Protecting Your Infant and Toddler From Food Sensitivities!

by Ronald Lanfranchi, D.C., Patricia Deuster, Ph.D. & Russell Jaffe, M.D., Ph.D

From colic to ear aches; from fussiness to hyperactivity; from chronic myalgia to paraspinal pain, children (and parents) often suffer from food and chemical sensitivities without knowing that the cause of their suffering is based on acquired sensitivities to foods and chemicals, only recently testable through advanced cellular immune response assays and treatable through programs designed to evoke the human healing response.  This article focuses on recent advances in documenting the digestive mechanisms that dispose to acquired food or chemical sensitivities, criteria for accurate cellular testing of delayed sensitivity reactions and therapeutic uses of this information in clinical practice.

The concept that the food we eat can provoke immunotoxic reactions deserves attention.  Digestion is often assumed to be healthy: completely breaking foods into their elemental amino acids and peptides, glycerides and fatty acids, sugars, vitamins, minerals and cofactors.   In healthy people, this is how digestion works.  In people with chronic health problems, from myofacial and joint pain to irritability; from fatigue to chronic illness, disorder to digestion is the rule, occurring 82-100% of such cases (the more carefully digestive competence is studied, the more defects are documented).  From dysbiosis to maldigestion, from abnormal mucous production to repair defects in the intestinal wall; from absorption uptake block to enteropathy disorders of digestion make immunoreactive digestive remnants available for attack on the internal immune defense and repair systems of the body.  While maldigestion underlies these problems, the signs and symptoms of ill health are often systemic.  Further, the translocation of intestinal antigens are known to be disruptive of host immune competence.  Without overt intestinal symptomatology, many clinicians do not include immunologic provocation by digestive remnants in their differential diagnosis.

Cows milk, chicken egg, wheat, corn, soy and peanut sensitivity are common immunoreactors.  This is partly due to their being complex, difficult-to-digest foods and partly to their common inclusion in processed, restructured foods.  Previously, diagnosis has been difficult because accurate, patient-predictive specific information about reactive substances has been lacking.

Polls of nursing mothers show, for example, that over 75% drink approximately a quart of cow' milk a day, and eat eggs, wheat, soy, peanuts and corn on a regular basis.  Moreover, women who do not breast feed their infants are likely to be giving them formulas that contain cow's milk or cow's milk proteins (whey, casein, lactoglobulin), and/or soy milk and corn syrup.   In addition, when solid foods are started, most parents introduce cow's milk products (such as milk, ice-cream or cheese), wheat, corn, and eggs during the first year of life.  Is this healthy?  Probably not.  These are complex, difficult-to-digest foods, especially for the still developing infant digestive tract which does not mature for 1-2 years.  The immature intestine is highly permeable, designed for oligoantigenic breast milk.  Given the digestive remnants commonly left in the child's intestine, the common association of food allergies/hypersensitivities to these foods are predictable.

The term food sensitivity/hypersensitivity (FS) can be defined as "a clinical manifestation of an immulogical response in which foods, their proteins, or their metabolic derivatives act as antigens and stimulate the production of antibodies (or cellular responses) against them". For example, in the case of cow's milk allergy (CMA), the proteins may be B-lactoglobulin, casein, or bovine immunoglobulin, casein or bovine immunoglobulin G (IgG), among others.  There are two different types of immulogic response, depending on the clinical appearance: immediate or delayed.  Some infants and/or children develop clinical manifestations in less than one hour, and indication of a Type 1, or immediate hypersensitivity reaction; this type of response is typically indicated by elevated total serum immunoglobulin E (IgE) and antigen-specific IgE Radio-allergosorbent (RAST) values.   The short time between exposure and symptom provocation makes careful history useful in identifying offenders.  However, more commonly infants/children exhibit a late or delay-in-onset response with clinical symptoms appearing later, from hours to days after exposure.  In the past, most food allergies were believed to be IgE-mediated, but most infants were proven CMA/FA do not  fall into the Type 1, immediate (IgE) category, but rather exhibit delay-in-onset responses of Type 11, 111 or 1V reactions.   Unfortunately, these differences in timing and the fact that many of the symptoms are not always associated with an allergic ediology make diagnosis frustrating for the parent and difficult for the doctor.  Thus, CMA and FS often escape recognition, especially when the symptomatic response is long delayed.

The symptoms and sign of CMA/FS are many, and children may suffer a variety of health consequences.   The most common clinical manifestations are:

1. cutaneous or skin-related, with eczema and urticaria;

2. gastrointestinal colic, vomiting (including projectile vomiting), diarrhea, and/or constipation;

3. respiratory wheezing/asthma, recurrent bronchitis, sinusitis, nasal congestion or rhinitis;

4. unexplained fatigue; and

5. myalgic, fibrositis or arthralgic pain.

However, recurrent middle ear disturbances, failure to thrive, anorexia, behavioral disorders, and/or musculoskeletal aches are also common.  The frequency of CMA/FS in infants with no special family antecedents if reported range between 2.2 and 7%, and approached 25% when childhood eczema is present.  Unfortunately, the diagnosis of CMA/FS is frequently not made until many months of unsuccessful therapies have been attempted to reduce symptoms.  The possibility that CMA/FS may actually be the problem is too often considered only when other explanations for recurrent symptoms cannot be found.  Many mothers report frustration about making numerous trips to their pediatrician without success.  Only after proper laboratory diagnosis and substitution for the offending food(s) does the reactive child begin to thrive and behave in a normal, healthy fashion.   One mom who experienced the maze of food allergies with her children said

"We bring these wonderful children into the world and in our hearts we want to do the best of everything for them. If we know that dairy, corn, and wheat are the most common allergens, why feed them to our kids?  Why not avoid those foods for at least the first year?   This may help to create a better balance in their overall growth and immune defenses in the future."

We think this is a sound and sensible approach.

Of all the substances, cow's milk seems to provoke the major health problems during the first year of life.  Interestingly, the first indication that cow's milk may not be suitable for infants was noted long ago.  Around the 1800s, if a mother was unable to nurse and a "wet-nurse" could not be employed, many infants were fed directly from the udder of cows, goats, or asses.  Although infant mortality was extremely high in non-breast fed babies, the rates were lowest in infants fed ass-milk and highest among those fed cow's milk.  More such evidence related to the health consequences of cow's milk emerged over the next decades.

As noted above, one clinical manifestation of CMA is middle ear disturbances or infections, and in the 1970's a physician stated that far too many children have tubes put in their ears before allergy is even considered.  Today, as in the past, recurrent ear problems are often diagnosed as infections and treated unsuccessfully by prescribing antibiotics and then surgery, when in fact CMA was the problem.  Most mothers would be willing to remove milk from their diet before submitting their infant to unnecessary surgery, if there were even a remote chance for success.  In addition to its effects on ears, milk is regarded as the food most frequently associated with asthma, either as a causative or exacerbating agent.  Some physicians believe that every patient in whom asthma is poorly controlled should be taken off milk products for at least a trial period of three weeks.  Finally recent evidence suggests an association between cow's milk feeding in infancy and the subsequent development of juvenile onset diabetes.  Clearly there is no harm in avoiding milk products during the first year, and there is a good chance that doing so will decrease the likelihood of having your infant, toddler, or child suffer needlessly, undergo useless therapies or invasive procedures, and/or develop other related diseases later on.  It seems wise to attempt dietary approaches first.

Part 2 of this article will be entitled How Do You Determine If Your Child has CMA/FS?