Food intolerance in children

Food allergy is an intolerance to food products caused by immunological reactions or the release of biologically active substances by non-immune mechanisms.

Food intolerance in children is a broader concept than food allergy and can be caused by:

• hereditary enzyme deficiencies;
• acquired diseases of the gastrointestinal tract;
• psychological reactions to food;
• the entry of infectious agents or microbial toxins into the child's body.

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Causes of food intolerance in children

In children, the most common cause of food intolerance is hypersensitivity to cow's milk - 72-76.9%. The data indicate that children with milk allergy received cow's milk proteins significantly more often in the first three, especially in the first month of life, and the average age of clinical symptoms of milk allergy in patients was 2 months. I. M. Vorontsov and O. A. Matalygina noted the absence of a significant difference between the frequency of mixed feeding and the conditions for switching to artificial feeding in groups of children with milk and non-milk allergies. No clear difference was also observed in the duration of mixed feeding periods. A sharp change from breastfeeding to artificial (1-2 days) was observed in 32% of children with food allergies.

Causes of food allergies

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Symptoms of food intolerance in children

In the process of evolution of clinical manifestations of food intolerance in children, 3 stages can be distinguished:

1. A clear connection between the clinical picture and food provocation and a clear (until the complete disappearance of symptoms) effect of elimination measures.
2. Chronic course of the disease with food addiction: the severity of clinical manifestations is associated with the allergenicity of the diet, but it is no longer possible to achieve a stable state of remission even with long-term elimination.
3. Complete food independence. The formed chronic disease continues to develop based on the inclusion of secondary pathogenetic chains.

Symptoms of food allergies

Classification of food intolerance in children

I. M. Vorontsov proposes the following classification of food allergies.

By genesis:

1. Primary forms:
   • family-hereditary:
   • paraallergic (in young children with exudative-catarrhal abnormal constitution);
2. secondary forms:
   • gastrointestinal tract pathology;
   • intestinal infections, dysbacteriosis;
   • liver and pancreas diseases;
   • helminthiasis, giardiasis;
   • hypovitaminosis, microelement deficiency;
   • hereditary diseases
   • cystic fibrosis, celiac disease, etc.

Classification of food allergies

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Diagnosis of food intolerance in children

Food intolerance in children is diagnosed primarily on the basis of anamnestic data.

The gold standard in diagnosing food allergies is a double-blind, placebo-controlled challenge test.

Skin tests with allergens in food allergy are less informative than in inhalation sensitization and should be interpreted only in conjunction with the history and clinical manifestations of food allergy.

Diagnosis of food allergies

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Treatment of food intolerance in children

First of all, it is necessary to exclude a food allergen, for the identification of which parents are advised to keep a food diary. The diary must indicate not only the name of the food product, but also its quality, method of cooking, shelf life. It is necessary to record the exact time of change in the child's condition, appetite, stool type, the appearance of regurgitation, vomiting, rashes, diaper rash and other elements on the skin and mucous membranes. If a child in the first months of life is allergic to cow's milk, it is necessary to provide him with breast milk from donors, if this is impossible, prescribe fermented milk mixtures. Such mixtures include acidophilic mixture "Malutka", "Atu", "Bifilin", "Biolact", "Acidolact", "Nutrilak acidophilic".

How is food allergy treated?

Diet therapy -the basis of treatment of food allergies. Breastfeeding with the mother following a hypoallergenic diet is optimal for children with food allergies. If the mother has no milk and is allergic to cow's milk, soy formulas are used (Alsoy, Bonasoya, Frisosoy, etc.). In case of soy intolerance - formulas based on products of high protein hydrolysis (Alfare, Alimentum, Pepti-Junior, etc.) and partial hydrolysis of milk protein (Humana, Frisopep).