- Breast milk and infant formula: WHO indications
- What is formula milk and how is it made
- The risks of administering infant formula: the recommendations of the European Union
- Reactions to formula milk: the difference between milk allergy and lactose intolerance
- Allergy to milk proteins
- Lactose intolerance
- Symptoms of allergic reaction to milk
- IgE mediated allergic reaction to milk
- Allergic reaction to non-IgE mediated milk
- The child has a milk allergy or lactose intolerance: what alternatives to the formula?
- Can infant formula cause nutrient deficiencies?
The Istituto Superiore di Sanità, following the indications of the WHO, Unicef , and the European Union, suggests – if the conditions of the mother and child allow it – to breastfeed exclusively in the first six months of life and to continue until the age of two. years and beyond, according to wishes and needs. When, for reasons of different nature, breastfeeding is unwanted or not possible, artificial breastfeeding is used: while recalling the recommendations of the WHO and other bodies that take care of the health of mothers and children, it is important to emphasize that formula milk is suitable for the health and growth of infants.
However, the choice of infant formula is not free from doubts and questions about the possible possibility of triggering allergies and inflammation in the newborn, as well as doubts regarding the actual presence of all the necessary nutrients. Let’s go deeper into the topic below, looking closely at the properties and characteristics of the formulated milk, to then understand in which cases allergies or intolerances can occur.
BREAST MILK AND INFANT FORMULA: WHO INDICATIONS
To correctly understand the characteristics of infant formula, it is important to first investigate the properties of breast milk because, as stated by the Istituto Superiore di Sanità in agreement with the WHO, the latter is to be considered the best food for newborns. It contains all the elements necessary for healthy growth and development in the first months of life, and among these we find:
- nutrients, such as polyunsaturated fatty acids, proteins, assimilable iron, mineral salts, vitamins;
- bioactive and immunological substances, which help the child’s immune system to develop barriers against bacterial and viral infections, and promote the development of healthy intestinal flora, thus strengthening the entire organism.
The milk prepared in formula contains the nutrients but has no defense properties from a bioactive and immunological point of view.
But when, as mentioned, the mother does not want or cannot proceed with breastfeeding, what do you need to know about formula milk, and what are any risks associated with it? Let’s see it together.
WHAT IS FORMULA MILK AND HOW IS IT MADE
Formula milk, also called formula milk, is designed to be as similar to breast milk as possible.
Its elements derive from cow’s milk, or cow’s milk, which is made soluble by separating the solid elements from the liquid part and subsequently readapted to be suitable for human nutritional needs.
Depending on the composition, infant formula is distinguished in:
- adapted milk, rich in lactose, fats, minerals, and vitamins;
- partially adapted milk, in which lactose is more scarce or absent, and replaced by other sugars such as glucose and sucrose, and may have a different protein component;
- follow-on milk, which contains more iron, and is generally indicated between 6 and 12 months;
- growth milk, indicated after the baby year, is more similar to cow’s milk.
It is essential to keep in mind that the choice of the most suitable infant formula for each child must be made in agreement with the pediatrician, to identify which of the products on the market may be best suited to the specific needs of the newborn or infant.
Furthermore, it is good to keep in mind that the artificial milk on the market in our country must comply with the guidelines of the European Society for Pediatric Gastroenterology Hepatology and Nutrition – ESPGHAN, an international body that deals with studying, analyzing, and disseminating correct information regarding dietary needs. of children, also to prevent any problems in adulthood.
It is precisely ESPGHAN that establishes the concentration parameters of each nutritional element in infant formula and is responsible for applying very strict control standards, which contribute to the safety of food on the market.
However, as mentioned, bottle feeding is not without its risks: let’s delve into what they consist of, and what official sources say about it.
THE RISKS OF ADMINISTERING INFANT FORMULA: THE RECOMMENDATIONS OF THE EUROPEAN UNION
In the document “Feeding infants and children up to three years: standard recommendations for the European Union”, signed by the EU and the WHO Research Unit for Health Services and International Health, it is highlighted that resorting to Powdered milk is a choice that may carry some risks. Among these, the guidelines highlight: “increased risk for numerous infectious diseases, especially infections of the gastrointestinal and respiratory tract and other infections in general”.
Precisely for this reason, it is essential to agree with the pediatrician on the best formula of infant formula suitable for your child, and to carefully monitor the health and growth conditions of the child, to prevent problems from developing.
To be able to breastfeed with serenity, it is, therefore, necessary to have the complete picture in mind and to know how to recognize manifestations of allergies, inflammation and irritation that the newborn may develop, to understand if, indeed, they can be connected to the intake of formula milk.
REACTIONS TO FORMULA MILK: THE DIFFERENCE BETWEEN MILK ALLERGY AND LACTOSE INTOLERANCE
As we have seen, taking infant formula can favor the onset of allergic reactions: this can happen because the little one manifests a real allergic reaction to milk or an intolerance to the lactose contained in it .
In fact, it is a question of two different conditions: let’s see better what it is.
ALLERGY TO MILK PROTEINS
Allergy to casein AaS1 proteins , alpha-lactalbumin and betalactoglobulin contained in cow’s milk, from which milk powder is derived, is caused by an abnormal response of the immune system to the proteins themselves .
It generally appears when the baby takes the formulated milk and, as we will see shortly, has very specific symptoms which, in most cases, disappear within 3-4 years of age.
Lactose intolerance, on the other hand, is caused by the deficiency or inefficiency of the lactase enzyme that allows the digestion of lactose itself , i.e. the sugar contained in cow’s milk – and therefore in infant formula – as well as in breast milk.
In this regard, even breastfed babies may show this type of intolerance, which can reveal itself with different symptoms depending on the intensity, including swelling, irritability, diarrhea, constipation , meteorism.
It is currently believed that the main cause that can lead to the development of milk protein allergy or lactose intolerance is a hereditary predisposition, which also causes the development of conditions such as atopic dermatitis, which in turn is linked to the inefficiency of intestinal bacterial flora.
SYMPTOMS OF ALLERGIC REACTION TO MILK
Knowing how to recognize the symptoms of milk allergy is essential to identify these reactions in time and to act promptly, always in agreement with the pediatrician, to modify the food administration to the child, and therefore evaluate the best alternatives.
The allergic reaction can be of two types:
- IgE mediated reaction , i.e. the rapid and violent anaphylactic reaction, which occurs immediately and involves antibodies
- non-IgE mediated reaction , which appears a few hours or days after taking the milk-based food.
Let’s see what it is, and which symptoms to monitor.
IGE MEDIATED ALLERGIC REACTION TO MILK
In the event of an anaphylactic reaction, the following may appear immediately after taking milk or up to 2 hours later :
- vomiting and diarrhea
- widespread redness and swelling
- laryngospasm, breathing difficulties, bronchial asthma
- hives and skin rashes
- in severe cases, anaphylactic shock can occur .
ALLERGIC REACTION TO NON-IGE MEDIATED MILK
The most persistent allergic reaction, not mediated by IgE antibodies can result in the following days:
- diarrhea or constipation
- bloating and abdominal pain
- acid reflux
- itching and dermatitis
- accentuated nervousness and sleep disturbances .
As also reported by the Veronesi Foundation – citing a study that appeared in the Jama Pediatrics journal that investigates the details of milk allergy – it regresses in 50% of cases by one year of age, within 2 years in 70% of cases and within 3 years in 90% of cases.
It is important to know that children who develop this type of allergy can, over time, develop others as well, such as allergies to dust, mites , pollen and grasses.
THE CHILD HAS A MILK ALLERGY OR LACTOSE INTOLERANCE: WHAT ALTERNATIVES TO THE FORMULA?
If the child has manifested an allergy or intolerance to formulated milk, it is possible, in agreement with the pediatrician and a specialist in infant nutrition, to administer the so-called “ highly hydrolyzed protein-based milk”, following the advice of the pediatrician. In these preparations, proteins harmful to the body are broken down into many tiny pieces, which are not recognized by the immune system.
Alternatively, it is possible to resort to formulations based on amino acids , which however have a very different taste compared to hydrolyzed milks: it will be your doctor who will indicate the best choice for the child, and the reaction of the child must always be taken into account . in full respect of his tastes and needs .
After six months of life, and always in consultation with a health specialist, it is possible to opt for other types of milk of animal or vegetable origin, including:
- soya milk
- oat milk
- almond milk
- rice milk
- goat and sheep milk , which have proteins very similar to mother’s milk
- donkey milk , to always be found in pasteurized form.
The process of renouncing infant formula in case of allergies and intolerances must be done with constant attention and control, and in the same way the re-insertion of the food must be carried out, in the ways and at times suitable for the child’s health .
CAN INFANT FORMULA CAUSE NUTRIENT DEFICIENCIES?
As we have seen, if the baby’s body is intolerant or allergic to infant formula, it is not uncommon for adverse reactions to occur, which can compromise the intestinal balance and the general health of the baby. Any nutritional deficiencies or food discomfort can, therefore, derive from a general decompensation also due to the fatigue of taking this food.
In the absence of allergies or intolerances, it is difficult for formulated milk – if administered in the right quantities and with the right preparation – to generate nutritional deficiencies . As we have had the opportunity to underline, these are safe formulas, which provide the baby with everything he needs, in the full awareness that the most complete nutritional choice is still mother’s milk .
In case of doubts and questions, it is essential to contact your trusted pediatrician or bodies, which is responsible for promoting a healthy culture of breastfeeding and its possible alternatives, to make informed choices and make the best decisions for the health of our baby , without ever forgetting the needs, inclinations and peculiarities of the mother.
In addition, to accompany mothers and fathers in the process of raising their children, it may be useful to know that there are insurance policies dedicated to children and their parents, such as Medicare Youth Family Protection which also offers the “Pediatrician responds” service, with the which you can contact by phone a specialist to ask questions and ask for information for the well-being of our children.
Have you ever thought about such a solution?