Cow's milk protein allergy (CMPA ) is the first food allergy to appear in children and most often begins in infants in the first few months of life. It is an allergic reaction to cow's milk protein (CMMP), which involves the immune system. Gastrointestinal, respiratory or skin symptoms may occur. Even a small amount of cow's milk protein can cause this allergic reaction. This allergy usually disappears within the first 2 to 3 years of life (variable depending on the child and the type of CMPA). But what can you do on a daily basis to feed your baby if he has CMPA? What can be used to replace foods containing PLV to limit deficiencies in a growing child?
What foods contain VLPs?
Once the diagnosis of CMPA has been made, your child's GP, paediatrician orallergist will recommend the appropriate infant milk for the child's allergy and will ask you to follow a diet free of CMPA. A simple hypoallergenic infant milk (or HA) will not be suitable and vegetable juices (such as almond milk, for example) should be avoided altogether , as a substitute for breastfeeding or a suitable infant milk, as this can cause serious deficiencies.
You should also be aware that if you are breastfeeding, cow's milk proteins can be transferred from your diet into your breast milk. Only in certain cases will the breastfeeding mother also have to avoid VDPs.
Apart from milk, it is dairy products in general and milk derivatives such as butter and cream that contain VDP. These products should be avoided at the time of and after diversification until the health professional has given the green light to reintroduce them.
To help you, here is a list of ingredients present in industrial products containing VDPs: milk proteins, lactoproteins, milk whey proteins, milk casein, caseinate, lactoglobulin, milk lactalbumin, milk lactose, margarine, cream, butter.
These ingredients should be removed from your baby's diet in the event of VDPs.
It is therefore necessary to carefully decipher the food labels. The more "elaborate" a product is, the more likely it is to contain milk or one of its derivatives.
Keep your food choices simple ! Take raw, unprocessed products and if in doubt, abstain!
What alternatives to cow's milk exist?
In addition to infant milk without adapted and prescribed POS, which remains the basic food, you can diversify your child's diet with food products available in:
- Pharmacie : « Dessert sans lait » de PICOT Pepti-junior (plusieurs parfum au choix) et « Mes premiers boudoirs sans lait » de PICOT Pepti-junior
- Large surfacesor organic shops :
- Complete meals for babies: for example Good taste or Babybio without milk (different recipes) ...
- CĂ©rĂ©ales pour bĂ©bĂ© : « CĂ©rĂ©ales et LĂ©gumes » et « CĂ©rĂ©ales et Fruits » de BĂBĂ M (BĂ©bĂ© Mandorle), « CĂ©rĂ©ales JunĂ©o Riz » de PrĂ©mibio (ces 3 produits contiennent du calcium) âŠ
- Desserts for babies: Babybio or Good taste "Brassé végétal" bottles (but be careful, these products do not contain calcium)...
- Laitages vĂ©gĂ©taux : Yaourts « Gourmand et vĂ©gĂ©tal » de Andros (que vous prendrez de prĂ©fĂ©rence nature, ce yaourt est dâailleurs enrichi en calcium), « Absolumande » brassĂ© dâamande des Petites Pousses (que vous prendrez de prĂ©fĂ©rence nature, mais malheureusement non enrichi en calcium) âŠ
This list is, of course, not exhaustive and you can find other products without VDP in the shops. However, you should always choose products with as little added sugar as possible. You can also make homemade preparations or desserts using your child's infant milk without VDP: béchamel sauce, vegetable purée, semolina or rice pudding, etc. From time to time, you can use vegetable juices for your preparations, but always take them enriched with calcium.
What are the possible deficiencies and how can they be avoided?
As you will have understood above, it will be necessary to ensure a sufficient intake of :
- Protein: As milk and dairy products provide a significant amount of protein, a diet without VDP may reduce protein intake. The presence of suitable infant milk will therefore be essential, as well as the presence of meat, fish,egg oroffal. Beware, however, ofcross-allergies with certain meats in very rare cases.
- Calcium The same applies to calcium, as milk and dairy products provide an essential amount of calcium. Other sources of calcium should be found:
- 100 g de lĂ©gumes = 45 mg de calcium (en moyenne), les plus riches sont les lĂ©gumes feuilles comme les salades, les choux, le cĂ©leri, le cerfeuil, les Ă©pinards⊠Mais il y a aussi : le cresson, le persil, la fĂšve, le cĂ©leri, lâĂ©pinard, le poireau, lâartichaut, les choux, le haricot vert, la carotte, le petit pois, le champignon, lâasperge, la betterave. Et dans les lĂ©gumes secs : le pois chiche, le haricot blanc ou rouge, la lentille⊠(Ă introduire Ă partir de 15/18 mois)100 g de fruits = 30 mg de calcium (en moyenne), les fruits acides comme les agrumes (orange, pamplemousse, citronâŠ), les baies comme la groseille, la fraise, la framboise, la mĂ»re, le cassis, le kiwi⊠et les fruits secs et olĂ©agineux sont les plus riches. Comme pour les lĂ©gumes, les fruits crus contiennent plus de calcium que les fruits cuits.Pensez aux poissons en conserves : sardines, maquereaux⊠(si on consomme les arĂȘtes ! donc Ă proposer mixĂ©s en tartinades pour les plus jeunes)Choisissez des eaux riches en calcium : Talians, HĂ©par, Courmayeur, Contrex, Wattwiller, Salvetat, San Pellegrino, Vittel (en petites quantitĂ©s pour les plus petits et sur avis mĂ©dical)
- Think of aromatic herbs: basil, savory, marjoram, thyme, herbes de Provence, sage, oregano, mint, rosemary, bay leaves, parsley, chervil...
- Also use seeds or spices: poppy seeds, fennel seeds, cinnamon, sesame seeds, cumin seeds, coriander seeds, caraway seeds, curry, cardamom, flax seeds (to be crushed for babies), etc.      Â
Quoi quâil arrive, jâattire vraiment votre attention sur le fait quâil est important de consulter et de se faire accompagner par un professionnel de santĂ©, car ce nâest pas toujours si Ă©vident que cela ! Le mĂ©decin gĂ©nĂ©raliste ou spĂ©cialiste posera le diagnostic et Ă©tablira la conduite Ă tenir et une diĂ©tĂ©ticienne-nutritionniste pĂ©diatrique pourra rĂ©aliser un bilan nutritionnel Ă lâaide dâune enquĂȘte alimentaire pour dĂ©celer et combler une Ă©ventuelle carence et vous proposez des solutions adaptĂ©es et personnalisĂ©esâŠ
Dietician - Nutritionist specialising in paediatrics
- The author declares that he has no ties of interest.
Source:
COUDERC L. MOUTERDE O. MARGUET C. Cow's milk protein allergy. Elsevier Masson, May 2017.