de Boissieu D, Matarazzo P, Rocchiccioli F, Dupont C
Unité de Gastroentérologie Pédiatrique, Hôpital Saint Vincent de Paul, Paris, France.
Acta Paediatr. 1997 Oct;86(10):1042-6. doi: 10.1111/j.1651-2227.1997.tb14803.x.
Six infants suspected of food allergy during breastfeeding were evaluated using prick tests, total IgE, RASTs and intestinal permeability measurements during fast and provocation with mother's milk. An elimination diet was undertaken in mothers, removing first cow's milk protein (CMP), then, when inefficient, all foods suspected on the clinical history or a positive prick test in the child, followed by oral challenges in mother's diet with the corresponding food. The sole CMP-free diet in mothers always proved insufficient. In four, an additional diet excluding two to three other foods cleared the symptoms. Oral provocations in mother's diet with those foods were positive in all. In two, mothers turned down a diet excluding more than four foods, symptoms cleared while feeding the child with an extensively hydrolysed formula, whereas challenges with mother's milk induced immediate reactions. Intestinal permeability was altered during provocation tests with mother's milk sampled before maternal diet. Food allergy during breastfeeding may be due to multiple foods and the inefficacy of the sole CMP elimination in mothers does not rule out food sensitization.
对6名母乳喂养期间疑似食物过敏的婴儿，在禁食和用母乳激发试验期间，采用点刺试验、总IgE、放射性变应原吸附试验（RAST）和肠道通透性测量进行评估。对母亲采用排除饮食法，先去除牛奶蛋白（CMP），然后，若效果不佳，则去除临床病史中可疑或孩子点刺试验呈阳性的所有食物，随后在母亲饮食中用相应食物进行口服激发试验。母亲单纯采用不含CMP的饮食总是证明不足。在4名婴儿中，额外排除两到三种其他食物的饮食消除了症状。母亲饮食中用这些食物进行口服激发试验，结果均为阳性。在2名婴儿中，母亲拒绝了排除四种以上食物的饮食，在给孩子喂食深度水解配方奶粉时症状消除，而用母乳激发试验则引发即刻反应。在用母亲饮食调整前采集的母乳进行激发试验期间，肠道通透性发生改变。母乳喂养期间的食物过敏可能归因于多种食物，母亲单纯排除CMP无效并不排除食物致敏。
