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Food allergies in children

What you need to know about feeding young children with food allergies

Food allergies are the earliest form of allergic diseases and can manifest themselves from the first months of life. Its detrimental effect on health is associated not only with the immediate signs of food allergies in children, which in themselves can be painful for the baby, for example, skin itching or intestinal colic, but also with the fact that due to the forced restriction of nutrition, there is a threat to normal development child. On the other hand, the current food allergy in children creates conditions for the rapid formation of subsequent forms of allergic diseases, including such severe ones as bronchial asthma.

Causes of food allergies

The main cause of food allergies lies in the violation of the fundamental mechanism of the nutrition process, which in the language of specialists is called food tolerance. Its biological meaning is that, on the one hand, it allows various natural substances to penetrate into the internal environment of the body as part of food, in order to then build tissues and organs from them. On the other hand, the same mechanism provides a powerful barrier to the penetration of those substances that can violate the genetic integrity of the human body. This mechanism belongs to the domain of the immune system. Due to its extreme importance, it begins to form very early, already from the 7th week of intrauterine development. Interestingly, its improvement occurs under the direct control of the nutrients themselves, which first penetrate the fetus through the cord blood into the baby's body with mother's milk, and then through the child's independent nutrition.

All the main components of food, namely: proteins, fats, carbohydrates, trace elements, vitamins have a strong effect on the immune system. They regulate the work of immune cells, cooperate with the interaction of various participants in the immune process, and are even able to change the activity of genes responsible for the immune response. This influence is especially powerful in the first months and years of life, but is not lost in all other periods of a person's life. An active role in the formation of food tolerance is played by beneficial intestinal microorganisms. They provide the right balance of individual participants in the immune system, enhance the production of protective immune proteins and support the overall activity of the immune system with the help of their waste products.

What foods cause food allergies in children?

Food allergies can occur after eating a variety of foods that have allergenic properties.

Animal food proteins are considered the most allergenic, especially those whose structure differs significantly (more than 55%) from the structure of human proteins. These include proteins in the muscle tissue of crustaceans, fish, mammalian milk, chicken eggs. At the age of the first 3 years, especially in the first year of life, the most important allergens are animal milk proteins (cow, goat). There are more than 200 of them in milk. Each of them or several proteins at the same time can become allergenic for a child, so it is not practical to consider that some milk is less allergenic than another.

Plant foods also have a number of allergenic properties. Its allergenic potential is largely determined by the presence of so-called "plant protection proteins". These substances are able to break down insect chitin, protect the plant from microbes and fungi, and help it fight chemical and mechanical damage. Under unfavorable plant growth conditions or improper storage conditions for food raw materials (vegetables, fruits, cereals, nuts), their concentration can be very high, therefore, cutting off the damaged part of the fruit, you will slightly reduce its allergenic properties.

Seed germ proteins, cereals and gluten components are also highly allergenic. From a practical point of view, it is important that the allergens of some plants have a certain similarity with each other. This leads to the fact that at the same time the child may have intolerance to antigenically related pollens (for example, birch and wormwood pollen), vegetables (for example, carrots) and fruits (for example, apples). For the ability to cross-react, such allergens are called "panallergens". The same property of plant allergens is associated with the regular formation of pollen allergy (hay fever) in a child who has a food allergy to plant foods.

Is it possible to reduce the allergenic properties of food?

Studies have proven the failure of attempts to reduce the allergenic properties of food through culinary or industrial processing. Since the 60s of the last century, it has become known that if the protein is not acted too aggressively, then it temporarily changes its “architecture”, but then spontaneously restores it when the environment “normalizes” (Anfinsena K. B., 1972, Nobel Prize) . For example, during the industrial production of infant milk formulas, during pasteurization, drying, and other influences, milk protein reduces its allergenic properties, but when the dry milk formula is diluted with water, it regains it. In some cases, prolonged heat treatment can lead to a significant increase in the allergenic properties of the protein. So, in the process of preparing boiled condensed milk, beloved by children, milk protein combines with sugar and forms an aggressive chemical compound that can cause severe manifestations of food allergies. Similar compounds are also formed during long-term storage of the opened package of dry infant formula, which exceeds the recommended time.

There are foods that do not lose their high allergenicity either during cooking or during digestion and can cause food allergies, cause allergic reactions even when consumed in small quantities. Such products include fish, caviar, shrimp, eggs, nuts, honey, mushrooms, citrus fruits, strawberries, coffee, cocoa, chocolate. They are called obligate allergens and are mandatory removed from the children's diet for food allergies.

Recommendations of a pediatric allergist

The risk of food allergies in a small child is also associated with high intestinal permeability. It is especially high in a child in the first months of life. In breastfeeding conditions, this is not dangerous, since the intake of food allergens through mother's milk is extremely small, and besides, breast milk itself has powerful anti-allergic properties. At the same time, early artificial feeding can lead to inadequately high penetration of proteins with high allergenic properties into the body. So with 40g of a standard milk formula, a child will receive the same amount of the most allergenic milk protein (ß-lactoglobulin) as it is contained in 8000l of breast milk! In conditions of an immature immune system, and especially if the child has a hereditary predisposition to allergies, this leads to the rapid formation of food allergies in children. The same undesirable effect occurs with unreasonably early introduction of complementary foods, especially if they contain highly allergenic components.

Mistakes in child nutrition create a high risk of developing food allergies. At the same time, with proper management, it is nutrition that becomes a powerful and effective therapeutic and preventive measure.

Diet for children with food allergies

Features of the organization of a diet for food allergies in a child, of course, depend on age, but there are general rules that ensure its effectiveness: For a child of the first year of life, this is, of course, long-term (at least 6 months) breastfeeding. In those rare cases when allergens that penetrate breast milk cause allergy symptoms in the child, it is necessary to organize a hypoallergenic diet for the mother with the exception of obligate food allergens, foods that cause allergic reactions in the child (most often, these are dairy products), irritating dishes. In conditions of artificial feeding, the diet for children with food allergies is based on highly effective medicinal products in which milk protein is split into non-allergenic substances. They are called complete hydrolysates. Their choice is quite wide. Such mixtures can even be tailored to a particular clinical manifestation, such as a predominant skin or gastrointestinal tract lesion. They contain everything necessary for the good development of the child and can be used for a long time. If a child has signs of a food allergy to cow's milk proteins, in no case should therapeutic mixtures be replaced with fermented milk products or so-called hypoallergenic mixtures, which are intended only for the prevention of food allergies if there is a risk of its development.

The timing and correct sequence of complementary foods are very important. In children with food allergies, complementary foods are introduced no earlier than 4.5 and no later than 6 months. life. It is more profitable to start with vegetables, since their overall allergenic potential is lower than that of cereals. The optimal first choice is mono-component mashed potatoes from zucchini, cauliflower, broccoli without salt and sugar. From 5 months pumpkin puree, carrots and vegetable mixtures can be introduced, then vegetable stews and vegetables supplemented with cereals, such as rice. At the severity of the disease, potatoes are not recommended. Its main allergen (Sola t1) is resistant to digestion and heat treatment and can cause a reaction. Starch does not contain this allergen. The first porridge should be not only monocomponent, but also gluten-free (low-allergenic buckwheat, rice, corn). Early introduction of cereals containing gluten (for example, semolina) can cause allergic inflammation of the intestinal mucosa and increase its permeability. The absence of gluten-containing admixtures can only be guaranteed by cereals of industrial production. Their advantages, which are important for a child with allergies, include supplementation with substances useful for immunity - dietary fiber, fatty acids, vitamins and minerals. Meat complementary foods are introduced to children with food allergies on time (7-8 months) and in full, because. it ensures the intake of sufficient quantities of nutrients important for the development of immunity, such as protein, iron and zinc. When choosing a type of meat, one should be guided by its allergenic properties. Horse meat, rabbit, turkey, pork, beef are preferred. During a diet with food allergies, fish, caviar, eggs are not given (sometimes chicken eggs can be replaced with quail eggs), nuts, honey, cocoa, chocolate (they can be a component of some children's cereals and cookies), strawberries, strawberries, citrus fruits.

• Correction of emerging nutritional deficiencies. Depriving a child for a long time of important food for his age can lead to the formation of nutritional deficiencies, primarily mineral salts and vitamins. Under the conditions of the use of specialized therapeutic mixtures, this does not happen, but only if their daily volume is sufficient. If they are not used in the diet of children with food allergies, or their volume is too small, then additional correction with multivitamin and mineral complexes may be necessary. Vitamins A, E, C, B6, B12, folates, minerals zinc and selenium are especially important for maintaining immunity. Their combination with polyunsaturated fatty acids (omega acids) is optimal.
• Ensuring environmentally friendly products. Unfortunately, modern food products are characterized by a high degree of environmental pollution. These can be antibiotics, hormone-like substances, traces of fertilizers and pesticides, molds that release toxic substances. Industrial production of food products, their transportation and storage are inconceivable without the so-called food additives. It turned out that many of them provoke the manifestation of food allergies in children. This happens especially often when using products containing benzoic acid and benzoates (E 210-213), butylated hydroxyanisole (E 320), butylated hydroxytoluene (E 321), gallates (E 310-313), sodium glutamate (E 621), diphenyl (E 230 ) and some others. All these undesirable impurities are found in abundance in general-purpose industrial products, so you should never feed a small child with dishes from a common family table. This food does not correspond to the digestive and immune capabilities of the child and always puts him on the brink of illness. The only reliable choice is industrial children's products made in an environmentally friendly manner.

Eating a child with food allergies is a troublesome and painstaking task. It requires strict adherence to the recommendations of a pediatric allergist, utmost care in choosing food, and adherence to the duration of a therapeutic diet. Be patient. Change takes time, but you will be rewarded by bringing significant relief to your child, and sometimes a full recovery.

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Any food is capable of causing an allergic reaction, and we cannot exclude absolutely everything. But when we talk about food allergies, we immediately remember the big eight allergens:

• Eggs
• Milk
• Soya
• Peanuts
• Nuts
• Wheat
• Fish
• Mollusks and crustaceans

Let's take a look at each product individually.

So, eggs. Eggs are recommended to be introduced into the diet from 6-8 months of age. Only fully cooked eggs should be given to children.

Milk. Milk is not recommended for use in children under one year of age. After a year and up to 5 years, you can include milk in the menu daily.

Soy. Soya is also recommended for consumption from one year. It is worth recalling that any plant milk is not a complete replacement for regular cow's milk.

Peanuts. Peanuts are a common allergen in many developed countries. At the same time, there are a large number of studies that have shown that the introduction of peanut butter at the age of 4-6 months reduces the risk of developing an allergy to it at an older age. So peanut butter can be consumed from six months.

Nuts. Nuts are introduced into the diet from the year. It must be remembered that whole nuts or peanuts should not be given to children under five years of age due to the high risk of suffocation.

Wheat. Introduced into the diet from 8-10 months in the form of cereals, pasta, bread, baby cookies.

Fish. We add it to the child's diet from 8-10 months, starting with white fish, from the year you can start introducing red.

Mollusks and crustaceans. "Seafood" can be introduced into the diet of a child from the age of one. The main thing is that they are thermally fully cooked.

Thus, all the most important food allergens of this world can and should be consumed. If you suspect that your child is allergic to any product, you should consult a doctor to understand this issue. But you definitely shouldn’t exclude entire food groups from your child’s diet, since the most varied diet is the key to good health.

To be fair, there are also foods that contain high levels of histamine or cause it to be released in the body. When eating large amounts of these foods, some children may experience an allergic-like reaction. But this is not a true allergy, and the effect in this case is dose-dependent, that is: if a child eats two tomatoes, and not a kilogram, then nothing will happen.

These products include:

• Eggplant
• Tomatoes
• Pineapple, plum, banana, papaya, kiwi
• Almost all citrus fruits: lemon, lime, orange
• Pickled or preserved foods
• Hard cheeses, aged cheeses
• Smoked products, deli meats: salami, ham, sausages
• Shellfish, seafood
• Beans and legumes, chickpeas, soy flour
• Hazelnuts, walnuts, pine nuts, peanuts, cashews, almonds, pistachios
• Chocolate and other cocoa products
• Most vinegars

If you notice a reaction to any of the above foods, you can try reducing the amount in your diet and find a dose that your child can tolerate.

Food allergies are not that common in practice. This disease occurs in 6-8% of children and 3% of adults. At the same time, most children “outgrow” their allergies, and in adulthood they can safely eat foods previously excluded from the diet.

Still, there is something that should be excluded from the child's diet:

• Sugar up to two years. WHO clearly does not recommend foods containing added sugar for children under two years of age. After two years, it is worth focusing on age norms.
• Salt. It is not recommended to add it to the diet before 9 months. Up to three years - no more than two grams per day. Older than three years - no more than five.
• Honey up to a year. This is not due to its allergenicity, but to the risk of containing spores of the bacterium that causes botulism.
• Nuts, peanuts, whole grapes. Young children are at risk of suffocation with these products.
• Caffeine up to 4-5 years. Not recommended due to its stimulating effect.
• Rice milk up to 5 years. This milk may contain a high concentration of arsenic. This does not apply to rice itself and dishes from it.
• Trans fats. They are not recommended for children, as well as adults, because they increase the risk of CVD, a carcinogenic effect.
• Unwashed vegetables, raw eggs, meat.
• Products with a large amount of preservatives, dyes. It is not recommended to use up to 5-7 years, after - their content in the diet should be minimized.

In summary, we can say that there are no allergenic foods that need to be excluded from a child's diet. The diagnosis of food allergy is confirmed by the doctor, he also recommends a certain diet. And trying to delay the introduction of the most common allergens is not food allergy prevention.

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