- Reflux and regurgitation
- Abdominal pain
- Anorexia, refusal to feed
- Failure to thrive
- Occult blood loss
- Iron-deﬁciency anemia
Up to 60% of affected infants have digestive symptoms.7
Non-allergic food hypersensitivities, such as intolerances, result from the inability to digest certain components of foods i.e. lactose or fructose. Non-allergic food hypersensitivities do not involve the immune system.1
Food allergies arise through an immunological reaction to certain allergens in food. These allergens are almost always proteins.2 Other components in food, such as lactose and other carbohydrates, do not commonly act as allergens.
Certain allergens cause more reactions than others. In no particular order, here are the eight most common allergens accounting for approximately 90 percent of all allergic reactions to food in children.3
Food allergy is an increasing health concern in infants and young children.4
CMA is one of the most common food allergies in the first year of life. It occurs when an infant’s immune system reacts abnormally to the proteins in cows' milk, which are either transferred from the mother while breastfeeding or from cows' milk protein-containing formulas and complementary food. The immune reaction may be immunoglobulin (Ig)E-mediated, non-IgE-mediated, or mixed. The reactions can be immediate (early) reactions, occurring from minutes to hours after exposure, and/or delayed (late) reactions, which can manifest 48 hours or even a week following ingestion. Immediate reactions are more likely to involve IgE, but combinations of immediate and delayed reactions can occur in some infants.4
Lactose intolerance results from a decreased ability to digest and absorb lactose (the sugar present in mammalian milk) due to a lack of the enzyme lactase. It is very rare in infants younger than 5 years5, even in those with CMA. Breast milk naturally contains a high amount of lactose, which is beneficial for healthy infant growth and development.6
Lactose Intolerance Prevelance
3% of infants ≤1 year 2,7
As a key component of human breastmilk, it is very rare in children ≤5 years5
Lactose is a disaccharide comprising glucose and galactose.5 As a key component of breast milk, lactose is important for healthy growth and development, providing energy and supporting the absorption of calcium15. Lactose inhibits putrefactive bacteria and promotes the development of healthy gut microbiota.9 Therefore, it is not recomended that lactose is eliminated from the infant’s diet.
In specialist infant formulas, lactose also has another important benefit: it improves their taste. The pleasant taste and aroma of lactose contribute toward improved acceptance of extensively hydrolysed formulas (eHFs) intended for the management of CMA in infants.10 This reinforces the importance of lactose in the infant’s diet.
Prospective cohort studies in Europe suggest a 10-year prevalence of 1.9% to 4.9% for CMA in infancy.11 The results of a meta-analysis of 229 articles published between 1967 and 2001 support this, with incidence rates of CMA shown to be between 2% and 3% in infants less than 1 year old.7
The majority of children outgrow CMA: 60–77% children outgrow CMA by 2 years, this increases to 84–87% before the age of 3.7
The non-specific signs and symptoms of CMA, ranging from colic and reflux to constipation, insomnia, eczema, diarrhoea and crying, make diagnosis a real challenge. The symptoms involve many different organ systems, predominantly the skin and the gastrointestinal and respiratory tracts. The involvement of two or more organ systems increases the likelihood of CMA.
Diagnosis of CMA should always be made by a healthcare professional
We believe breast milk is the best food for infants. When in consultation with their healthcare professional, mothers and families find that optimal breastfeeding is not possible due to their infant’s medical condition, formulas for special medical purposes play a vital role in providing essential nutrients to infants. We have a global commitment to market breast-milk substitutes responsibly.
This website is about the management of cows’ milk protein allergy and nutritional solutions intended for infants. By continuing on this website, you accept that Nestlé Health Science supplies the information at your own request.
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