Food intolerance in children

Food allergy is food intolerance caused by immunological reactions or by the liberation of biologically statutory substances by non-immune mechanisms.

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

• hereditary enzymopathies;
• acquired diseases of the gastrointestinal tract;
• psychological reactions to food;
• the ingestion of infectious agents or microbial toxins into the body.

[1], [2], [3]

Causes of food intolerance in children

In children, as the cause of the development of food intolerance, the most often observed is an increased sensitivity to cow's milk - 72-76.9%. The data show that children with milk allergy were significantly more likely to get cow's milk proteins in the first three months, especially in the first month of life, and the average age of clinical symptoms of allergy to milk in patients was 2 months. IM Vorontsov and OA Matalygina noted the absence of a significant difference between the frequency of use of mixed feeding and the conditions for switching to artificial in groups of children with dairy and non-dairy allergies. There was no clear difference in the duration of the periods of mixed feeding. A sharp change in breastfeeding by artificial (for 1-2 days) was observed in 32% of children with food allergies.

Causes of food allergy

[4], [5], [6], [7]

Symptoms of food intolerance in children

In the evolution of clinical manifestations of food intolerance in children, there are 3 stages:

1. A clear connection of the clinical picture with food provocation and a clear (before the disappearance of symptoms) effect of elimination measures.
2. Chronic course of the disease with food dependence: the severity of clinical manifestations is associated with the allergenic diet, but to achieve a stable state of remission, even with prolonged elimination is no longer possible.
3. Complete nutritional independence. Formed chronic disease continues to develop on the basis of the inclusion of secondary pathogenetic chains.

Symptoms of food allergy

Classification of food intolerance in children

IM Vorontsov suggests the following classification of food allergies.

By genesis:

1. primary forms:
   • family-hereditary:
   • parallergic (in young children with exudative-catarral abnormal constitution);
2. secondary forms:
   • pathology of the gastrointestinal tract;
   • intestinal infections, dysbiosis;
   • liver and pancreas diseases;
   • helminthiases, giardiasis;
   • hypovitaminosis, micronutrient deficiency;
   • hereditary diseases
   • cystic fibrosis, celiac disease, etc.

Classification of food allergy

[8], [9]

Diagnosis of food intolerance in children

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

The gold standard in the diagnosis of food allergy is a double-blind provocative test using a placebo.

Skin tests with allergens in food allergies are less informative than with inhalation sensitization, and should be interpreted only in conjunction with anamnesis and clinical manifestations of food allergies.

Diagnosis of food allergy

[10], [11]

Treatment of food intolerance in children

First of all, it is necessary to exclude the food allergen, for the detection of which parents are encouraged to maintain a food diary. In the diary it is necessary to indicate not only the names of the food product, but also its quality, the way of cooking, the shelf life. It is necessary to record the exact time of change in the child's condition, appetite, character of the stool, the appearance of regurgitation, vomiting, rashes, diaper rash and other elements on the skin and mucous membranes. When the baby is allergic to the first months of life, it is necessary to provide cow milk with breast milk, if it is impossible, to appoint fermented milk. Such mixtures include the acidophilic mixture "Malyutka", "Atu", "Bifilin", "Biolact", "Acidolact", "Nutrilak acidophilic".

How is food allergy treated?

Dietotherapy is the basis for treating food allergies. Breastfeeding with a mother's hypoallergenic diet is optimal for children with food allergies. In the absence of milk from the mother and with allergies to cow's milk, soya mixtures (Alsoy, Bonasoa, Frisoosa, etc.) are used. If soy is intolerant, a mixture based on products of high protein hydrolysis (Alfare, Alimentum, Pepti-Junior, etc.) and partial hydrolysis milk protein (Humana, Frisepep).