Fórmulas extensivamente hidrolizadas. Importancia del grado de hidrolisis / Extensively hydrolyzed formulas. Role of the protein hydrolysis degree

RESUMEN

La alergia a las proteínas de la leche de vaca (APLV) es la alergia alimentaria más frecuente en lactantes y niños de corta edad, con una prevalencia de un 2-3%. Las recomendaciones para el tratamiento de la APLV se fundamentan en las guías de las sociedades médicas, como DRACMA (Diagnosis and Rationale for Action against Cow's Milk Allergy) de la World Allergy Organization, el Comité de Nutrición de la European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) y el Comité de alergia alimentaria de la Spanish Society of Pediatric Allergy, Asthma and Clinical Immunology (SEICAP), basadas en 3 puntos fundamentales evitación estricta de la proteína vacuna, mantenimiento del estado nutricional óptimo y adquisición de la tolerancia lo antes posible. Las fórmulas sustitutivas (cuando la lactancia materna no es posible) para nutrir a los niños afectados de APLV son las denominadas fórmulas hipoalergénicas fórmulas a base de proteínas de leche de vaca extensivamente hidrolizadas (con/sin lactosa), fórmulas a base de proteínas de arroz hidrolizado, fórmulas de soja (aislado o hidrolizado) y fórmulas elementales a base de L-aminoácidos libres. Conocer la composición de cada una de estas fórmulas es importante para decidir qué tipo de alimentación está indicado en cada caso

ABSTRACT

Cow's milk protein allergy (CMPA) is the most frequent food allergy in infants and young children with a prevalence of 2-3%. The recommendations for the treatment of the CMPA are based on the guidelines of medical societies such as Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) of the World Allergy Organization, Nutrition Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the Food Allergy Committee of the Spanish Society of Pediatric Allergy, Asthma and Clinical Immunology (SEICAP), are based on 3 basic points Strict avoidance of the milk protein, maintenance of optimal nutritional status and acquisition of tolerance as soon as possible. Substitute formulas, when breastfeeding is not possible, to nourish children affected by CMPA are the so-called hypoallergenic formulas that are formulas based on extensively hydrolyzed cow's milk proteins (with/without lactose), formulas based on hydrolyzed rice proteins, soy formulas (isolated or hydrolyzed) and elemental formulas based on free L-amino acids. Knowing the composition of each of these formulas is important to decide what type of food is indicated in each case