Therapeutic milk mixtures: how to choose and how to apply. Medicinal mixtures

Food allergies are a fairly common occurrence in young children, both at the breast and at birth. artificial feeding. In the latter case, the most important component in its treatment and prevention is diet therapy with hypoallergenic mixtures, which allows you to reduce the drug load on the body and achieve a faster disappearance of the symptoms of the disease.

Important! An allergy in a breastfed baby does not require transferring the baby to a hypoallergenic formula. In this case, a correction of the diet of the nursing mother is recommended. If the child receives complementary foods, then the timing of its introduction is reviewed, taking into account the composition.

Types of hypoallergenic mixtures

The main purpose of hypoallergenic mixtures is treatment and prevention. In this regard, their protein component differs from conventional mixtures and can be represented by:

• partially hydrolyzed milk protein;
• highly hydrolyzed milk protein;
• protein components - a mixture of amino acids.

The main task of such a transformation is to prevent the body from recognizing the allergen in the altered cow protein. The smaller parts of the protein are formed in the process of hydrolysis, the less likely that the body "recognizes" them and responds with an allergic reaction. After hydrolysis, the resulting mixture of peptides and amino acids is freed from non-cleaved molecules and their large fragments by ultrafiltration and processed on sorbents.

Depending on the purpose, all hypoallergenic mixtures are divided into preventive and therapeutic. Sometimes, in the group of prophylactic mixtures, a subgroup of therapeutic and prophylactic mixtures is distinguished, which are no longer used for prevention, but for the treatment of mild manifestations of allergies. Classification of the mixture as prophylactic or treatment-and-prophylactic depends on the degree of protein cleavage and recommendations for its use by the manufacturer.

Preventive hypoallergenic mixtures

Depending on the degree of adaptation, prophylactic mixtures can be adapted from birth to six months (mixture formula 1), adapted to the age of children from birth to one year old, and also partially adapted from six months (mixture formula 2). You can distinguish hypoallergenic mixtures by the marking on the can "GA" or by the word: "Low-allergenic".

The protein in such mixtures is subject to partial hydrolysis, as a result of which separate fragments are split off from it - peptides, the allergenicity of which is reduced by 300-1000 times compared to cow's milk protein. In the HIPP Combiotic GA 1 mixture, the protein has more a high degree hydrolysis compared to other prophylactic mixtures, but, nevertheless, this mixture is not curative. Almost all mixtures with partially hydrolyzed milk protein contain lactose, so these mixtures are not recommended for lactose intolerance. The exception is the Bellakt GA 1 and 2 mixture, which belongs to lactose-free hypoallergenic mixtures and can be used for lactase deficiency.

Prophylactic mixtures contain quite a lot of large protein fragments with a high molecular weight, capable of certain conditions cause an allergic reaction, so they are used:

• for feeding healthy children who have a predisposition to food allergies to cow's milk proteins (the father or mother has an allergy);
• with the gradual transfer of the child from therapeutic mixtures to conventional mixtures;
• when an allergy to cow's milk proteins is not confirmed and its external manifestations are moderate.

Important! Formulas based on partially hydrolysed protein are not recommended for confirmed allergy to cow's milk proteins, even if it is mild.

If the child has reached the age of 5-6 months, he is not allergic to soy proteins, and the diagnosis of intolerance to cow's milk proteins is laboratory confirmed, then mixtures based on partially hydrolyzed milk protein can be used instead. They are therapeutic dairy-free, lactose-free mixtures and can only be prescribed by a doctor. A child receiving such mixtures should be under constant supervision, as there is a risk of intolerance to soy protein.

Another alternative to mixtures based on partially hydrolyzed milk protein can be the usual adapted ones ("Cabrita" and), but they must be used with extreme caution, since there are cases when, after the onset of an allergy to cow's milk proteins, an allergy to proteins develops goat milk.

Important! Goat milk and isolate formulas soy protein are not hypoallergenic. Their use instead of prophylactic hypoallergenic mixtures should be agreed with the doctor.

And probiotic blends are also non-hypoallergenic and are only used in the convalescent stage of expansion if cow's milk proteins are intolerant. dairy-free diet. The use of products with probiotics is especially important when frequent infections or infectious complications of an allergic disease.

List of hypoallergenic prophylactic formulas

List of hypoallergenic formulas

Therapeutic hypoallergenic mixtures

Most therapeutic mixtures, unlike prophylactic ones, are not divided into adapted mixtures (with formula 1) and partially adapted mixtures (with formula 2), but are adapted mixtures intended for feeding from birth to one year. The exception is the Nutramigen Lipil mixture, which has degrees of adaptation with formulas 1 and 2.

Indications for the appointment of these mixtures are:

• acute allergic reactions;
• malabsorption and digestion syndrome (non-infectious diarrhea, acute intestinal infections, galactosemia, celiac disease, etc.);
• hypotrophy;
• after operations on the stomach or intestines;
• feeding premature newborns.

Treatment mixtures include mixtures based on highly hydrolyzed protein (whey or casein) and synthetic amino acids.

Highly Hydrolyzed Protein Blends

The allergenicity of mixtures based on highly hydrolyzed cow's milk protein is reduced by 10,000-100,000 times compared to unchanged cow's protein. They contain quite a lot of peptides with a molecular weight of 1.5 kilo Daltons, which have minimal allergenicity, but at the same time, there are protein antigens with a molecular weight of 3.5-5 kilo Daltons, which in some cases can cause food allergies. Therefore, the criterion of their effectiveness is not the depth of hydrolysis, but the results of clinical studies, as a result of which 90% of children have no allergic reaction to cow's milk proteins.

The basis of the protein component of mixtures based on highly hydrolyzed protein can be whey protein hydrolyzate and casein hydrolyzate.

1. Mixtures based on whey protein hydrolyzate. They are considered more allergenic than mixtures based on casein hydrolysates, as they have quite a lot of peptides with a molecular weight of about 5 kilo Daltons. Most of these mixtures can be used for lactase and lipase deficiency, as they are lactose-free and contain easily digestible medium chain triglycerides (up to 50% of all lipids). The exceptions are mixtures based on highly hydrolyzed whey protein "Nutrilon Pepti Allergy" and "Alfare Allergy", which contain lactose and lack medium chain triglycerides. Used for moderate allergies. Whey protein hydrolysates have a greater nutritional value than casein hydrolysates, and therefore, when using these mixtures, a large increase in body weight is observed, which is important for malnutrition and for premature babies. They have a bitter taste due to the significant amount of free amino acids.
2. Mixtures based on casein hydrolyzate. The average molecular weight of the peptides of these mixtures is 3.5 kilodaltons, therefore mixtures based on casein hydrolysates rarely cause allergic reactions and are recommended for severe forms of food allergies or hypersensitivity to whey proteins. Because of a large number free amino acids, they taste even more bitter than whey protein blends.

List of Whey Protein Hydrolyzate Treatment Blends

List of medical mixtures based on casein hydrolyzate

Therapeutic mixtures based on synthetic amino acids

These mixtures do not contain protein at all, so the occurrence allergic reactions impossible for protein. The disadvantages of these mixtures include high osmolality and low taste.

The appointment of mixtures based on amino acids is carried out if:

• treatment with mixtures based on highly hydrolyzed milk proteins for two weeks does not give a result;
• allergy to cow's milk proteins is accompanied by malabsorption in the small intestine and delayed physical development;
• allergic reaction to mixtures with highly hydrolyzed protein.

List of medicinal mixtures based on synthetic amino acids

Algorithm for choosing a therapeutic mixture for children of the first year of life with an allergy to cow's milk proteins

How to switch to a hypoallergenic mixture

When prescribing any of the above mixtures, it is necessary to take into account the content of lactose in them, since an allergy to cow's milk proteins is often accompanied by lactose intolerance. In such cases, the appointment of lactose-free hypoallergenic mixtures is recommended.

A confirmed allergy to cow's milk proteins requires a complete conversion to therapeutic mixtures. However, amino acid mixtures can be used for a relatively short time to diagnose milk protein allergy. Preventive and treatment-and-prophylactic mixtures can be given to a child as supplementary food or as the main type of food.

When transferring a child to a hypoallergenic mixture, the following rules must be followed:

• introduce the product gradually, by reducing the amount of the previously obtained mixture;
• before each feeding, first give a formula based on protein hydrolyzate, and then the usual one.

Important! A change in the color of the stool to greenish or its consistency is not a reason to cancel the hypoallergenic mixture and is considered to be a variant of the norm.

The duration of taking hypoallergenic mixtures is individual and takes an average of 3-6 months, but in some cases treatment may be required for a year or more.

In contact with

It is quite easy for a healthy baby to choose a milk formula, but some children have allergies, impaired digestive function, cannot tolerate certain products. Especially for such children, therapeutic mixtures for feeding have been created. They greatly simplify the life of parents and are absolutely safe for the baby.

How to choose a healing mixture

First, you should consult a pediatrician who will correctly determine the presence of the disease. After passing the tests and a competent examination, the doctor will easily advise a certain mixture.

If the baby has obvious problems with digestion, then you should opt for a mixture with a probiotic. It helps a lot in the tummy, or diarrhea. Probiotics, which are contained in the diet, help strengthen the baby's immunity, heal the body. With regular intake of a mixture with a probiotic, digestion normalizes, disorders disappear. Often, pediatricians recommend a probiotic for children with allergic reactions. The mixture is perfectly absorbed by the body, does not irritate it. In a pharmacy, you can easily buy a mixture of "Nan" with a probiotic produced in Switzerland. It is the most popular among medicinal mixtures.

Some children are born lactose intolerant. This often becomes a problem for mothers because they do not understand what to feed their babies. Fortunately, pharmacies have long had mixtures that are lactose-free. An example is Nutrilak low-lactose, a mixture is produced in Russia. The Nan mixture has proven to be excellent, which pediatricians and parents often choose.

How to use therapeutic milk mixtures correctly

First of all, the mixture should be appropriate for the age of the baby. Moms can easily navigate by the markings on the food box.

Medicinal mixtures can be used in mixed feeding i.e. in combination with breast milk. And for artificial feeding they fit perfectly. The main thing is to follow the instructions for dosages. After the positive effect of the treatment mixture, you can gradually transfer the child to a good adapted one.

When choosing a treatment, trust the opinion of a specialist. Don't choose anymore budget options, they certainly will not bring benefits. If the baby responds well to the selected mixture, then you should not experiment and change it.

Breastfeeding experts confidently state that any woman can breastfeed a child. However, sometimes the desire to feed the baby comes across serious obstacles. The main obstacle to breastfeeding are diseases, the treatment of which is not compatible with breastfeeding. Sometimes, having started successfully, breast-feeding ends in a few months due to the fact that the mother failed to establish lactation and competently organize the feeding process. There are cases when a mother, due to her own views and beliefs, does not at all try to breastfeed her baby, giving a mixture from birth. In all these cases, the child grows up on artificial feeding. It is important for parents to understand what mixtures for newborn children are in terms of their composition and properties. The fact is that the nutrition of the baby in early age- the guarantee of his health for the future. Of course, nothing can be better than mother's milk, but if, for some reason, the child grows up on artificial feeding, the choice of a mixture for nutrition must be approached very thoroughly.

Types of mixtures: study and classify

Market baby food has a wide range of varieties of infant formula, which are consistent with the requirements of GOST and the Institute of Nutrition. It is very easy to get confused in the variety of colorful jars and boxes with baby formula. Therefore, to begin with, we propose to figure out who is who on the store shelf and what the numbers and inscriptions on the packages with the mixture mean. In other words, we will consider what infant formulas are in terms of consistency, composition, age indicator and purpose.

Consistency

By consistency, infant formula can be divided into dry and liquid.

• Dry mixes. On Russian market it's 90% of infant formula. Such mixtures are packed in cardboard box or tin can powder, which must be diluted with boiled water before use.
• Liquid. Such mixtures are already ready for use and require only heating. They are sold in tetrapacks and packaged in 200 ml. The only problem is that in Russian stores the share of such mixtures is negligible. You can find such mixtures only in large cities.

The most common are dry, they are convenient to store, dispense, easy to transport and have a wide variety of choices. Liquid mixtures are easier to prepare than dry ones, as they only require heating. But they have short term storage (only a couple of days).

Compound

Almost all milk mixtures are made on the basis of cow's milk. Since cow's milk protein is foreign to our body, it must be present in the mixture in an altered form. Depending on the degree of processing of milk protein, infant formulas can be divided into:

• Adapted. They are made on the basis of demineralized whey of cow's milk, therefore, such mixtures are as close as possible to breast milk in their properties. They are quite light, nutritious, quickly absorbed. Adapted mixtures are designed just for newborns. In addition to demineralized whey, adapted mixtures include polyunsaturated fatty acids, vitamins, minerals, and nucleotides. Of course, such mixtures are more expensive to manufacture, so they can be attributed to the premium class in terms of price. The most popular adapted mixtures are:

– Nestle NAN (price is about 400-500 rubles per pack of 400 gr, depending on availability additional components);

- Nutricia Nutrilon (prices range from 375 to 650 rubles per 400g);

- Semper (sold in packs of 350g, price range 360-480r.);

Some babies suffer from intolerance to cow's milk protein, so formulas based on cow's milk whey are not suitable for them. For such children, there are adapted milk formulas based on goat's milk:

- Bibikol Nanny (packing 400g costs about 1300 rubles);

• Partially adapted to some extent close in structural composition to breast milk, they include in their composition not only lactose, but also sucrose, they do not have a stabilized mineral-fat composition;
• Subsequent are made from dried whole cow's milk, to which sucrose and starch are added, they do not contain whey.

Depending on the child's age: Up to 6 months - starting, and older than six months - subsequent.

Liquid mixtures are also adapted. The most accessible of them are:

— Ready dairy NAN mixture(price about 60 rubles per pack of 200 ml)

– Agusha ready-made milk formula (price is about 25 rubles per pack of 200 ml)

• Unadapted. These mixtures are made on the basis of cow's milk protein - casein. As additional components, they may contain everything that is available in adapted mixtures. There are mixtures that are very “poor” in composition: they lack taurine and fatty acids. On this basis, in some sources, non-adapted infant formula divided into "less adapted" (casein instead of demineralized whey, other components as in adapted mixtures) and "partially adapted" (casein and poor composition of additional components). This is not entirely correct, because the degree of adaptation of the mixture is determined by how easily the mixture is absorbed by the child's body, and this depends precisely on what is present in it as a milk base: demineralized whey or cow's milk protein. Casein mixtures, regardless of their nutritional value, are more difficult to digest, so they are all unadapted in any case, and they should be given only after 6 months. The main "representatives" of casein mixtures are:

- Similac (price from 350 to 650 rubles for a standard package);

- Nestle Nestogen (a package weighing 370g is sold for an average of 240 rubles);

- Baby (price per package is about 210 rubles).

As a child grows, their digestive system develops. If mixtures based on demineralized whey are better suited for a newborn, then for children older than six months, casein mixtures or mixtures based on dry milk can be used. cow's milk(these are mixtures of the second and subsequent levels).

Age indicator

The formula for infant formula is highly dependent on the age of the baby for whom it is intended. This is due to the fact that as the child grows and develops, the child’s digestive system improves and the body’s needs for food change. nutrients Oh. This is a completely natural process, because breast milk also changes its composition with the growth of the baby. The formula number of the milk formula is always indicated on the packaging. Behind each number and designation is a certain age range.

The gradation of mixtures by age is as follows:

• "0" or the prefix "pre" in the name - the mixture is intended for newborn premature or low birth weight babies;
• "1" - a mixture for children from birth to 6 months;
• "2" - a mixture for babies from 6 months to 1 year;
• "3" - a mixture for children older than a year.

As we said earlier, as the age formula of the mixture changes, its milk base changes: the amount of non-adapted cow's milk proteins increases. In addition, the content of vitamins and minerals increases, because. the need for these substances increases. It is also believed that mixtures for older children are more satisfying and high-calorie.

Moms take note!

Hello girls) I didn’t think that the problem of stretch marks would affect me, but I’ll write about it))) But I have nowhere to go, so I’m writing here: How did I get rid of stretch marks after childbirth? I will be very glad if my method helps you too ...

Specialized and therapeutic mixtures

Sometimes the characteristics of the body and the state of health of the baby are presented with milk mixtures. special requirements. In such cases, the child needs specialized or therapeutic mixtures. Depending on what kind of problem the baby has, the following infant formulas can be distinguished:

• Formulas intended for premature babies: They have a lot of protein, vitamins and whey protein in the composition and have a great energy value. Manufacturers designate packages with such feed as «0» or another attachment "pre-" in the title.

• Dairy mixtures. They are used for digestive problems (for colic, constipation, during the recovery period after taking medication, for the treatment of dysbacteriosis). Such mixtures contain lactic acid and bifidobacteria. If babies have colic, vomiting, diarrhea, regurgitation, it is effective to use antireflux food containing substances (gum or starch) that act as thickeners. For example: Nutrilon AR, Enfamil AR, Nutrilak AR, Freeze. For constipation, food is also used, which is also enriched with gum, which has the characteristics of dietary fiber, or lactulose. Lactulose is a disaccharide that activates the growth of bifidobacteria. Lactulose contains Detolact Bifidus, Semper Bifidus.

More common and most popular mixtures:

- Nutrilac Sour-milk (price about 400 rubles)

- Nutrilon Sour-milk (price about 410 rubles)

— NAN Sour Milk(price about 450 rubles).

• Mixtures with high iron content. Such mixtures are prescribed for babies older than 4 months for the prevention and treatment iron deficiency anemia. The signal for the appointment of a mixture with a high iron content are low rates hemoglobin in the child's blood. Of course, it is impossible to bring hemoglobin back to normal with just a mixture, and the pediatrician will prescribe iron supplements. The mixtures themselves with a high iron content are not positioned on the Russian market as medicinal, they simply have a richer composition and the proportion of iron in them is greater than in other mixtures.

— Enfamil Premium (price about 390 rubles)

- Similac Premium (price about 350 rubles).

• Hypoallergenic blends. Such nutrition is necessary for babies prone to allergic reactions. Cow's milk protein is a strong allergen, therefore, hydrolyzed is used in such mixtures, i.e. already partially digested, enzyme-cleaved protein. Hypoallergenic infant formulas often have the abbreviation "HA" in their name.

- Nutrilon Hypoallergenic (price about 550 rubles)

— NAN Hypoallergenic (price about 550 rubles)

• lactose-free and soy mixtures. Used for intolerance to cow's milk protein. This is a pronounced form of food allergy, in which even hypoallergenic mixtures will not help.

- Nutrilon Soya (price about 560 rubles)

— Frisosa (price about 450 rubles)

- NAN lactose-free (price about 690 rubles)

- Similac Isomil (price about 410 rubles)

• Anti-reflux mixtures. Essential for frequent spitting up babies. These mixtures contain special thickening components: carob gluten, rice or corn starch. The packaging of such mixtures often bears the abbreviation "A.R."

— Enfamil A.R. (price about 670 rubles)

— Frisov (price about 610 rubles)

- Nutrilon Antireflux (price is about 680 rubles)

It is important to know! There is also such a thing as "supplementary feeding while breastfeeding." Complementary formula used when the baby does not have enough mother's milk. Then highly adapted mixtures are used (they can be called breast milk substitutes).

Choosing a formula for a newborn

The choice of nutrition for artificial feeding of a child must be carried out after consultation and examination of the baby by a pediatrician. At the same time, every attentive parent must be familiar with the fundamental principles that will help you choose the right mixture.

In order to choose a mixture for a newborn baby, you need to remember what requirements high-quality infant formula meets.

1. For newborn babies, you need to choose only adapted mixtures. They are closest in composition to breast milk, are easily digested and absorbed by the infant's body.
2. When choosing a mixture, you must strictly adhere to age recommendations. It is possible to start artificial feeding of a newborn baby only from the initial stage of mixtures; it is impossible to switch to a mixture of another level before 6 months.
3. If the baby has any health problems or has digestive difficulties, choose specialized or therapeutic mixtures. By the way, it is not at all necessary to completely transfer the child to the treatment mixture. In some cases, it is enough to replace it with 1-2 feedings per day.
4. Do not blindly follow advertising, always study the composition of the mixture yourself, compare it with other mixture options. If possible, choose a blend that does not contain palm or canola oil and is rich in vitamins and minerals.
5. Pay attention to the expiration date of the mixture. Do not buy mixture with a borderline expiration date.
6. Buy baby food only in specialized stores.
7. The presence of carnitine, linoleic acid, taurine is useful - they are involved in fat, protein, vitamin and energy exchange, tissue generation, formation of internal organs.
8. Watch your baby's reaction to food. If you have allergies or digestive problems, consult a pediatrician. It is possible that the mixture you have chosen is not suitable for your baby and needs to be replaced.

How to understand that the mixture is not suitable

As the experience of mothers whose babies grow up on artificial feeding shows, finding “your” mixture is not always easy and fast. The only search method is the trial and error method. In order not to get a breakdown of digestion and health problems, mom needs to carefully monitor the baby's reaction to the mixture. Some tips will help the mother navigate and understand whether the selected mixture is suitable for the child. So oh new mixture Worth considering if:

• Appear in the form of a rash and redness of the skin;
• The child often liquid stool with white patches (undigested particles of the mixture);
• The baby shows anxiety, screams and cries after feeding, does not withstand the required interval between meals;
• The child gains weight poorly ();
• At night, the baby sleeps very restlessly, often wakes up.

Prepare the mixture only in accordance with the preparation method indicated on the package, observe the proportions of the components.

Artificial feeding is expensive. Parents who use the mixture note that the baby's nutrition becomes a very tangible expense item. family budget. However, saving on mixtures by choosing cheaper and low-quality options is not worth it. The best option save money and be sure that the baby has enough for growth and development - this is breastfeeding, so try to establish lactation and feed, and take a bottle only when breastfeeding is really impossible.

The question of choosing a mixture for healthy child very important, but it gets more complicated when we are talking about a baby with any diseases or disorders. In this case, such children are prescribed therapeutic mixtures for children as the main type of nutrition.

Medicinal mixtures can be a powerful therapeutic factor that will favorably affect the course of the disease, normalize the work gastrointestinal tract, restore metabolism, the body's defenses. For some types of childhood diseases, especially in infants, therapeutic mixtures are the only medicine.

Today in Russia there is a huge choice special types therapeutic and preventive nutrition (mixtures) of both domestic and foreign production. All of them are designed to contribute to the correction and cure of various diseases in children from birth to 1-2 years of age. It is very important to choose a healing mixture with your pediatrician or your doctor. More precisely, only a doctor should prescribe such a mixture. After all, the course and outcome of the disease depends on how correctly the composition of the mixture is selected, how much it will correspond to the nature of the violation and the characteristics of the disease, as well as the correct dosages.

Some may be surprised by the term "dosage" in combination with infant formula. But therapeutic infant formulas are prescribed and taken in this way - dosed and at a strictly defined time. This is another condition Get well soon baby.

The therapeutic mixture should not only provide the child with nutrients, but also provide real assistance with various diseases. For example, children with digestive problems (diarrhea, constipation) should be fed mixtures with probiotics. Each treatment mixture is specially designed for some type of child's disease. These can be mixtures for children with allergies, for babies suffering from constipation, diarrhea, regurgitation, poor weight gain, premature babies. There are also mixtures for children with hereditary diseases: celiac disease, cystic fibrosis, phenylketonuria, galactosemia, etc.

These mixtures have one thing in common - they must have such a composition of components that is most acceptable and useful for a particular disease. In one case, less protein may be needed, in the other, carbohydrate intake should be reduced.

Therapeutic milk formulas differ from simple milk formulas also in that they without fail must be adapted to human milk in terms of their other components. To do this, whey proteins, triglycerides and some other components that increase the absorption of the mixture are added to the treatment mixtures. Medicinal mixtures can be used in parallel with breastfeeding, but only if the type of disease of the baby allows.

Infants with disabilities digestive system should be fed anti-reflux therapeutic milk formulas. According to the type of thickener, they are:

• mixtures with locust bean gum (Nutrilak AR, Frisovom, Nutrilon AR, Humana AR);
• mixtures with starch (Samper Lemolak, Nutrilon Comfort, Enfamil AR)

Children prone to food allergies should eat special therapeutic hypoallergenic mixtures (NAS 1, NAS 2, Humana 1, Humana 2, etc.). They have hydrolysed proteins from cow's milk.

Medicated formulas for baby food are usually very expensive. In addition, often they are not able to provide the child with 100% nutrients. Therefore, it is worth making every effort so that the baby recovers faster, and transfer it to a healthy, nutritious diet.

Newborns with severe intolerance to baby food are prescribed therapeutic mixtures for children with allergies. These are hypoallergenic products that are produced with the preliminary breakdown of milk protein molecules.

For children with milk intolerance, therapeutic mixtures based on vegetable protein are produced. Transferring an allergic infant to formula is a necessary step and is justified on a short time until stable remission is achieved.

Clinical picture

WHAT DOCTORS SAY ABOUT EFFECTIVE ALLERGY TREATMENTS

Vice-President of the Association of Children's Allergists and Immunologists of Russia. Pediatrician, allergist-immunologist. Smolkin Yuri Solomonovich

Practical medical experience: more than 30 years

The best food for babies is mother's milk. WHO recommends breastfeeding up to 6 months of age.

Complementary foods are introduced later and stored mother's milk for as long as possible. However, there are times when breastfeeding is not possible, and cow's milk protein causes allergies.

Therapeutic hypoallergenic mixtures are produced on the basis of split milk protein (hydrolyzate) or on soy protein isolate, which significantly improves their absorption.

These are products that are as close as possible in composition, content of vitamins, minerals, nutrients (proteins, fats, carbohydrates) to breast milk.

Some formulas contain increased amounts of iron or certain vitamins and are indicated for children with specific disorders.

Medicinal mixtures have a specific taste, which is not always liked by kids. They are more expensive than regular ones. They cannot be called physiological nutrition for infants.

It should be understood that it is harmful to switch unnecessarily, for the purpose of “prevention”, to therapeutic mixtures for infants.

When are medicinal mixtures indicated?

Therapeutic mixtures for infants are prescribed by a pediatrician or an allergist after a preliminary examination. Indication of transfer to special food is a condition when a child has an allergy, beriberi, anemia, insufficient weight gain.

The reason for this may be:

• allergy to milk protein of moderate and severe degree;
• malabsorption of nutrients in the small intestine of an infant;
• hereditary diseases that are accompanied by a pronounced violation of the digestive processes;
• post-operative conditions surgical intervention on the intestines;
• pancreatic disease, chronic diarrhea in combination with allergies.

Note! Therapeutic mixture for infants should not go into the status of a permanent diet. The term of its use is 2-4 months.

As soon as the condition and digestion of the child are normalized, he is transferred to a prophylactic hypoallergenic or general mixture according to age.

Types of medicinal mixtures

Hypoallergenic baby food - which one to choose? According to the composition and method of production, all medical nutrition for newborns can be divided into:

• therapeutic milk mixtures - based on split cow's milk;
• dairy-free - therapeutic mixtures based on soy protein;
• amino acid - therapeutic mixtures that do not contain protein as such.

Therapeutic milk mixtures

Dairy formulas for children with allergies are produced on the basis of casein or on the basis of whey protein. Nutrition on whey protein (lactose-free mixture) is the closest to human milk.

Indicated for allergies, which is accompanied by an eating disorder. You can feed children from birth to 6 months and from six months (highly allergic) to a year.

According to the degree of preliminary processing of milk protein, the mixtures are divided into:

• highly hydrolyzed - for children with moderate and severe allergies
• partially hydrolyzed - for children with moderate allergies

Healing mixtures for children with allergies and digestive problems with split protein are not only hypoallergenic, but also the most tasteless for children.

Whey has a frankly bitter taste, bad smell. This causes difficulties in accustoming children to therapeutic mixtures. Nutrilon pepti allergy and analogues (peptidi sst, Frisopen) are well digested, have an enriched composition, but it is difficult to accustom children to them.

List of the most popular therapeutic mixtures for children under one year old. Mixtures are highly hydrolyzed - names, country of origin and approximate price:

• Nutrilon pepti allergy and Nutrilon pepti gastro - production Holland, price from 950 rubles.
• Nutrilak peptidi sst - inexpensive (from 450 rubles), domestic production, whey proteins
• Frisopen AS - casein hydrolyzate, produced in the Netherlands, from 1050 rubles.
• Frisopen - whey from 870 rubles, manufactured by Friso, an international European corporation
• Alfare Alergi - production by Nestle Netherlands from 1220 rubles. The product has an acceptable taste

Inexpensive therapeutic mixture of Nutrilac peptidial sst has a composition similar to Alfar Allergy, whey Frisopen, but 3 times more affordable.

Which one is better for allergies is up to the doctor to decide, but products with hydrolyzed protein (in the absence serious illnesses in children) are interchangeable. Selection is done on an individual level. If medical nutrition is not suitable, then try an analogue.

Note! Partially hydrolysed formulas are preferred for children with allergies. They retain milk protein, which has a positive effect on the ability to digest cow's milk in the future.

How to introduce a hypoallergenic mixture so that the child does not refuse to eat it? This question first arises before parents when prescribing therapeutic nutrition for children.

Dry foods have a specific taste that the baby does not accept after breast milk or an adapted sweet mixture.

The rules look like this:

• Hydrolysis formulas for baby food are allowed to be temporarily diluted more than the instructions require. This technique allows you to smooth out the unpleasant taste of the new product.
• Feeding is introduced gradually, over 5-7 days. It is unacceptable to abruptly transfer children to therapeutic non-allergenic hydrolysates due to possible disorders digestion and weight loss.
• How to replace the mixture is decided by the doctor.
• When transferred to a mixture with processed milk protein, the stool changes to green or brown. This is fine.

Whether the therapeutic mixture was suitable for the child or not can be judged by his behavior, weight gain and external manifestations allergies. If the baby sleeps well, colic bothers no more than healthy children, actively eats and looks satisfied, then we can say that the therapeutic mixture has come up.

In case of negative symptoms (increased allergies, indigestion), you should contact your doctor.

It is allowed to feed children with therapeutic hydrolysates for no more than 2 months in a row. As soon as the health of the baby stabilizes, it is recommended to transfer it to feeding with therapeutic and prophylactic mixtures, fermented milk anti-allergenic products or prophylactic mixtures.

Therapeutic mixtures based on vegetable protein

Children with a dairy allergy are fed a soy-based diet. Most manufacturers of baby food produce hypoallergenic therapeutic mixtures of all directions.

Soy is no exception. An overview of hypoallergenic mixtures without animal protein, vegetable oils:

• Nutrilon Soya - Holland, 730 rubles.
• Nutrilak Soya - Russia, 433 rubles.
• Similak Izomil - Denmark, 600 rubles.
• Frisosoy - Friso company, 655 rubles.
• Humana SL - Germany, 700 rubles.

The use of soy mixtures in children with allergies is allowed to a limited extent. They are administered no earlier than 5-6 months of life. When feeding, they watch how the digestive system reacts, fix dermatological reactions

Unlike hydrolysate products, these mixtures have the best taste and children eat them more willingly after milk feeding.

When introducing food without protein of animal origin, the following rules are observed:

• age qualification;
• the absence in adult relatives of allergic reactions to soy products, beans, vegetable oils;
• exclusion from the diet of the baby of other dairy supplements completely;
• gradual introduction of a new product;
• control of the baby.

Soy products when feeding allergic babies up to a year are used for no more than 4 months in a row.

Amino acid blends

The last large group of therapeutic nutrition for allergic babies is amino acid mixtures. Here, the choice of baby food is somewhat limited by manufacturers.

Amino acid mixtures are indicated for children with severe allergies, which are accompanied by chronic diseases respiratory tract, digestive tract. These are mixtures for feeding babies with asthma, hay fever.

List best products for feeding babies with allergies to cow protein - a mixture with amino acids:

• Neocate Advance - made in Great Britain, from 2500 rubles.
• Nutrilon amino acids - price from 2500 rubles.
• Alfare Amino - price from 2400 rubles.

As can be seen from the examples, amino acid mixtures are the most expensive food for the breast. They do not contain any vegetable or dairy protein.

Amino acid therapeutic mixtures for infants with allergies can be called the most hypoallergenic product for feeding children under one year old.

They are allowed to be used as the only product for feeding in the long term.

The energy value of mixtures without protein is increased, they dissolve well. The lack of amino acid nutrition is a high price.

Sour-milk mixtures in the nutrition of infants and options for their replacement

Fermented milk formulas are a good way to feed children with allergies, if there are no digestive problems. Mixtures with curdled milk protein are poorly tolerated by children:

• prone to frequent and profuse regurgitation;
• with an unstable chair;
• with increased gas production.

Share fermented milk products in the diet of children with allergies should not exceed half of the daily diet. Good healing effect have fermented milk (cow protein) mixtures in combination with breast milk on mixed feeding.

What to replace fermented milk mixture in the absence of an anti-allergic effect? Less allergenic in this case will be not a therapeutic, but a prophylactic mixture with a partially hydrolyzed protein.

Such nutrition allows you to maintain the susceptibility of the digestive system of the baby to milk protein, "training" immune system baby. At the same time, the load on histamine receptors is reduced, smoothing the manifestation of allergic reactions.

Transfer of the child to feeding adapted mixture according to his age should be gradual and multistage. This is a prerequisite in order to avoid a recurrence of allergies.

Video