Adapted goat milk formulas in infant nutrition: when, to whom and for how long
https://doi.org/10.21518/ms2023-036
Abstract
Breast milk is the gold standard for infant feeding. In case of its lack or insufficiency, this brings up the question about an affordable and adequate alternative. Adapted cow’s milk formulas are most commonly used, but the incidence of cow’s milk protein allergy in young children is increasing worldwide. Given the early onset of gastrointestinal disorders in infants, minimal digestive dysfunctions are often interpreted by doctors as sensitization to cow’s milk proteins or functional gastrointestinal disorders. However, there are conditions associated not with cow’s milk protein allergy, but intolerance. These conditions are difficult to diagnose, as the mechanism of development of cow’s milk protein allergy has not been sufficiently studied and is often not associated with an IgE-mediated immunological response. Food intolerance is associated with the enzymatic immaturity of the gastrointestinal tract and insufficient activity of intestinal microbiota. This article highlights the issues of cow’s milk protein allergy and food intolerance. In case of food sensitization and even minimal clinical manifestations of cow’s milk protein allergy, the choice of formula should always be made in favour of deep-hydrolyzed milk protein formulas. Goat protein formulas cannot be used in cases of cow’s milk protein allergy due to cross-sensitization effects. The aim of the article was to analyze a differentiated approach to the choice of infant nutrition in the absence of breastfeeding.
About the Authors
I. N. ZakharovaRussian Federation
Irina N. Zakharova - Dr. Sci. (Med.), Professor, Honoured Doctor of the Russian Federation, Head of the Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
I. V. Berezhnaya
Russian Federation
Irina V. Berezhnaya - Cand. Sci. (Med.), Associate Professor of the Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
D. K. Dmitrieva
Russian Federation
Diana K. Dmitrieva - Postgraduate Student of the Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
Ya. V. Orobinskaya
Russian Federation
Yana V. Orobinskaya - Clinical Resident of the Department of Pediatrics named after Academician G.N. Speransky, Russian Medical Academy of Continuous Professional Education.
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993
References
1. Danielewicz H. Breastfeeding and Allergy Effect Modified by Genetic, Environmental, Dietary, and Immunological Factors. Nutrients. 2022;14(15):3011. https://doi.org/10.3390/nu14153011.
2. Sakihara T., Otsuji K., Arakaki Y., Hamada K., Sugiura S., Ito K. Randomized trial of early infant formula introduction to prevent cow’s milk allergy. J Allergy Clin Immunol. 2021;147(1):224–232.e8. https://doi.org/10.1016/j.jaci.2020.08.021.
3. Halken S., Muraro A., de Silva D., Khaleva E., Angier E., Arasi S. et al. EAACI guideline: Preventing the development of food allergy in infants and young children (2020 update). Pediatr Allergy Immunol. 2021;32(5):843–858. https://doi.org/10.1111/pai.13496.
4. Nanishi K., Hongo H., Tada K. Does giving infant formula to prevent cow’s milk allergy hinder breast-feeding? J Allergy Clin Immunol. 2021;147(3):1118. https://doi.org/10.1016/j.jaci.2020.11.021.
5. Arasi S., Cafarotti A., Fiocchi A. Cow’s milk allergy. Curr Opin Allergy Clin Immunol. 2022;22(3):181–187. https://doi.org/10.1097/ACI.0000000000000823.
6. Fiocchi A., Brozek J., Schünemann H., Bahna S.L., von Berg A., Beyer K. et al. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines. Pediatr Allergy Immunol. 2010;21(Suppl. 21):1–125. https://doi.org/10.1111/j.1399-3038.2010.01068.x.
7. Fiocchi A., Barrio-Torres J., Dupont C., Howells H.E., Shamir R., Venter C., Meyer R. Hydrolyzed rice formula for dietary management of infants with cow’s milk allergy. World Allergy Organ J. 2022;15(12):100717. https://doi.org/10.1016/j.waojou.2022.100717.
8. D’Auria E., Salvatore S., Acunzo M., Peroni D., Pendezza E., Di Profio E. et al. Hydrolysed Formulas in the Management of Cow’s Milk Allergy: New Insights, Pitfalls and Tips. Nutrients. 2021;13(8):2762. https://doi.org/10.3390/nu13082762.
9. Blackham R.J. Goat’s milk for infants. Br Med J. 1906;2(2382):452–453. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2382067/.
10. Elvehjem C.A. What is new in the nutritive value of milk. J Dairy Sci. 1953;36:1264–1266. https://doi.org/10.3168/jds.S0022-0302(53)91629-4.
11. Inglingstad R.A., Devold T.G., Eriksen E.K., Holm H., Jacobsen M., Liland K. et al. Comparison of the digestion of caseins and whey proteins in equine, bovine, caprine and human milks by human gastrointestinal enzymes. Dairy Sci Technol. 2010;90:549–563. https://doi.org/10.1051/dst/2010018.
12. Dalgleish D.G., Spagnuolo P.A., Goff H.D. A possible structure of the casein micelle based on high-resolution field-emission scanning electron microscopy. Int Dairy J. 2004;14(12):1025–1031. https://doi.org/10.1016/j.idairyj.2004.04.008.
13. Gurova M.M. Goat Milk Formula. To whom, why, how. Meditsinskiy Sovet. 2022;(1):128–133. (In Russ.) https://doi.org/10.21518/2079-701X-2022-16-1-128-133.
14. Jianqin S., Leiming X., Lu X., Yelland G.W., Ni J., Clarke A.J. Effects of milk containing only A2 beta casein versus milk containing both A1 and A2 beta casein proteins on gastrointestinal physiology, symptoms of discomfort, and cognitive behavior of people with self-reported intolerance to traditional cows’ milk. Nutr J. 2016;15:35. https://doi.org/10.1186/s12937-016-0147-z.
15. Borovik Т.E., Semenova N.N., Lukoyanova O.L., Zvonkova N.G., Bushueva T.V., Stepanova T.N. et al. Efficiency of using the adapted goat’s milk formula in the diet of healthy young infants: a multicenter prospective comparative study. Current Pediatrics. 2017;16(3):226–233. https://doi.org/10.15690/vsp.v16i3.1733.
16. Wang L., Bravo-Ruiseco G., Happe R., He T., van Dijl J.M., Harmsen H.J.M. The effect of calcium palmitate on bacteria associated with infant gut microbiota. Microbiologyopen. 2021;10(3):e1187. https://doi.org/10.1002/mbo3.1187.
17. Donovan S.M., Comstock S.S. Human Milk Oligosaccharides Influence Neonatal Mucosal and Systemic Immunity. Ann Nutr Metab. 2016;69(Suppl. 2):42–51. https://doi.org/10.1159/000452818.
18. Verduci E., D’Elios S., Cerrato L., Comberiati P., Calvani M., Palazzo S. et al. Cow’s Milk Substitutes for Children: Nutritional Aspects of Milk from Different Mammalian Species, Special Formula and Plant-Based Beverages. Nutrients. 2019;11(8):1739. https://doi.org/10.3390/nu11081739.
Review
For citations:
Zakharova IN, Berezhnaya IV, Dmitrieva DK, Orobinskaya YV. Adapted goat milk formulas in infant nutrition: when, to whom and for how long. Meditsinskiy sovet = Medical Council. 2023;(1):90-95. (In Russ.) https://doi.org/10.21518/ms2023-036