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      Clinical Effect of Standardized Dietary Avoidance Therapy on Children with Milk Protein Allergy and Its Effect on Intestinal Flora

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          Abstract

          Objective

          The aim of this study is to analyze the clinical effect of standardized dietary avoidance therapy on children with cow milk protein allergy (CMPA) and its effect on the intestinal flora.

          Methods

          The clinical data of 200 children with CMPA from our hospital from February 2020 to May 2021 were collected, and they were divided into a study group ( n = 100) and a routine group ( n = 100) based on different intervention modalities. The routine group received routine treatment, whereas the standardized dietary avoidance therapy was used in the study group. The clinical effects and related intestinal microflora indexes of the two groups were analyzed and compared.

          Results

          There was no significant difference in the incidence of related symptoms between the two groups before intervention ( P > 0.05), and the conditions of the two groups were improved after intervention. The incidences of skin (2%), digestive tract (3.00%), and respiratory tract (1.00%) in the study group were significantly lower than those in the routine group (14.00%, 18.00%, and 11.00%) ( P > 0.05). The time taken for complete remission of symptoms and milk tolerance months in the study group (41.23 ± 23.68, 13.28 ± 6.17) were significantly shorter than those in the routine group (145.14 ± 66.74, 16.17 ± 8.05) ( P > 0.05). The values of height, weight, and head circumference (HC) of children in the study group (79.88 ± 2.18, 11.09 ± 1.34, 47.88 ± 0.63) were higher than those in the routine group (76.21 ± 2.34, 9.81 ± 1.18, 45.98 ± 0.59) ( P > 0.05). The levels of Lactobacillus and Enterococcus (9.95 ± 0.89, 11.31 ± 1.05) in the study group were higher than those in the routine group (9.11 ± 0.74, 10.38 ± 0.94), and the levels of yeast-like fungi in the study group (3.08 ± 0.24) were lower than those of the routine group (3.82 ± 0.31) ( P > 0.05).

          Conclusion

          The standardized dietary avoidance therapy is remarkable in the treatment of CMPA, in which the children were able to tolerate ordinary milk earlier, and the intestinal flora was significantly improved, thereby promoting the growth and development of children. It therefore merits clinical promotion.

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          Most cited references27

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          Milk nutritional composition and its role in human health.

          Susana Pereira (2014)
          Dairy and milk consumption are frequently included as important elements in a healthy and balanced diet. It is the first food for mammals and provides all the necessary energy and nutrients to ensure proper growth and development, being crucial in respect to bone mass formation. However, several controversies arise from consumption of dairy and milk products during adulthood, especially because it refers to milk from other species. Despite these controversies, epidemiologic studies confirm the nutritional importance of milk in the human diet and reinforce the possible role of its consumption in preventing several chronic conditions like cardiovascular diseases (CVDs), some forms of cancer, obesity, and diabetes. Lactose malabsorption symptoms and cow milk protein allergy are generally considered to be the adverse reactions to milk consumption. The present article reviews the main aspects of milk nutritional composition and establishes several associations between its nutritious role, health promotion, and disease prevention. Copyright © 2014 Elsevier Inc. All rights reserved.
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            When Should Infants with Cow's Milk Protein Allergy Use an Amino Acid Formula? A Practical Guide

            Rosan Meyer, Marion Groetch, Carina Venter (2018)
            Article 0 comments Cited 39 times – based on 0 reviews     Review now
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              Prevention and Management of Cow’s Milk Allergy in Non-Exclusively Breastfed Infants

              Yvan Vandenplas (2017)
              Introduction: The prevention and management of cow milk allergy (CMA) is still debated. Since CMA is much less frequent in breastfed infants, breastfeeding should be stimulated. Method: Literature was searched using databases to find original papers and reviews on this topic. Results: Hydrolysates with a clinical proof of efficacy are recommended in the prevention and treatment of CMA. However, not all meta-analyses conclude that hydrolysates do prevent CMA or other atopic manifestations such as atopic dermatitis. There are pros and cons to consider partially hydrolysed protein as an option for starter infant formula for each non-exclusively breastfed infant. A challenge test is still recommended as the most specific and sensitive diagnostic test, although a positive challenge test does not proof that the immune system is involved. The Cow Milk Symptom Score (CoMiSS™) is an awareness tool that enables healthcare professionals to better recognize symptoms related to the ingestion of cow milk, but it still needs validation as diagnostic tool. The current recommended elimination diet is a cow milk based extensive hydrolysate, although rice hydrolysates or soy infant formula can be considered in some cases. About 10 to 15% of infants allergic to cow milk will also react to soy. Mainly because of the higher cost, amino acid based formula is reserved for severe cases. There is no place for infant formula with intact protein from other animals as cross-over allergenicity is high. During recent years, attention focused also on the bifidogenic effect of prebiotics and more recently also on human milk oligosaccharides. A bifidogenic gastrointestinal microbiome may decrease the risk to develop allergic disease. The addition of probiotics and prebiotics to the elimination diet in treatment may enhance the development of tolerance development. Conclusion: Breastfeeding is the best way to feed infants. Cow milk based extensive hydrolysates remain the first option for the treatment of CMA for the majority of patients, while amino acid formulas are reserved for the most severe cases. Rice hydrolysates and soy infant formula are second choice options. Partial hydrolysates with clinical proof of efficacy are recommended in some guidelines in the prevention of CMA and allergic disease in at risk infants, and may be considered as an option as protein source in starter infant formula.
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                Author and article information

                Contributors
                Xiaojun Wang:
                ORCID: https://orcid.org/0000-0002-9611-2626
                Journal
                Journal ID (nlm-ta): Evid Based Complement Alternat Med
                Journal ID (iso-abbrev): Evid Based Complement Alternat Med
                Journal ID (publisher-id): ECAM
                Title: Evidence-based Complementary and Alternative Medicine : eCAM
                Publisher: Hindawi
                ISSN (Print): 1741-427X
                ISSN (Electronic): 1741-4288
                Publication date Collection: 2022
                Publication date (Electronic): 8 August 2022
                Publication date PMC-release: 8 August 2022
                Volume: 2022
                Electronic Location Identifier: 3362374
                Affiliations
                1Emergency Department, Ningbo Women and Children's Hospital, No. 339 Liuting Street, Ningbo, Zhejiang, China
                2Pediatric Digestionm, Ningbo Women and Children's Hospital, No. 339 Liuting Street, Ningbo, Zhejiang, China
                3Laboratory Department, Ningbo Women and Children's Hospital, No. 339 Liuting Street, Ningbo, Zhejiang, China
                4Comprehensive Birth Defect Prevention Center, Ningbo Women and Children's Hospital, No. 339 Liuting Street, Ningbo, Zhejiang, China
                5Pediatrics Department, Ningbo Women and Children's Hospital, No. 339 Liuting Street, Ningbo, Zhejiang, China
                Author notes

                Academic Editor: Tian jiao Wang

                Author information
                https://orcid.org/0000-0002-9611-2626
                Article
                DOI: 10.1155/2022/3362374
                PMC ID: 9377903
                SO-VID: 41bfd01f-f05f-4265-be67-abff74d880f0
                Copyright © Copyright © 2022 Wenying Hao et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 31 May 2022
                Date revision received : 27 June 2022
                Date accepted : 29 June 2022
                Funding
                Funded by: Zhejiang Province Medical and Health Youth Innovative Talents Support Program
                Award ID: 2022RC067
                Categories
                Subject: Research Article

                ScienceOpen disciplines: Complementary & Alternative medicine
                Data availability:
                ScienceOpen disciplines: Complementary & Alternative medicine

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