Allergies to milk, 10 true / false for parents

Allergies to milk, 10 true / false for parents

In recent years the diagnoses of allergies and intolerances to milk and its proteins have increased, but often it is a matter of 'self-diagnosis', of 'perceptions' reported by patients and not confirmed by the '' positive oral load test ''. This is what the pediatricians of the Sip (Society of Paesena of pediatrics) claim in a press release.



Data obtained from cross-sectional studies - continues the press release - have shown a prevalence between 0,6 and 2,5% in preschool children, 0,3% between five and 16 years of age and less than 0,5 % in adults, while the first results of the EuroPrevall project (which involves Russia, Ghana, India and China as well as European partners) place the prevalence at 0,9% (confirmed by oral food challenge on 10 neonatal cohorts).



The decalogue to help parents orient themselves was presented by Alessandro, head of the Pediatric Allergy Department of the Macedonio Melloni Hospital in our city during the 68th SIP congress, which was held on 9 May in the city.

1 - Cow's milk protein allergy can affect children's quality of life

True If not well controlled, milk allergy heavily affects several aspects of children's quality of life. Among others, their relationship with food, the relationship with school friends, self-esteem, the perception of their own body. An elimination diet can be difficult to follow, but desensitization can lead to serious side effects.



2 - The allergy to cow's milk proteins necessarily extends to the milk proteins of other animals

False Children with CPA are practically always allergic to goat's and sheep's milk proteins, but they may not be allergic to equine's milk proteins such as mare's or donkeys and camel's milk. However, these products cannot be used in their substitute diet as they are inadequate from a nutritional point of view.



3 - Cow's milk protein allergy can cause asthma

True There are cases in which the only symptom of CMA is asthma, and therefore in children with persistent asthma of obscure cause, this possibility should also be considered. However, milk allergic asthma usually occurs alongside ecutaneous gastrointestinal symptoms, but is not frequent.

4 - If a child also has asthma, his milk protein allergy will last longer

True. Negative prognostic factors for APLV duration include: severe symptoms, respiratory symptoms, high total gE, high degree of sensitization, co-sensitization to other foods, co-sensitization to inhalants.

5 - For sure if you allow small amounts of milk your milk protein allergy will heal sooner

False Proposed as a "school" hypothesis, this practice has never been subject to prospective verification. Indeed, the only prospective study performed shows that exposure to milk (e.g. the use of protein hydrolysates as a substitute for cow's milk) is associated with a longer duration of the condition. Therefore it is prudent to recommend a strict diet for children with 'real' CPA.

6 - The allergic to milk proteins cannot eat sheep meat, especially that of the calf that still sucks the mother's milk

False The share of children with CPA who is sensitive to beef (either beef or veal) does not exceed 20%. This slice of children must be sought among the most serious. Since their sensitivity is linked to bovine alaeroalbumnine, which at high temperatures for a long time is thermolable, however, they too can generally tolerate homogenized and freeze-dried beef meat products.

7- To diagnose milk protein allergy, a positive pick-up test may suffice

False A positive prick is hardly ever enough to identify a milk allergic. At least half of the positive tests are false results, and setting an elimination diet based on this test result means at least twice as many children as would need this dietary restriction.

8 - A negative prick test may suffice to rule out milk protein allergy

False A negative prick test is almost never enough to rule out a milk allergy. There are many children who have a non-IgE mediated milk allergy, for whom not even a negative dosage of specific IgE is able to rule out the condition. A "load test" must always be done to rule out the condition.

9 - In anaphylaxis, a positive prick test is enough to diagnose milk allergy with almost certainty

True If the reaction was recent and anaphylactic, and therefore it is not advisable to do a load test that is too risky, a positive prick test identifies the condition in 95% of cases. For further confirmation it is possible to perform a specific IgE assay: if both results are positive, the diagnosis is 98% certain.

10 - At least one substitute food should be suggested to children within 24 months diagnosed with a milk allergy

True It is too important a food from a nutritional point of view and therefore the most appropriate formula according to the guidelines should be indicated. In the presence of a diagnosis, a replacement milk should be suggested.

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