MODULE 7: Medical Nutrition Therapy for Specific
Conditions - Infants
Intro
Special Health Care Needs
Prematurity and Low Birthweight
Slow Weight Gain
Food Allergies
An allergy is an immune response to a specific protein; a food allergy is an immune response to a specific protein in a food. Symptoms can include hives, eczema, vomiting, diarrhea, abdominal pain, or swelling of the lips, tongue, and face and can occur immediately after the food is ingested or up to 72 hours later. Because the digestive and immune systems of infants are immature, food allergies are especially prevalent in infants and children. While many infants “outgrow” allergies, allergies can be lifelong for some individuals.
Diagnosis of a food allergy requires a medical history, diet history, and physical examination. Immunologic testing, such as skin tests, RAST, and elimination diets and challenges, are often performed.
Treatment
The goal of treatment of a food allergy is to remove the food from the infant’s diet while ensuring that the diet is nutritionally adequate. Because allergens can be transferred through breastmilk, treatment may require that the breastfeeding mother eliminate foods from her food pattern. For infants who are formula-fed, treatment may involve a switch to a different formula.
Some food allergies that are common among infants are listed in the table below.
| Allergen (Common symptoms) |
Foods breastfeeding mother should avoid and nutrients that may be at risk when the foods are eliminated | Infant formulas that are not appropriate | Infant formulas that might be indicated |
| Cow’s milk |
Milk, butter, cream, cheese, yogurt, casein, lactalbumin, whey Calcium, vitamin D, protein, vitamin A, riboflavin |
Standard infant formulas; soy based formulas* | Casein hydrolysate, amino acid based |
| Wheat |
Bread, baked goods, cereals pasta, malted products, sauces, processed meat; bran, farina, durum Iron, thiamin, riboflavin, niacin |
None | |
| Eggs |
Eggs, baked goods, mayonnaise, casseroles, pasta, sauces; albumin, surumi, lethicin Not a primary source of nutrients, but eggs contain vitamin B12, riboflavin, biotin, pantothenic acid, selenium |
None | |
| Soy |
Soy, processed grains, processed meats, sauces, soups, miso Not a primary source of nutrients, but soy contains thiamin, riboflavin, pyridoxine, folate, iron, zinc, magnesium |
Soy formulas | Standard infant formulas, casein hydrolysate, amino acid based |
| * 10-14% of infants with IgE-mediated cow milk protein allergy will also have a soy protein allergy. Infants with cow milk protein-induced enteropathy or enterocolitis are frequently sensitive to soy protein as well and should not be given isolated soy protein-based formula. Due to the overlap in cow milk protein reactions and soy protein intolerance, the AAP recommendation for these conditions is for a formula that is made from hydrolyzed protein or synthetic amino acids (AAP, 2008) | |||
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References:
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Table 7-2. Food allergies that are common among infants
Copyright 2007 | Disclaimers
Last updated: 12/07/2018