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Allergy to nondairy proteins in mother's milk as assessed by intestinal permeability tests
D de Boissieu1, C Dupont, J Badoual
1Service de Pédiatrie, Hôpital Saint Vincent de Paul, Paris, France.
Insights
This study shows that food allergy in infants can be diagnosed using an intestinal permeability test. Maternal dietary changes, specifically eliminating egg and pork, resolved infant symptoms and normalized test results.
Area of Science:
- Pediatric Allergy
- Gastroenterology
- Immunology
Background:
- Food allergies are a growing concern in infants.
- Diagnosing food allergies can be challenging.
- Intestinal permeability testing offers a noninvasive diagnostic approach.
Observation:
- A 1-month-old breastfed infant presented with symptoms suggestive of food allergy.
- Intestinal permeability tests were performed during breastfeeding.
- Initial tests indicated breast milk-induced alterations in intestinal permeability.
Findings:
- Eliminating dairy from the mother's diet did not improve the infant's symptoms or intestinal permeability.
- Symptoms resolved and intestinal permeability normalized after the mother eliminated egg and pork from her diet.
- This suggests non-cow's milk proteins transferred via breast milk can trigger infant hypersensitivity.
Implications:
- Intestinal permeability testing can identify specific food triggers in breastfed infants.
- Maternal diet modification, beyond dairy, is crucial for managing certain infant food allergies.
- This highlights the importance of considering diverse dietary proteins in breast milk for infant allergic reactions.
Abstract:
The intestinal permeability test is a noninvasive method which, when done during a food provocation procedure, can detect the deleterious effect of food on the intestinal mucosa in allergic children. We report on a 1-month-old breast-fed boy with a history of regurgitation, diarrhea, difficult feeding, and malaise suggesting food allergy. Intestinal permeability tests were done with the mother's milk and showed breast-milk-induced alterations of intestinal permeability. No improvement occurred in the child's clinical symptoms or in the results of the intestinal permeability test when the mother withdrew dairy products from her diet. Disappearance of the child's symptoms and normalization of intestinal permeability during provocation with the milk were obtained after elimination of egg and pork from the mother's diet. This observation suggests that dietary proteins different from cow's milk antigens may be transferred to breast milk and induce adverse reactions in hypersensitive infants.