

So, when vaccinating a child, it is necessary to consult a vaccinologist.

True allergy to cow's milk protein most often occurs in the first year of life, and in further its prevalence decreases. Milk contains approximately 36 types of different proteins that can cause sensitization. The main allergens of milk practically do not lose their biological activity during boiling, pasteurization, ultra-high temperature treatment and drying. The milk of other animals, in particular goats, has pronounced allergenic properties. At the same time, goat's milk can cause both cross - allergic reaction in patients with food allergy to cow's milk protein, and be an independent allergen and cause severe allergic reactions. Far from cheap mixtures based on goat's milk, so widely advertised everywhere, are used only in Russia, they are not sold in other countries ... ..

What other allergens currently exist?

Often the cause of the occurrence or exacerbation of various allergic diseases can be soy or products containing soy protein . Children who receive soy-based formulas are more affected. There are 16 different allergens found in soy. In addition, soy contains phytoestrogens, which are considered as a possible factor in the obesity of modern people.

Peanut (peanut) is actively used in the food industry and belongs to the "hidden allergens". After roasting and boiling, the allergenic properties of peanuts increase. Peanut allergy is one of the most common types of food hypersensitivity, characterized by severe reactions, including anaphylactic shock. The presence of an allergy to peanuts is an unfavorable harbinger of the development of severe systemic diseases in the future.

Fish and seafood also cause the development of allergic reactions, including in young children. Marine fish are more allergenic than river fish. Some patients are allergic to only one type of fish, and they do not react to other varieties. But in terms of composition, the proteins of different fish species have an almost homologous structure, and this explains the presence of cross-allergic reactions to all types of fish in many patients. It is characteristic that the allergy to fish does not decrease with age. Allergenic protein in some fish species can turn into steam during heat treatment, which explains the appearance of inhalation manifestations of allergy in sensitized patients. People with a seafood allergy should follow the same precautions as those with a fish allergy. Indeed, even a small amount of mollusk can cause a violent allergic reaction, life-threatening, up to anaphylactic shock.

Animal meat. Allergic reactions to animal meat are rare. Most allergenic meat proteins lose their sensitizing ability after thermal and culinary processing.

What are cross-allergic reactions?

This is the development of an allergic reaction to various other foods, as well as the appearance of identical symptoms to food, pollen and epidermal allergens. This is due to the similarity of the structure (amino acid composition) of these allergens and is essential for patients with food allergies and hay fever, since these patients may develop cross allergic reactions . For example, sagebrush pollen provokes a cross-allergic reaction to banana, avocado and melon. Birch pollen - for apple, pear, carrot, cherry, sweet cherry, dill, walnut, peach, plum, potato, spinach, peanut, celery, kiwi, cumin, coriander. Sunflower pollen - for sunflower oil, halva, mayonnaise, mustard. Down, feather - for meat and eggs of birds. Fungal allergens - for kefir, moldy cheeses, yeast dough products, kvass.

Thus, a hypoallergenic diet should be followed for lactating mothers with a burdened allergic history and children suffering from various types of allergic diseases. For the prevention of allergies, breastfeeding and the correct introduction of complementary foods to the child are very important.

What is a hypoallergenic diet?

This is a N 5 GA diet, from which products with increased sensitizing activity, containing artificial food additives (dyes, emulsifiers, preservatives), as well as dishes with the properties of non-specific gastrointestinal tract irritants, are excluded. This diet provides for gentle cooking, while the dishes are steamed, boiled or baked. The temperature of the dishes should be 20 degrees C. The calorie content of a hypoallergenic diet corresponds to the physiological need.

sorrel, spinach, tomatoes, bell peppers, sauerkraut, pickled and pickled cucumbers, as well as melon, watermelon, mushrooms, nuts, berries and fruits of orange and red color (citrus fruits, strawberries, strawberries, raspberries, sea buckthorn, kiwi, pineapple, apricot, pomegranate, peach, grapes), refractory fats, margarine, carbonated fruit drinks, kvass, coffee, cocoa, kissels, honey, chocolate, caramel, marshmallows, marshmallows, cakes, muffins, fresh pastries, chewing gum.