ANALYSIS OF NUTRITION OF CHILDREN OF THE FIRST YEAR OF LIFE WITH ALLERGY TO COW'S MILK PROTEINS
Main Article Content
Abstract
The aim of the research is to evaluate the nutrition of babies who suffer from allergies to cow's milk proteins.
Materials and methods. We analyzed 137 outpatient cards of children who live in Novosibirsk. The diagnosis of CMPA consisted of symptoms associated with the use of dairy products. Atopic dermatitis was detected in 100% of children, and gastrointestinal symptoms – in 34.3%. The average age of onset of the disease was 4.3 ± 0.3 months. An assessment was made of the rationality of choosing a milk formula in children who had mixed and artificial feeding, as well as the timing of the introduction of dairy products into complementary foods.
Results. All children had a milk mixture. 72% of children had an adapted milk formula from 5 months for the first time. 28.5% of children who had symptoms of CMPA then had 24.1% highly hydrolyzed and 4.4% amino acid milk formulas. 38.7% of children had partially hydrolyzed dairy formulas, 5.1% of children had fermented milk formulas, 10.2% of children had dairy formulas from goat milk, and 17.5% of children from cow's milk. 78.1% of children had cereals from milk with 6.6 ± 0.4 months in nutrition. 97.8% of children had fermented milk products in food, which were first eaten from 6 months. 24.1% of children had cottage cheese and 13.9% of children had kefir earlier than 8 months (the age of 8 months was recommended as the first period of the introduction of dairy products). 60.5% of children had meat puree with beef / veal, despite the fact that this type of meat puree increases the risk of crossing allergies of CMPA.
Conclusion. Cases of improper feeding of infants who suffer from CMPA and have mixed and artificial feeding have been identified. Less than 1/3 of children had therapeutic dairy formulas. The rest of the children used adapted dairy formulas, which was caused by the initiative of the parents. The main reasons for the refusal of therapeutic products were an unpleasant taste, a change in the characteristics of feces and expensive cost.
Keywords
Article Details
Information about financing and conflict of interests
The authors declare that they have no apparent or potential conflicts of interest related to the publication of this article.
This work is licensed under a Creative Commons Attribution 4.0 License.
How to Cite
References
1. Nocerino R, Carucci L, Coppola S, Oglio F, Masino A, Agizza A, et al. The journey toward disease modification in cow milk protein allergy. Immunol Rev. 2024; 326(1): 191-202. doi: 10.1111/imr.13372
2. Solano DE, Mendez M. A Review of the Literature on Cow Milk Protein Allergy Management. Pediatr Ann. 2025; 54(5): 179-181. doi: 10.3928/19382359-20250317-01
3. Bognanni A, Firmino RT, Arasi S, Chu DK, Chu AWL, Waffenschmidt S, et al. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update – XI – Milk supplement/replacement formulas for infants and toddlers with CMA – Systematic review. World Allergy Organ J. 2024; 17(9): 100947. doi: 10.1016/j.waojou.2024.100947
4. Muraro A, de Silva D, Halken S, Worm M, Khaleva E, Arasi S, et al. GA2LEN Food Allergy Guideline Group; GALEN Food Allergy Guideline Group. Managing food allergy: GA2LEN guideline 2022. World Allergy Organ J. 2022; 15(9): 100687. doi: 10.1016/j.waojou.2022.100687
5. Sorvacheva TN, Safronova AN. Cow’s milk allergy in infants: new trends in prevention and treatment. Pediatric Nutrition. 2024; 22(1): 88-96. Russian (Сорвачева Т.Н., Сафронова А.Н. Аллергия к белкам коровьего молока у младенцев: новые тенденции в профилактике и лечении //Вопросы детской диетологии. 2024. Т. 22, № 1. С. 88-96.) doi: 10.20953/1727-5784-2024-1-88-96
6. Chubarova AI. Opportunities and limitations of expanding indications for extensively hydrolyzed protein formulas for infants. Pediatric Nutrition. 2023; 21(6): 44-57. Russian (Чубарова А.И. Возможности и ограничения расширения показаний для применения смесей на основе высокогидролизованного белка для детей в возрасте до года //Вопросы детской диетологии. 2023. Т. 21, № 6. С. 44-57.) doi: 10.20953/1727-5784-2023-6-44-57
7. Ribes-Koninckx C, Amil-Dias J, Espin B, Molina M, Segarra O, Diaz-Martin JJ. The use of amino acid formulas in pediatric patients with allergy to cow's milk proteins: Recommendations from a group of experts. Front Pediatr. 2023; 11: 1110380. doi: 10.3389/fped.2023.1110380
8. Novik GA, Zhdanova MV, Zaitseva YO, Demidova AS. Formula Alternatives for Nutrition Therapy of Children with Cow’s Milk Protein Allergy. Review. Current Pediatrics. 2021; 20(3): 223-231. Russian (Новик Г.А., Жданова М.В., Зайцева Ю.О., Демидова А.С. Выбор смеси при диетотерапии детей с аллергией к белкам коровьего молока //Вопросы современной педиатрии. 2021. Т. 20, № 3. С. 223-231.) doi: 10.15690/ vsp.v20i3/2272
9. Meyer R, Groetch M, Santos A, Venter C. The evolution of nutritional care in children with food allergies – With a focus on cow's milk allergy. J Hum Nutr Diet. 2025; 38(1): e13391. doi: 10.1111/jhn.13391
10. Robert E, Al-Hashmi H, Al-Mehaidib AI, Al-Turaiki M, Aldekhail W, Al-Herz W, et al. Symptoms and management of cow's milk allergy: perception and evidence. Front Allergy. 2024; 5: 1348769. doi: 10.3389/falgy.2024.1348769
11. Zakharova IN, Osmanov IM, Berezhnaya IV, Dmitrieva DK, Skorobogatova EV, Gostiukhina AD. Innovations in the dietary therapy of cow's milk protein allergy: enrichment of highly hydrolyzed infant formulas with human milk oligosaccharides. Pediatrics. Consilium Medicum. 2022. 2: 122-127. Russian (Захарова И.Н., Османов И.М., Бережная И.В., Дмитриева Д.К., Скоробогатова Е.В., Гостюхина А.Д. Инновации диетотерапии аллергии к белкам коровьего молока: обогащение высокогидролизованных смесей олигосахаридами грудного молока //Педиатрия. Consilium Medicum. 2022. № 2. С. 122-127.) doi: 10.26442/26586630.2022.2.201745
12. Barrera EL, Ramirez-Farias C, Marriage BJ. Nutritional Management of Cow's Milk Allergy in Infants: Comparison of DRACMA, ECPGHAN and AAP Guidelines. The Open Nutrition Journal. 2021; 15(1): 1-9. doi: 10.2174/1874288202115010001
13. Turganova EA, Elkina TN, Surovikina EA. Benefits of partially hydrolyzed whey protein infant formulas. Review. Lechaschy Vrach. 2025; 5: 53-58. Russian (Турганова Е.А., Елкина Т.Н., Суровикина Е.А. Актуальные аспекты применения смесей на основе частично гидролизованных белков в практике педиатра //Лечащий Врач. 2025. № 5. С. 53-58.) doi: 10.51793/OS.2025.28.5.009
14. Pyrieva EA, Gordeeva EA. A paradigm shift in children's allergy prevention. Review. Lechaschy Vrach. 2021; 1: 41-45. Russian (Пырьева Е.А., Гордеева Е.А. Смена парадигм в профилактике аллергии у детей //Лечащий врач. 2021. № 1. С. 41-45.) doi: 10.26295/OS.2021.93.77.009
15. He T, Rombouts W, Einerhand AWC, Hotrum N, van de Velde F. Gastric protein digestion of goat and cow milk infant formula and human milk under simulated infant conditions. Int J Food Sci Nutr. 2022; 73(1): 28-38. doi: 10.1080/09637486.2021.1921705
16. Zakharova IN, Berezhnaya IV, Dmitrieva DK, OrobinskayaYaV. Adapted goat milk formulas in infant nutrition: when, to whom and for how long. Meditsinskiy Sovet. 2023; 17(1): 90-95. Russian (Захарова И.Н., Бережная И.В., Дмитриева Д.К., Оробинская Я.В. Адаптированные смеси на основе козьего молока в питании детей раннего возраста: когда, кому и как долго //Медицинский совет. 2023. Т. 17, № 1. С. 90-95.) doi: 10.21518/ms2023-036
17. Cheburkin AA, Kiseleva ES. Prevention of food allergies: current trends. Review. Clinical Practice in Pediatrics. 2023; 18(5): 62-70. Russian (Чебуркин А.А., Киселева Е.С. Профилактика пищевой аллергии: современные тенденции //Вопросы практической педиатрии. 2023. Т. 18, № 5. С. 62-70.) doi: 10.20953/1817-7646-2023-5-62-70
18. Arasi S, Cafarotti A, Fiocchi A. Cow's milk allergy. Curr Opin Allergy Immunol. 2022; 22(3): 181-187. doi: 10.1097/ACI.0000000000000823
19. Meyer R, Venter C, Bognanni A, Szajewska H, Shamir R, Nowak-Wegrzyn A, et al. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guideline update – VII – Milk elimination and reintroduction in the diagnostic process of cow's milk allergy. World Allergy Organ J. 2023; 16(7): 100785. doi: 10.1016/j.waojou.2023.100785.
20. Novikova VP, Bokovskaya OА, Turganova EA. Soy formulas in the pediatrician’s practice. Lechaschy Vrach. 2023; 11(26): 39-46. Russian (Новикова В.П., Боковская О.А., Турганова Е.А. Соевые смеси: место в практике педиатра //Лечащий Врач. 2023. № 11. С. 39-46.) doi: 10.51793/OS.2023.26.11.006
21. Saad K, Aboelgheet A, Hashim K, Gad EF, Elgenidy A, Odat RM, et al. Rice Hydrolysate Formula in Infants and Children Allergic to Cow's Milk: A Systematic Review of Evidence. Clin Med Insights Pediatr. 2025; 19: 11795565251332173. doi: 10.1177/11795565251332173
22. Lemoine A, Nieto-García A, Nieto-Cid M, Espín-Jaime B, Mazón Á, Salhi H, et al. Growth, Safety and Tolerance in Infants Fed Rice Protein Hydrolysate Formula: The GRITO Randomised Controlled Trial. Nutrients. 2024; 17(1): 162. doi: 10.3390/nu17010162
23. Kutluğ Ş, Hancıoğlu G, Karadağ-Kökçü Şİ, Sancak R, Öztürk F. Evaluation of red meat allergy patients and review of the literature. Turk J Pediatr. 2021; 63(5): 832-845. doi: 10.24953/ turkjped.2021.05.011
24. Revyakina VA, Mukhortykh VA, Larkova IA, Kuvshinova ED. Food allergies to cow’s milk proteins and meat. Russian Pediatric Journal. 2023; 26(5): 368-375. Russian (Ревякина В.А., Мухортых В.А., Ларькова И.А., Кувшинова Е.Д. Пищевая аллергия к белкам коровьего молока и мясу //Российский педиатрический журнал. 2023. Т. 26, № 5. С. 368-375.) doi: 10.46563/1560-9561-2023-26-5-368-375