Equip Parents with Allergy Knowledge
Help parents and caregivers stay educated on the rising rates of food allergies and what that means for their infants.
Since the late 1990s, the rate of food allergies among children (under 18 years of age) has nearly doubled, and food allergy-related hospitalizations have tripled1-3. Researchers are working to discover the causes, but so far clear answers are elusive. Some hypothesize that epigenetic environmental factors and lack of early exposure to important microbes are at play4,5. One thing we do know is that young children are the most commonly affected6.
Help parents identify their infant’s potential allergies:
Food Allergy by the Numbers
Raising awareness for food allergies, especially early in childhood, is important.
Infants with food allergies are up to four times more likely to exhibit other allergies as they grow2.
Infants with certain food allergies, including egg, fish and cow’s milk allergy (CMA), often present other allergic manifestations later in life. This association, known as the “Allergic March,” refers to the progression of the allergic response. It typically begins with atopic dermatitis and food allergy in infancy, progresses to aeroallergen sensitization in pre-elementary ages, and culminates in allergic rhinitis and/or chronic asthma later in life9.
Allergic Manifestation in Children with CMA:
Supporting oral tolerance and gut development can help infants overcome food allergies and reduce the likelihood of the Allergic March.
Most infants who have CMA build tolerance to cow’s milk protein by 3–5 years of age10-12. Extensively hydrolyzed protein formula is the first-line recommendation for CMA over soy or amino acid formulas, and has been shown to support the development of oral tolerance13.
Management impacts outcomes for infants with CMA.
Watch Dr. Christina Valentine review background significance and key highlights from recent studies on early relief and long-term outcomes for infants with CMA.
Looking for an option to support your patients with food allergies? Learn more about Mead Johnson’s CMA options:
Teaching Parents About the Indications: Allergy vs. Intolerance
Explaining allergic response to parents can be challenging because of the complex nature of the disease process. Plus, as you know, not all children who react to a certain food have an allergy. Instead, they may have a food intolerance to components such as lactose or gluten.
GERD: gastroesophageal reflux disease
Addressing Infant Allergy Prevention and Updated Clinical Guidelines
Until recently, it was generally accepted that avoiding or delaying infant introduction to common allergenic foods was the most effective way of avoiding food allergies.
However, newer studies suggest that introducing certain foods into an infant’s diet between the ages of 4-6 months (and regular exposure thereafter) can actually help build and maintain tolerance5,22.
More specifically, a groundbreaking study of 640 allergy-prone children ages 4-11 months found that early introduction of peanuts significantly decreased the chances of developing peanut allergy compared to complete avoidance23.
Identifying allergic patients
Identifying patients with food allergies can be challenging. Issues may vary and can often seem disconnected, and, in the case of infants and young children, your patients may not be able to verbalize exactly what they are experiencing.
The difference between moderate and severe food allergies can also present challenges. The subtle indications of a food allergy in infants, like drooling or spit-up, may be misinterpreted as a normal issue, but can be related to a severe allergic reaction.
Anaphylaxis in infants
Anaphylaxis is a severe, potentially fatal, allergic reaction involving multiple systems24. Infants with allergies are at risk for anaphylaxis, and the indicators of an anaphylactic reaction may be more difficult to recognize in these patients24.
It is important that healthcare providers and caregivers alike recognize the indicators of anaphylaxis in infants, as even mild indications can progress quickly25.
Severe allergies and inflammation
Severe allergies create an excessive and ongoing inflammatory immune response. DHA, an omega-3 fatty acid, may help modulate the immune response in infants with severe allergies. The ratio of DHA and ARA, an omega-6 fatty acid, is important for developing an appropriate immune response26-28.
Alpha-linolenic acid (ALA) and linoleic acid (LA), precursors of DHA and ARA, are commonly found in food sources such as oils, nuts, seeds and eggs. However, infants may not be able to efficiently convert dietary ALA and LA into DHA and ARA compared to adults29. Ensuring these patients have an extra source of both DHA and ARA is important27.
Download this clinical correspondence to learn about the mechanism of action of DHA and ARA to support the immune response:
When should you consider recommending an amino acid formula?
A review of peer-reviewed, published articles found an amino acid-based formula may be used for the following conditions30:
Ineffective resolution with an EHF
The degree of hydrolysis determines the allergenic response. Approximately 10% of patients with IgE-mediated CMA may not see resolution with an extensively hydrolyzed formula; for non-IgE-mediated gastrointestinal CMA, the percent of patients may be higher30.
Eosinophilic esophagitis (EoE)
The American Academy of Allergy, Asthma & Immunology currently suggests using an amino acid formula as first-line management for EoE. Successful management has been reported for 90% of patients with EoE using an amino acid formula31.
Up to 24% of children with food allergies may have growth stunting30. When growth faltering does not resolve on an EHF, especially when multiple systems are involved and with multiple food eliminations, an amino acid formula should be considered.
Milk-induced anaphylaxis may affect up to 9% of patients with CMA. Amino acid formula is the first-line recommendation for patients with milk-induced anaphylaxis32.
Consider an amino acid formula for these issues as well30:
Mead Johnson offers a selection of amino acid formulas:
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