1 / 13

Pathophysiology

Pathophysiology. Infant is responding to allergens in mom’s diet Cows milk protein and soy are most common Sensitization could start in utero Occasionally symptoms are seen day 1 Restricting mom’s diet during pregnancy currently not recommended

lilac
Download Presentation

Pathophysiology

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Pathophysiology • Infant is responding to allergens in mom’s diet • Cows milk protein and soy are most common • Sensitization could start in utero • Occasionally symptoms are seen day 1 • Restricting mom’s diet during pregnancy currently not recommended • Large bowel edema, erosions of mucosa, eosinophilic infiltration of the intestinal lining

  2. BMC gastroenterology 2011 11:82

  3. Maternal Elimination DietABM protocol • Start with elimination of cows milk products • Most cases will improve in 72-96 hours • No more blood, mucous is gone, stools appear normal • If no change at all after 2 weeks, also eliminate soy. If no change, add dairy and soy back into the diet, and eliminate something else. Continue in this way with other allergens. • Citrus fruits, eggs, nuts, peanut, wheat, corn, strawberries, chocolate • Families need education on how to read food labels to avoid substances of each allergen. • Geographic variability in the most common allergens

  4. Severe Cases • Consider starting with a strict maternal elimination diet • Lamb, pears, squash, rice • Once symptoms resolve, add a new allergen once a week • Addition of pancreatic enzymes • No randomized controlled trials • Theoretically breaks down allergens in mom’s gut before absorption • Two Creon 6000 with each meal, one with each snack

  5. Breastfed Babies Receiving Formula Supplementation • Change to a soy based formula first. • If sx are severe and persistent, change to a hydrolyzed formula, or possibly an amino acid-based formula

  6. Re-introducing Allergens • Consider allergy testing if other allergic symptoms such as eczema, allergies, hives, chronic diarrhea • If baby otherwise well, OK to reintroduce offending allergens 6-9 mo after initial reaction, or wait until 12 moold

  7. Other Website Resources • Web Links • ILCA, Academy of Nutrition and Dietetics • Resources for recipes • Food allergy information

  8. Future Research • Further defining the relationship between these gastropathies • Incidence in the population • Who is more at risk? • Other means of identifying offending antigens • Further research on maternal treatment such as pancreatic enzymes

  9. Check Out www.infantproctocolitis.org

More Related