An allergy to Cow’s Milk Protein (CMA) is one of the most frequent food allergies in the first months of life, even in preschool-age children and adults. Recent studies indicate that it is associated with the development of other types of allergies such as asthma, atopic dermatitis and rhinitis.
CMA can cause serious health complications for infants and children such as skin conditions and problems with their gastrointestinal and respiratory systems. One of the most alarming conditions linked to CMPA is the development of asthma, a condition that is 69.9% underdiagnosed in Colombia, while its prevalence continues to rise.
Dr. Juan Pablo Riveros, pediatric gastroenterologist and president of the Colombian College of Pediatric Gastroenterology, Hepatology and Nutrition COLGAHNP states that “it has never been so important to strengthen the immune system in the pediatric population and even more so in children with food allergies, since early diagnosis and proper management of CMA can contribute to a decrease in the burden of this disease and its complications ”.
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The intestinal microbiota refers to the set of bacteria that naturally colonize the intestine of people and is important for the proper functioning of the gastrointestinal system, it has been shown that the microbiota of infants with allergies has an imbalance when compared to that of healthy infants breastfed. Breast milk contains oligosaccharides and bacteria that contribute to the development of a healthy gut microbiota.
The development and maintenance of a balance in the microbiota (beneficial bacteria that live in the human intestine) and its relationship with the immune system is an essential factor for health, especially in infants and children.
Probiotics are live microorganisms intended to maintain or increase the “good” bacteria (balanced microbiota) in the body. Prebiotics are the food (usually fiber) that acts as a nutrient for “good” bacteria. Prebiotics are used with the intention of improving the balance of these beneficial microorganisms.
“Symbiotics are a combination of prebiotics and probiotics. These bacterial strains directly or indirectly influence the immune system through the intestinal microbiota, and therefore play an important role in preventing the development of allergy. The objective of combining prebiotics and probiotics is to obtain more powerful positive effects (synergy) than using them separately ”, emphasizes Dr. Riveros.
According to Dr. José Fernando Vera-Chamorro, Gastroenterologist, nutritionist and clinical epidemiologist, member of COLGAHNP, leader of the pediatric research group: “Pediafe”; and with improvement in research at Harvard Medical School; “The changes in the intestinal microbiota are responsible, in part, for the increase or the presence of allergic diseases. The ideal would be to promote a balance of the intestinal microbiota from pregnancy with adequate nutrition of the mother, ensuring a vaginal delivery (where a natural microbiota is acquired) and the start of breast milk, ideally, in the first hour of life, avoiding the use of formulas and the indiscriminate use of antibiotics, in order to reduce the risk of these symptoms. ”
“Taking into account the importance of prebiotics and probiotics in feeding allergic infants and in cases where breastfeeding is not possible, nutritional management with symbiotics in infants with CMA is an excellent option to promote early tolerance. and avoid other allergic diseases, such as asthma, rhinitis and atopic dermatitis, ”says Dr. Vera-Chamorro.
Scientific studies carried out in more than 1500 patients with food allergies, demonstrate the evidence of the use of symbiotics in the treatment and evolution of these. Symbiotics act not only by improving the symptoms associated with allergy but also by favoring its disappearance, since they restore the lost balance to the intestinal microbiota.
For the nutritional management of food allergies, a product approved as APME (Food for Special Medical Purposes) will soon be available in Colombia with a symbiotic mixture that is considered an innovation for the management of this condition. Its prescription and use must be supervised by a health professional, which is why it is covered by the mandatory health system (POS).
This scientific finding is of great importance, since it will not only contribute to improving the quality of life of infants and children with food allergies, but it will also prevent adults from developing associated allergies such as rhinitis, asthma or atopic dermatitis, three of the pathologies that are frequently consulted by patients in Colombia, concludes Dr. Riveros.
Food allergies in Colombia
Despite the little evidence available, studies in Colombia show an increase in food allergies in pediatrics, the real prevalence varies between 2% to 7%. Additionally, only in 20% of cases is a food allergy suspected early, therefore, in most patients, inappropriate nutritional behaviors are defined, which impact the nutritional status.
Risk factors for the development of food allergies in pediatrics show high figures in recent years in Colombia. First, cesarean deliveries are about 45.5%, as well as early exposure to cow’s milk in 62% of infants and the prematurity rate of 19.3%; On the other hand, exclusive breastfeeding in children under 6 months is only 36.1%; other risk factors are also considered, such as a smoker mother, atopic mother and father, among others.