Zuigelingenvoeding en allergie: Preventie en behandeling van koemelkallergie bij jonge kinderen

In this manuscript an overview is given of the role of nutrition in the prevention and treatment of atopic diseases. The currently available infant formulas are described in detail with respect to differences in content of proteins, lactose, fat and the presence of pro- and prebiotics. Subsequently, the consequence of these differences with respect to the prevention of atopic disease and the treatment of cow's milk allergy is described. In order to prevent atopic disease, human milk is still regarded to be the best infant feeding. On the other hand, the likelihood to develop atopic disease in a high-risk infant is also decreased if a partial or extensive hydrolysate is used. Which hydrolysate offers the best opportunity is not yet scientifically determined. Therefore, which hydrolysate is prescribed is nowadays mostly determined by practical issues. Although one study showed that use of probiotics resulted in prevention of eczema, additional studies are required to confirm this finding. With respect to the treatment of cow's milk allergy, breast feeding is the infant feeding of choice, while an elimination diet is prescribed to the mother. If the infant uses a hydrolysate both the type of hydrolysate and the degree of hydrolysation are important. Extensively hydrolysed formulas are a good alternative for breast feeding. In case of severe cow's milk allergy, caseïne hydrolysates may be more effective than whey hydrolysates. Aminoacid based feeding is indicated for infants with severe cow's milk allergy or multiple food allergies, when prescription of a hydrolysate did not result in complete recovery.