Independent Health Info

Getting Started: Allergies

2009-02-10T13:19:13+00:00

Independent Health Info is getting started. I plan to start sharing the URL when a few articles on different topics have been added. I am starting with articles on allergies. Stay tuned for more health articles, coming soon!

Introducing Independent Health Info

2009-02-03T11:20:33+00:00

Welcome to Independent Health Info.

This site was created to fill a need: the need for accessible and accurate information about your health. Many other health sites on the web fuffer from one or more of the following problems:

Biased towards a product or company. These sites are geared toward selling a specific product.
Unsourced. Some sites do not specify where the information comes from.
Unreliable. Sites that allow authors without expertise to contribute have a basic problem with reliability.

Independent Health Info is a source you can trust. Its articles are written by a professional health and science writer for the single purpose of bringing you accurate information about your health. And you don't need to take my word for it. References are provided with every article so you can judge the reliability for yourself.

Milk Allergy Treatment for Infants: Formula Options

2009-02-02T20:36:07+00:00

In infants who are not exclusively breastfed, a cow's milk allergy complicates the decision of which infant formula to use. In addition to ordinary cow's milk-based formula, other options are soy-based formula, milk formula with extensively hydrolyzed protein, and formula whose proteins consist of single amino acids. When a milk allergy is present, an ordinary milk-based formula is out of the question, but the other options can be considered.

Background on Proteins and Allergic Reactions

Proteins are complex, twisted chains made of building blocks called amino acids. In an allergy, certain proteins cause an allergic reaction. Proteins can be broken up (pre-digested) into smaller pieces. These are called hydrolyzed proteins. Since hydrolyzed proteins are broken into small bits, they are less likely to trigger an allergic reaction.

Instead of hydrolyzing protein into pieces, some infant formulas use single amino acid building blocks. These are called monomeric amino acids. Because the amino acids are not linked into proteins, they cannot cause allergic reactions.

Soy Formula for Milk Allergy

Soy formula does not contain any milk proteins, is widely available, and is comparatively priced with cow's milk formula. Therefore, it may be an option for some infants with cow's milk allergies. Some doctors consider it a good first choice for infants with milk allergy [1]. However, the American Academy of Pediatrics does not recommend soy formula in most cases [2]. Though soy allergies are somewhat less common than milk allergies in infants, individuals at high risk for milk allergy are the very ones most likely to develop a soy allergy, and 10 to 14% of infants with cow's milk allergy will also become sensitized to soy [2]. Soy formula is not proven to help prevent the development of allergies in high-risk babies [2].

Hydrolyzed Formula for Milk Allergy

In a hydrolyzed formula, the proteins have been partially broken down, or "pre-digested." These formulas are classified as partially hydrolyzed or extensively hydrolyzed [1]. The proteins have been broken down more in extensively hydrolyzed formula than in partially hydrolyzed formula.

Carnation Good Start® is a partially hydrolyzed formula made from hydrolyzed whey protein [3]. Extensively hydrolyzed formulas are made from casein hydrolysate and are less likely to cause an allergic response than hydrolyzed whey protein formula. Casein hydrolysate formulas on the market in the United States include Nutramigen®, Pregestimil®, and Alimentum® [3]. Unfortunately, they are much more expensive than regular formula.

Hydrolyzed protein formulas are less likely to cause reactions than ordinary cow's milk fomula in infants allergic to cow's milk protein, but allergic reactions are still possible. About 70% of children with cow's milk allergy will react to partially hydrolyzed formula, while about 5% will react to extensively hydrolyzed formula [1].

Amino Acid Formula for Milk Allergy

For the most senstive infants, amino acid formula can be used. This formula contains no whole proteins or protein fragments at all; they have been completely broken down. Therefore, amino acid formula contains no proteins to cause allergic reactions, no matter how severe the infant's allergies may be. The only brand currently available in the United States is Neocate® [3]. A 2007 research review found that for most infants with cow's milk allergy, extensively hydrolyzed cow's milk formula was equal to amino acid formula in alleviating allergy symptoms, but in some subgroups, amino acid formula was tolerated when extensively hydrolyzed formula was not [4].

References

Sam S. Mehr and Andrew S. Kemp. "Feeding choice for children with immediate allergic reaction to cows milk protein." Link. Letter in Medical Journal of Australia 2008;189(3):178-179.
Jatinder Bhatia, Frank Greer, and the APA Committee on Nutrition. "Use of Soy Protein-Based Formulas in Infant Feeding." Link. Pediatrics 2008 May;121(5):1062-8.
University of Washington. "Infant formula." Link. 2007, Gaining and Growing Website.
D. J. Hill, S. H. Murch, K. Rafferty, P. Wallis, C. J. Green. "The efficacy of amino acid-based formulas in relieving the symptoms of cow's milk allergy: a systematic review." Abstract link. Clinical and Experimental Allergy 2007 Jun;37(6):808-22.

Egg Allergy

2009-01-28T16:55:36+00:00

A child has a 50% chance of outgrowing an egg allergy.

Milk Allergy

2009-01-28T16:55:12+00:00

Milk allergy usually starts in the first year of life and resolves by school age [1], but occasionally it persists into adulthood. About 1% of infants have a true allergy to milk, defind as an immune system reaction involving IgE antibodies. Another 1.5% of have an "allergy" or intolerance to milk that is not IgE-moderated [1]. In adults, this allergy is rare but can be severe, with very small doses of milk allergen causing symptoms. When milk allergy does persist into adulthood, it is usually in highly atopic individuals, that is, the people whose allergies are the most severe [1].

The allergens in milk are whey protein and casein [2]. All foods made with milk have the potential to cause symptoms, including cream, butter, cheese, and other dairy products; cakes, breads, crackers, and other baked goods made with milk or cheese; cream soups, chowders, and salad dressings; and other, less obvious foods like some lunch meats and frozen French fries [3]. There is no cure for milk allergy, so the best treatment is avoidance of foods containing milk, which requires careful label-reading. In the United States, food labels are required to note when milk products are present in the food, usually under the heading "Allergy Information."

Milk Allergy Symptoms

The symptoms of milk allergy are highly variable, and symptom onset may be immediate or delayed. Milk allergy symptoms that may present immediately include wheezing, vomiting, and skin symptoms such as hives, while delayed-onset symptoms include abdominal cramps, loose stools, diarrhea, and bloating; coughing, sneezing, and runny nose; and a skin rash [4]. According to a small study, milk allergy in newborns can present with symptoms similar to Hirschsprung's disease, a serious congenital disease of the intestine that is treated by abdominal surgery. The majority of infants identified with a milk allergy in the study were breastfed, not cow's milk-formula fed [5].

References

1. Rhoda Sheryl Kagan. "Food allergy: an overview." Link (PDF). Environ Health Perspect. 2003 February; 111(2): 223–225.
2. H. Y. Lam, E. van Hoffen, A. Michelson, K. Guikers, C. H. van der Tas, C. A. Bruijnzeel-Koomen, and A. C. Knulst. "Cow's milk allergy in adults is rare but severe: both casein and whey proteins are involved." Abstract link. Clinical and Experimental Allergy 2008 Jun;38(6):995-1002.
3. "Milk Allergy Diet." Link. University of Virginia Health System: Asthma, Allergy, & Immunology 2007.
4. Mayo Clinic staff. "Milk Allergy: Symptoms." 2008 July. Link.
5. A. Kubota, H. Kawahara, H. Okuyama, Y. Shimizu, M. Nakacho, S. Ida, M. Nakayama, A. Okada. "Cow's milk protein allergy presenting with Hirschsprung's disease-mimicking symptoms." Abstract link. Journal of Pediatric Surgery 2006 Dec;41(12):2056-8.

Photo credit: tanakawho. Some rights reserved.

Food Allergies

2009-01-28T16:54:33+00:00

The big eight common food allergies.

Rare food allergies.

Introduction to Allergies

2009-01-28T16:54:05+00:00

Basic information about allergies.