- Protein flaw and lactose intolerance
- Protein flaw - diagnosis
- Protein flaw - treatment
- Protein flaw - prevention
- Protein flaw - prognosis
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Protein flaw and milk allergy is a colloquial term for an allergy to cow's milk protein. Protein diathesis most often occurs in children under 1 year of age. It is estimated that by the age of 5, symptoms of protein blemish disappear in as much as 80-90%. young patients. It is good to know what are the causes of protein blemish, how does protein blemish manifest itself, how to diagnose protein blemish and what is the treatment of protein blemish.Worth knowing
- Important differential diagnosis
The symptoms of protein blemish listed above are also characteristic of other food allergies. While cow's milk protein is one of the foods most commonly sensitizing babies, there are many other ingredients that can cause food allergies.
These include, for example, nuts, fish, eggs, citrus and chocolate. Before we exclude any foods from a child's diet, we should make sure that our suspicions about the source of the allergy are correct.
Protein blemish should also be differentiated from other causes of gastrointestinal complaints in children. The most important of them are infectious diarrhea, celiac disease and inflammatory bowel diseases. Protein diathesis in children is often equated with lactose intolerance. However, these are two completely separate disease entities.
Protein flaw and lactose intolerance
Protein flawis an abnormal reaction of the immune system to proteins contained in cow's milk and its products. Lactose intolerance occurs in a completely different way. Its cause is a deficiency or incorrect function of the enzymes responsible for digesting one of the milk sugars - lactose. The development of lactose intolerance has nothing to do with the stimulation of the immune system as a result of consumed milk.
Some symptoms may be common to protein diathesis and lactose intolerance (flatulence, diarrhea, abdominal pain, constipation), so these disease entities are often confused with each other. One of the criteria useful in their differentiation is the age typical for the development of both diseases.
Protein flawis most common in children under the age of one. Lactose intolerance in such young children is extremely rare; its first symptoms usually appear around the age of five. Intolerancelactose is typically found in older children and adults.
Protein flaw - diagnosis
How to recognize a protein defect? The diagnosis of a protein defect cannot be made during a single medical visit. It is a process that aims to confirm the relationship between the consumption of milk proteins and the occurrence of clinical symptoms. In diagnostics, it is also necessary to exclude other potential causes of the ailments.
The first stage of making a diagnosis is collecting a very detailed medical history. In addition to a comprehensive analysis of the child's symptoms, you should also expect questions about the history of allergic diseases in the family (allergic rhinitis, bronchial asthma, atopic dermatitis).
Then the child must be physically examined for skin changes and other symptoms characteristic of a protein blemish.
The next stage in the diagnosis of protein defect are laboratory tests, determining the number and quality of IgE antibodies present in a child. Currently, it is possible to determine specific IgE antibodies against cow's milk proteins. A positive result of this test confirms the presence of an allergy with an IgE-dependent mechanism.
Does a negative result of specific antibodies to cows' milk proteins exclude the possibility ofprotein defect in infants ? Absolutely not - remember that a food allergy to cow's milk protein may also arise in the IgE-independent mechanism.
Then, despite the lack of specific IgE antibodies, the child may have delayed type hypersensitivity to cow's milk protein. Skin tests with cow's milk protein antigens are used in a similar way.
The so-called "gold standard" in the diagnosis of all types of food allergies (including protein blemish) are provocation tests. The idea behind provocation tests is to withdraw certain nutrients from the diet and then re-introduce them together with constant clinical observation of the patient.
If a protein defect is suspected, milk and all its products should be excluded from the child's diet. The exclusion period usually lasts several weeks (2-4) depending on the type and severity of the disease symptoms. In the case of exclusively naturally fed children, the exclusion of dairy products applies to the mother who is nursing the child.
If, on the other hand, the child receives modified milk, it is necessary to switch to mixtures containing hydrolysed proteins (specially ground). Relief of disease symptoms after the withdrawal of dairy products and their return afterre-introducing them to the child's diet is a confirmation of food hypersensitivity to cow's milk protein.
In case of diagnostic difficulties or unclear clinical picture of the disease, tests for other diseases of the gastrointestinal tract may be necessary. They include, among others screening for celiac disease, inflammatory bowel diseases or breath tests for lactose intolerance.
Protein flaw - treatment
Confirmation of a protein blemish is an indication for the elimination of milk and dairy products from the child's diet. If the baby is exclusively breastfed, the elimination diet applies to the nursing mother. Formula fed babies should receive formulas with a high degree of protein hydrolysis. These are preparations with the nutritional value identical to that of regular formula milk.
The only difference is the degree of fragmentation (hydrolysis) of milk proteins. Highly hydrolysed mixtures contain protein "cut" into small pieces that do not cause food allergy symptoms in a child. A diet that excludes cow's milk protein is the only treatment for the causal protein blemish.
The duration of the elimination diet depends on the child's age and the severity of the disease symptoms. The recall of dairy products should take no less than 6 months. The exclusion diet is usually followed for a period of 6-12 months. Then, under strict medical supervision, you can try to reintroduce products containing cow's milk protein to your child's diet.
It is also worth remembering that it is inadvisable to use cow's milk substitutes in the form of goat's milk or soy milk (and their products). In children allergic to cow's milk protein, the so-called cross-reactions causing disease symptoms also when using this type of substitutes.
Some patients also show cross-reactions with other foods (e.g. eggs, beef). In such situations, it may be necessary to exclude more ingredients from the diet.
Protein flaw - prevention
Unfortunately, there are no methods that would guarantee avoiding the development of food allergies in a child. The main risk factor for the occurrence of protein defect is genetic conditions, which, unfortunately, are beyond the control of patients. Currently, it is believed that the protective effect against the development of food allergies is shown by natural feeding of the baby for a minimum period of 4-6 months.
Importantly, during pregnancy and breastfeeding, it is not recommended to eliminate any ingredients from the mother's diet(unless there are clear medical indications for this). It has not been proven that such a procedure has any preventive value, but it carries the risk of nutrient deficiencies.
It is also worth paying attention to the recommendations for expanding the child's diet. In the past, it was believed that delaying the introduction of allergenic foods (nuts, fish, gluten, eggs) protects your baby from developing food allergies.
It is now known that expanding a child's diet should be started between the 17th and 26th week of life, and foods with strong allergenic properties should be introduced into the diet together with other nutrients. It is believed that delaying the child's contact with allergenic foods does not affect the subsequent development of food allergies.
Protein flaw - prognosis
The exclusion of cow's milk protein from a child's diet is a rather onerous task. Fortunately, protein diathesis in most children is temporary. It is estimated that after the first year of life, symptoms disappear in about 50 percent. patients. With age, an increasing percentage of children develop a tolerance to cow's milk protein. At the age of 5, protein diathesis disappears in as much as 90%. patients.
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