SOVREMENNAYA PEDIATRIYA.2017.7(87):64-69; doi 10.15574/SP.2017.87.64

Besh L. V., Fus S. V., Matyura O. I., Mykytchyn O. M.
Danylo Halytsky Lviv National Medical University, Ukraine
Lviv Communcal Children's Clinical Hospital, Ukraine
Scientific and Technical Center «Viria», Kyiv, Ukraine

This article discusses the diet adjustment for various forms of allergy in children, and the justification of the need for an individual approach while addressing this issue in a particular clinical case. The hazard of unreasonable prescription of an uncertain and strict long0term diet (hypoallergenic, lactose0free, gluten free) has been shown. It has been noted that the diet should not only exclude some food or ingredient, which is or may be potentially harmful, but also include its equivalent substitution. Removal without replacement is a gross mistake that leads to impoverishment of the person's diet and deprives young organism of many substances needed for growth and development. The presented criteria should be processed individually with each patient, with the following aspects taken into account: the use of products that may provoke an allergic reaction; nutritional value of products; the patient's dietary skills; the presence of food supplements that may cause reactions of hypersensitivity; the presence of natural and synthetic substances and their smell, color, taste; prescribed oral medications. Approaches for the food diary maintenance are presented, as its results will enable to make the right decision about the need of certain products exclusion and to assess the balance of calories and nutritional status. A clinical case of a 2-year-old girl with a diagnostic search of food allergy was presented. The use of provocative oral tests allowed to confirm the diagnosis of cow's milk protein allergy, to determine the dose of the product that is tolerated by the patient and to prescribe oral desensitisation. The cooperation of three specialists (paediatrician, allergologist and dietician) contributed to a complex approach to the diagnosis, treatment and prescription of a balanced diet. The example of this particular clinical case shows the importance of an individual approach to the prescription of a diet while taking into account the patient's age, physical development and the particularities of the disease.

Key words: food allergy, cow's milk protein allergy, diet, nutrition, oral provocative tests, children.

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