The controversial role of food allergy in infantile colic: evidence and clinical management.
Abstract: Food allergies (FAs) are an increasing problem in Western countries, affecting up to 10% of young children. FAs are frequently associated with gastrointestinal manifestations. The role of FAs as a potential causative factor for infantile colic (IC) is still controversial. We report the most recent evidence on the pathogenesis, clinical and diagnostic aspects of FA-induced infantile colic (IC) and suggest a stepwise diagnostic approach. We selected articles on clinical and immunologic features, pathogenesis and management of FAs and IC from of 1981 to 2015. Original and review articles were identified through selective searches performed on PubMed, using the following terms: colic, infantile colic, food allergy and infantile colic, infantile colic treatment. The possible relationship between FAs and IC derives from the presence of dysmotility with visceral hypersensitivity and dysbiosis, demonstrated in both conditions, and the clinical response to dietary interventions. Unfortunately, the design of the studies, poor characterization of atopy and different dietary approaches limit the understanding of the importance of FAs in subjects with IC. The role of FAs in IC subjects without other symptoms of atopy remains controversial. However, where there is a suspicion of FAs, a short trial with an extensively hydrolyzed cow's proteins formula or, if breast fed, with maternal elimination diet may be considered a reasonable option.
Publication Date: 2015-03-19 PubMed ID: 25808260PubMed Central: PMC4377897DOI: 10.3390/nu7032015Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Review
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
This research article reviews recent advancements in understanding allergies to mammalian milk proteins that are not related to Cow’s Milk Allergy (CMA). It delves into the study of selective allergies from milk derived from mammals other than cows, such as goats, sheep, buffalos, camels, and donkeys.
Understanding Selective Allergies to Mammalian Milk Proteins
- The study examines allergies from types of milk that come from mammals like sheep, buffalo, and goats. These types of milk fall under mammalian milk and their consumption can cause allergic reactions in some people because the milk proteins in these animals are fairly similar to cow’s milk proteins. This is known as clinical cross-reactivity.
- In contrast, milk from camels, mares, or donkeys has been found to be occasionally tolerated by individuals who are otherwise allergic to milk proteins. This suggests that the composition of proteins found in the milk of these animals may differ from that in the milk of the other mentioned animals.
Signs and Symptoms of Selective Mammalian Milk Allergies
- Persons affected by selective mammalian milk allergies may experience severe symptoms, which include respiratory issues, urticaria (hives), anaphylaxis (a severe, potentially life-threatening allergic reaction), and angio-oedema (swelling beneath the skin, often in the lips and eyes).
- These allergies are considered rare and are characterized by their severe manifestation of symptoms.
Common Sources and Major Allergens
- Cheese products, including Ricotta, Romano, Pecorino, and Mozzarella, have been associated as a common source of allergens in people with allergies to goat’s, sheep’s and buffalo’s milk. This suggests a need for individuals with these specific allergies to be cautious when consuming these types of cheese.
- Milk from mares, camels, or donkeys has different major allergens including whey proteins like lysozyme, α-lactalbumin, and β-lactoglobulin. This is due to the lower casein/whey protein ratio found in these types of milk.
The research aims to broaden knowledge about these selective allergies and reduce risks among individuals with these allergies by making people more aware of the potential allergens present in different types of mammalian milk.
Cite This Article
APA
Nocerino R, Pezzella V, Cosenza L, Amoroso A, Di Scala C, Amato F, Iacono G, Canani RB.
(2015).
The controversial role of food allergy in infantile colic: evidence and clinical management.
Nutrients, 7(3), 2015-2025.
https://doi.org/10.3390/nu7032015 Publication
Researcher Affiliations
- Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Diseases, CEINGE-Advanced Biotechnologies University of Naples "Federico II", 80131 Naples, Italy. ritanocerino@alice.it.
- Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Diseases, CEINGE-Advanced Biotechnologies University of Naples "Federico II", 80131 Naples, Italy. cinzia.pezzella@gmail.com.
- Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Diseases, CEINGE-Advanced Biotechnologies University of Naples "Federico II", 80131 Naples, Italy. lindacosenza@libero.it.
- Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Diseases, CEINGE-Advanced Biotechnologies University of Naples "Federico II", 80131 Naples, Italy. antonioamoroso87@gmail.com.
- Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Diseases, CEINGE-Advanced Biotechnologies University of Naples "Federico II", 80131 Naples, Italy. carmendiscala@gmail.com.
- Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Diseases, CEINGE-Advanced Biotechnologies University of Naples "Federico II", 80131 Naples, Italy. rnocerino13@gmail.com.
- UOC of Gastroenterology "Arnas Civico", 90127 Palermo post code, Italy. cinzia3006@gmail.com.
- Department of Translational Medical Science and European Laboratory for the Investigation of Food Induced Diseases, CEINGE-Advanced Biotechnologies University of Naples "Federico II", 80131 Naples, Italy. berni@unina.it.
MeSH Terms
- Animals
- Breast Feeding
- Colic / diet therapy
- Colic / etiology
- Colic / immunology
- Humans
- Infant Formula
- Milk / adverse effects
- Milk / immunology
- Milk Hypersensitivity / complications
- Milk Hypersensitivity / diet therapy
- Milk, Human / immunology
References
This article includes 63 references
- Nwaru B.I., Hickstein L., Panesar S.S., Muraro A., Werfel T., Cardona V., Dubois A.E.J., Halken S., Hoffmann-Sommergruber K., Poulsen L.K.. The epidemiology of food allergy in Europe: A systematic review and meta-analysis.. Allergy 2014;69:62–75.
- Prescott S.L., Pawankar R., Allen K.J., Campbell D.E., Sinn J.K.H., Fiocchi A., Ebisawa M., Sampson H.A., Beyer K., Lee B.W.. A global survey of changing patterns of food allergy burden in children.. World Allergy Organ. J. 2013;6:21.
- Høst A.. Frequency of cow’s milk allergy in childhood.. Ann. Allergy Asthma Immunol. 2002;89:33–37.
- Muraro A., Werfel T., Hoffmann-Sommergruber K., Roberts G., Beyer K., Bindslev-Jensen C., Cardona V., Dubois A., duToit G., Eigenmann P.. EAACI food allergy and anaphylaxis guidelines: Diagnosis and management of food allergy.. Allergy 2014;69:1008–1025.
- Lack G.J.. Update on risk factors for food allergy.. Allergy Clin. Immunol. 2012;129:1187–1197.
- Leonardi S., Pecoraro R., Filippelli M., del Giudice M.M., Marseglia G., Salpietro C., Arrigo T., Stringari G., Ricò S., La Rosa M.. Allergic reactions to foods by inhalation in children.. All Asthma Proc. 2014;35:288–294.
- Hyman P.E., Milla P.J., Benninga M.A., Davidson G.P., Fleisher D.F., Taminiau J.. Childhood functional gastrointestinal disorders: Neonate/toddler.. Gastroenterology 2006;130:1519–1526.
- De Weerth C., Fuentes S., de Vos W.M.. Crying in infants: On the possible role of intestinal microbiota in the development of colic.. Gut Microbes 2013;4:416–421.
- Roberts D.M., Ostapchuk M., O’BRIEN J.G.. Infantile colic.. Am. Fam. Phys. 2004;70:735–740.
- Vandenplas Y., Gutierrez-Castrellon P., Velasco-Benitez C., Palacios J., Jaen D., Ribeiro H., Shek L.P., Lee B.W., Alarcon P.. Practical algorithms for managing common gastrointestinal symptoms in infants.. Nutrition 2013;29:184–194.
- Akhavein M.A., Patel N.R., Muniyappa P.K., Glover S.C.. Allergic mastocytic gastroenteritis and colitis: An unexplained etiology in chronic abdominal pain and gastrointestinal dysmotility.. Gastroenterol. Res. Pract. 2012;2012:950582.
- Valeur J., Lappalainen J., Rita H., Lin A.H., Kovanen P.T., Berstad A., Eklund K.K., Vaali K.. Food allergy alters jejunal circular muscle contractility and induces local inflammatory cytokine expression in a mouse model.. BMC Gastroenterol. 2009;9:33.
- Murch S.. Allergy and intestinal dysmotility—Evidence of genuine causal linkage?. Curr. Opin. Gastroenterol. 2006;22:664–668.
- Thompson-Chagoyan O.C., Fallani M.F., Maldonado J., Vieites J.M., Khanna S., Edwards C., Doré J., Gil A.. Faecal microbiota and short-chain fatty acid levels in faeces from infants with cow’s milk protein allergy.. Int. Arch. Allergy Immunol. 2011;156:325–332.
- Lozinsky A.C., Morais M.B.. Eosinophilic colitis in infants.. J. Pediatr. 2014;90:16–21.
- Hill D.J., Roy N., Heine R.G., Hosking C.S., Francis D.E., Brown J., Speirs B., Sadowsky J., Carlin J.B.. Effect of a low-allergen maternal diet on colic among breastfed infants: A randomized, controlled trial.. Pediatrics 2005;116:e709.
- De Weerth C., Fuentes S., Puylaert P., de Vos W.M.. Intestinal microbiota of infants with colic: Development and specific signatures.. Pediatrics 2013;131:e550–e558.
- Hill D.J., Hudson I.L., Sheffield J., Shelton M.J., Menahem S., Hosking C.S.. A low allergen diet is a significant intervention in infantile colic: Results of a community-based study.. J. Allergy Clin. Immunol. 1995;96:886–892.
- Jakobsson I., Lothe L., Ley D., Borschel M.W.. Effectiveness of casein hydrolysate feedings in infants with colic.. Acta Paediatr. 2000;89:18–21.
- Ravelli A.M., Tobanelli P., Steffen R.M., Banez G.A.. Vomiting and gastric motility in infants with cow’s milk allergy.. J. Pediatr. Gastroenterol. Nutr. 2001;32:59–64.
- Nowak-Wegrzyn A., Muraro A.. Food protein-induced enterocolitis syndrome.. Curr. Opin. Allergy Clin. Immunol. 2009;9:371–377.
- Yu M.C., Tsai C.L., Yang Y.J., Yang S.S., Wang L.H., Lee C.T., Jan R.L., Wang J.Y.. Allergic colitis in infants related to cow’s milk: Clinical characteristics, pathologic changes, and immunologic findings.. Pediatr. Neonatol. 2013;54:49–55.
- Morita H., Nomura I., Orihara K., Yoshida K., Akasawa A., Tachimoto H., Ohtsuka Y., Namai Y., Futamura M., Shoda T.. Antigen-specific T-cell responses in patients with non-IgE mediated gastrointestinal food allergy are predominantly skewed to T(H)2.. J. Allergy Clin. Immunol. 2013;131:590–592.
- Saps M., Lu P., Silvana B.. Cow’s-milk allergy is a risk factor for the development of FGIDs in children.. J. Pediatr. Gastroenterol. Nutr. 2011;52:166–169.
- Saavedra Y., Vergara P.. Hypersensitivity to ovalbumin induces chronic intestinal dysmotility and increases the number of intestinal mast cells.. Neurogastroenterol. Motil. 2005;17:112–122.
- Wood J.D.. Histamine, mast cells, and the enteric nervous system in the irritable bowel syndrome, enteritis, and food allergies.. Gut 2006;55:445–447.
- O’Mahony S.M., Hyland N.P., Dinan T.G., Cryan J.F.. Maternal separation as a model of brain-gut axis dysfunction.. Psychopharmacology 2011;214:71–88.
- Mayer E.A.. Gut feelings: The emerging biology of gut-brain communication.. Nat. Rev. Neurosci. 2011;12:453–466.
- Rhee S.H., Pothoulakis C., Mayer E.A.. Principles and clinical implications of the brain-gut-enteric microbiota axis.. Nat. Rev. Gastroenterol. Hepatol. 2009;6:306–314.
- El-Salhy M.. Irritable bowel syndrome: Diagnosis and pathogenesis.. World J. Gastroenterol. 2012;18:5151–5163.
- El-Salhy M., Seim I.. Irritable bowel syndrome: The role of gut neuroendocrine peptides.. Front. Biosci. 2012;4:2783–2800.
- Verdú E.F., Bercik P., Chopin L., Gundersen D., Hatlebakk J.G., Hausken T.. Specific probiotic therapy attenuates antibiotic induced visceral hypersensitivity in mice.. Gut 2006;55:182–190.
- Bercik P., Verdú E.F., Foster J.A., Lu J., Scharringa A., Kean I., Wang L., Blennerhassett P., Collins S.M.. Role of gut-brain axis in persistent abnormal feeding behavior in mice following eradication of Helicobacter pylori infection.. Am. J. Physiol. Regul. Integr. Comp. Physiol. 2009;296:R587–R594.
- Ibeakanma C., Miranda-Morales M., Richards M., Bautista-Cruz F., Martin N., Hurlbut D., Vanner S.. Citrobacter rodentium colitis evokes post-infectious hyperexcitability of mouse nociceptive colonic dorsal root ganglion neurons.. J. Physiol. 2009;587:3505–3521.
- O’Mahony S.M., Clarke G., McKernan D.P., Bravo J.A., Dinan T.G., Cryan J.F.. Differential visceral nociceptive, behavioural and neurochemical responses to an immune challenge in the stress-sensitive Wistar Kyoto rat strain.. Behav. Brain Res. 2013;253:310–317.
- Ling Z., Li Z., Liu X., Cheng Y.W., Luo Y.Q., Tong X.J., Yuan L., Wange Y.Z., Sunc J., Li L.J.. Altered fecal microbiota composition associated with food allergy in infants.. Appl. Environ. Microbiol. 2014;80:2546–2554.
- Molloy J., Allen K., Molloy J., Allen K., Collier F., Tang M.L.K., Ward A.C., Vuillermin P.. The potential link between gut microbiota and IgE-mediated food allergy in early life.. Int. J. Environ. Res. Public Health. 2013;10:7235–7256.
- Berni Canani R., di Costanzo M.. Gut microbiota as potential therapeutic target for the treatment of cow’s milk allergy.. Nutrients 2013;5:651–662.
- Infante D., Segarra O., Luyer B.L.. Dietary treatment of colic caused by excess gas in infants: Biochemical evidence.. World J. Gastroenterol. 2011;17:2104–2108.
- Savino F., Ceratto S., De Marco A., di Montezemolo L.C.. Looking for new treatments of infantile colic.. Ital. J. Pediatr. 2014;5:40–53.
- Rhoads J.M., Fatheree N.Y., Norori J., Liu Y., Lucke J.F., Tyson J.E., Ferris M.J.. Altered fecal microflora and increased fecal calprotectin in infants with colic.. J. Pediatr. 2009;155:823–828.
- Evans R.W., Fergusson D.M., Allardyce R.A., Taylor B.. Maternal diet and infantile colic in breast-fed infants.. Lancet 1981;1:1340–1342.
- Lucassen P.L., Assendelft W.J., Gubbels J.W., van Eijk J.T., Douwes A.C.. Infantile colic: Crying time reduction with a whey hydrolysate: A double-blind, randomized, placebo-controlled trial.. Pediatrics 2000;106:1349–1354.
- Arikan D., Alp H., Gözüm S., Orbak Z., Cifçi E.K.. Effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic.. J. Clin. Nurs. 2008;17:1754–1761.
- Forsyth B.W.. Colic and the effect of changing formulas: A double-blind, multiple-crossover study.. J. Pediatr. 1989;115:521–526.
- Iacono G., Carroccio A., Montalto G., Cavataio F., Bragion E., Lorello D., Balsamo V., Notarbartolo A.. Severe infantile colic and food intolerance: A long-term prospective study.. J. Pediatr. Gastroenterol. Nutr. 1991;12:332–335.
- Lothe L., Lindberg T., Jakobsson I.. Cow’s milk formula as a cause of infantile colic: A double-blind study.. Pediatrics 1982;70:7–10.
- Berseth C.L., Johnston W.H., Stolz S.I., Harris C.L., Mitmesser S.H.. Clinical response to 2 commonly used switch formulas occurs within 1 day.. Clin Pediatr. 2009;48:58–65.
- Berni Canani R., Nocerino R.. Diagnosing and treating food allergy.. Curr. Pediatr. Rep. 2013;1:189–197.
- Nocerino R., Granata V., Di Costanzo M., Pezzella V., Leone L., Passariello A., Terrin G., Troncone R., Berni C.R.. Atopy patch tests are useful to predict oral tolerance in children with gastrointestinal symptoms related to non-IgE-mediated cow’s milk allergy.. Allergy 2013;68:246–248.
- Berni Canani R., Buongiovanni A., Nocerino R., Cosenza L., Troncone R.. Toward a standardized reading of the atopy patch test in children with suspected cow’s milk allergy-related gastrointestinal symptoms.. Allergy 2011;66:1499–1500.
- Savino F., Tarasco V.. New treatments for infant colic.. Curr. Opin. Pediatr. 2010;22:791–797.
- Berni Canani R., Leone L., D’Auria E., Riva E., Nocerino R., Ruotolo S., Terrin G., Cosenza L., Di Costanzo M., Passariello A.. The effects of dietary counseling on children with food allergy: A prospective, multicenter intervention study.. J. Acad. Nutr. Diet. 2014;114:1432–1439.
- Giovannini M., D’Auria E., Caffarelli C., Verduci E., Barberi S., Indinnimeo L., Iacono I.D., Martelli A., Riva E., Bernardini R.. Nutritional management and follow up of infants and children with food allergy: Italian Society of Pediatric Nutrition/Italian Society of Pediatric Allergy and Immunology Task Force Position Statement.. Ital. J. Pediatr. 2014;40:1.
- Chau K., Lau E.J., Greenberg S., Jacobson S., Yazdani-Brojeni P., Verma N., Koren G.. Probiotics for Infantile Colic: A Randomized, Double-Blind, Placebo-Controlled Trial Investigating Lactobacillus reuteri DSM 17938.. J. Pediatr. 2015;166:74–78.
- Savino F., Cordisco L., Tarasco V., Palumeri E., Calabrese R., Oggero R., Roos S., Matteuzzi D.. Lactobacillus reuteri DSM 17938 in infantile colic: A randomized, double-blind, placebo-controlled trial.. Pediatrics 2010;126:e526–e533.
- Sung V., Hiscock H., Tang M.L.K., Mensah F.K., Nation M.L., Satzke C., Heine R.G., Stock A., Barr R.G., Wake M.. Treating infant colic with the probiotic Lactobacillus reuteri: Doubleblind, placebo-controlled randomised trial.. BMJ 2014;348:g2107.
- Szajewska H., Gyrczuk E., Horvath A.. Lactobacillus reuteri DSM 17938 for the management of infantile colic in breastfed infants: A randomized, double-blind, placebo-controlled trial.. J. Pediatr. 2013;162:257–262.
- Shergill-Bonner R.. Infantile colic: Practicalities of management, including dietary aspects.. J. Fam. Health care. 2010;20:206–209.
- Agostoni C., Axelsson I., Goulet O., Koletzko B., Michaelsen K.F., Puntis J., Rieu D., Rigo J., Shamir R., Szajewska H.. Soy protein infant formulae and follow-on formulae: A commentary by the ESPGHAN Committee on Nutrition.. J. Pediatr. Gastroenterol. Nutr. 2006;42:352–361.
- Bhatia J., Greer F., The Committee on Nutrition. Use of soy protein-based formulas in infant feeding.. Pediatrics 2008;121:1062–1068.
- Vandenplas Y., Gotrand F., Veereman-Wauters G., De Greef E., Devreker T., Hauser B., Benninga M., Heymans H.S.. Gastrointestinal manifestations of cow’s milk protein allergy and gastrointestinal motility.. Acta Paediatr. 2012;101:1105–1109.
- Lifschitz C., Szajewska H.. Cow’s milk allergy: Evidence-based diagnosis and management for the practitioner.. Eur. J. Pediatr. 2015;174:141–150.
Citations
This article has been cited 17 times.Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists