Written by Registered Dietitian Nishti
Cow’s milk protein allergy remains the most common food allergy in children worldwide. In clinic we have lots of parents ask us how they can prevent their second baby from developing an allergy to dairy. This blog is here to shine some light on this topic and provide you with some handy top tips. However, please note that there is a genetic component to food allergy risk, a component we can’t control.
Pregnancy:
- Don’t avoid any allergenic foods:
There is no evidence to suggest that avoiding particular foods helps to prevent food allergies in the unborn child. If you can tolerate it and if it is part of your diet, eat the common allergens such as dairy, soya, and nuts.
- Ensure your diet is healthy:
A healthy diet fav the mom’s microbiome which in turn may have a protective effect on the infant’s immune system. This means that it is crucial that you ensure your diet is healthy and balanced. One recent study showed that a mother’s free sugar (refined sugar) intake during pregnancy is associated with an increased risk of offspring developing eczema, wheeze, and food allergies. Another study showed that a diet high in vegetables and yogurt and low in French fries, juice, and cereal may reduce the odds of the offspring developing asthma, atopic dermatitis, wheeze but not food allergy.
- Correct Vitamin D deficiency and take a daily Vitamin D3 supplement:
Some research suggests that children who are vitamin D deficient are more likely to develop a food allergy. This research is limited and conflicting. However, given that Vitamin D is so crucial for many other bodily processes, it is always a good idea to ensure we have enough and that we aren’t deficient.
- Make your home environment healthy:
Over 200.000 new chemicals have been introduced to our lives in the last 60 years. Detergents and food emulsifiers which research suggests may disrupt the epithelial barrier causing a “leaky gut”.
A leaky gut allows bacteria and toxins to “leak” through the intestinal wall. Therefore, consider making your own environment toxin free. Swap your laundry detergents and your cleaning products for fewer toxin ones. You could make your own (white wine vinegar and baking soda are all healthy cleaning products!).
Other factors associated with a reduced risk of developing allergenic disease include being born via vaginal delivery (out of our control), being breastfed during the first 4 months of life, pet ownership, and the absence of early antibiotic exposure.
Milk Feed:
Breastfeeding remains the best nutrition for the growing infant and fewer cases of children with cow’s milk protein allergy are found in infants who are breastfed. Therefore, if possible, breastfeeding should be encouraged at least in the first 6 months. If breastfeeding isn’t an option, then there are formulas that may help.
Specialized Baby Formulas:
Some evidence, but not much, shows that a partially or extensively hydrolyzed formula may reduce the risk of allergy in children who are at high risk. For example, proven benefits of preventing allergy, mainly atopic eczema has been seen in children with a genetic risk. Because the evidence isn’t strong to support this claim, some healthcare professionals may not agree with this claim. Looking on the bright side, given that there is no harm in using these formulas in infants, families who worry about their second or third child developing an allergy to cow’s milk for instance may want to consider this option. Always seek advice from your dietitian or doctor first.
- Specialized formulas that are partially hydrolyzed can be bought in your local supermarket and include the comfort range. These formulas have been processed in such a way that the cow’s milk protein is broken down slightly which makes it easier to digest.
- Extensively hydrolyzed formulas contain even smaller protein particles and can be prescribed by your dietitian or doctor and include brands such as Aptamil Pepti 1+2, SMA Althera, and Similac Alimentum. These formulas are prescribed in children with a suspected non-IgE mediated allergy to cow’s milk.
Child’s Diet:
There is research to show that in children, a diet rich in vegetables, fruit, and home-cooked foods is associated with fewer food allergies later in life. Diet diversity can also help to reduce the likelihood of developing a food allergy as shown in a large British study that followed almost 1000 infants from birth and assessed their feeding. It is therefore crucial that children are provided with healthy and varied home-cooked meals. Preferably in-season fruit and vegetables.
The importance of Fiber:
Non-digestible carbohydrate is fiber which can be in foods such as asparagus, onions, leek, rolled oats, beans and pulses, and underripe bananas.
When these foods reach our gut, they are fermented by bacteria that rely on and feed on these foods. It is this fermentation process that leads to the production of short-chain fatty acids (SCFAs).
SCFAs which result from the bacterial fermentation of dietary fibers in the colon have multiple beneficial effects in autoimmune and inflammatory diseases because of their impact on the immune system. Butyrate is a SCFA that promotes regulatory T cells in the large intestine and T cells ensure that our immune system is kept in perfect balance.
Fiber and Cow’s Milk Protein Allergy:
Butyrate is basically the link between the gut and the immune system and the healthier and more diverse the gut microbiome, the more butyrate we can make which in turn can help us tolerate more food allergens.
Research also shows that:
- A high level of fecal butyrate in early life has been shown to act as a protector against the onset of cow’s milk protein allergy.
- children with cow’s milk protein allergy have lower levels of fecal butyrate in comparison to children without cow’s milk protein allergy.
- children with higher levels of butyrate outgrow their allergy quicker than those with lower levels.
The research on this topic is still poor and the research is mainly observational in nature (poor quality research). However, it still highlights the importance of a healthy diet for both the mother and child.
In Summary:
- During pregnancy, ensure you eat a healthy balanced diet, reduce refined sugars and ensure you supplement with Vitamin D. Transform your home environment into a toxin-free space!
- If breastfeeding isn’t an option, consider a partially hydrolyzed formula. If you suspect an allergy to cow’s milk, contact your dietitian or doctor and they will prescribe the correct formula for your baby.
- Ensure your child’s diet is rich in fruit and vegetables, preferably home-cooked meals, and include plenty of SCFA as part of their diet.
If this blog post was helpful, please leave a comment below and share it with a parent who you may think could benefit from reading this. Thanks for reading to the end. If you are interested in more videos on cow’s milk protein allergy please visit Nishti’s Choice on Youtube.
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References
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