Milk formulae in the prevention of food allergy.

Because food allergy is frequent and severe, all possible means should be used to try to prevent its manifestations or at least to delay them until the child is older and stronger and therefore better able to follow an exclusion diet. The capacity of breast-feeding for preventing food allergy has been challenged in the past, but a consensus seems to be emerging now that breast-feeding can indeed prevent food allergy if it is started at birth and is exclusive for at least 4, and preferably 6, months. In the most "at-risk" babies the breast-feeding mother should try to eliminate the most potent allergens (eggs, fish, soya, nuts, and cow's milk) from her diet. If a substitute or a complement to breast milk is necessary, neither goat's milk nor soy milk formula are adequate. Heat treatment alone will not be sufficient to make cow's milk hypoallergenic. Only a combination of protein hydrolysis and managed heat treatment can make cow's milk hypoallergenic and retain its nutritional value. This nutritional value should be assessed by animal studies and also by studying infant growth. The hypoallergenicity of a formula can be studied in vitro and with animal tests, but only clinical trials on human infants will prove its efficacy.

Effect of an acidified milk on diarrhoea and the carrier state in infants of low socio-economic stratum.

The effect on diarrhoeal disease of an acidified, modified powdered cow's milk infant formula (Pelargon) was evaluated in 82 infants (Group I) for six months; 104 infants who received the same formula but non acidified, served as controls (Group II). Nutritional status remained satisfactory in both groups throughout the observation period. Some children rejected the taste of the acidified milk. The incidence of diarrhoea was lower in Group I (p less than 0.001). The proportion of days in which the children suffered from acute diarrhoea, and the duration of the episodes were also lower in the children given the acidified milk (p less than 0.001). The rate of detection of enteropathogens and the species identified were comparable in both groups. Carrier rates for bacterial enteropathogens fell over time in Group I while they rose in Group II (p less than 0.001). Carrier rates for enteric parasites were comparable to those expected in our setting for this age group. These results suggest that acidified milk exerts a protective effect against diarrhoeal disease.

[New aspects in the nutrition of newborn infants with low birth weight]. / Neue Aspekte der Ernährung von Neugeborenen mit niedrigem Geburtsgewicht.

Optimalize the feeding of low birth weight infants is a very important problem in industrial as well as in developing countries where such infants are very numerous. Water need is very important but gastric and vascular capacity is limited in LBW infants. Energy has to be absorbed at a rate of 120 to 130 Kcal/kgBW/day without raising the osmolarity of the food. Protein intake has to be higher than in term babies but due to enzyme and kidney immaturity the amino acid pattern of the protein has to be carefully adapted to the pattern of the proteins to be synthesized. Calcium, phosphorus, iron, zinc and other trace minerals as well as vitamins have to be provided in relatively large quantities but their bioavailability has also to be checked. The utilisation of breast milk and particularly of own mothers milk having delivered prematurely is also discussed.