Diversification alimentaire et risque allergique

[Management and prevention of cow's milk protein allergy: Contribution of community pharmacists]

Cow's milk protein allergy (CMPA) is a public health issue in children whose quality of life is strongly affected. The objective of this article is to review the present state of knowledge on the CMPA, and highlight some emerging alternatives in its management and in its prevention. Good knowledge in the appropriate infant formula, exclusion diets, the handling of the emergency treatment thanks to the use of epinephrine auto-injector pens, the use of personalized care project and accessibility to allergic patients' association are factors that secure the management. Breastfeeding and appropriate dietary diversification are for their part major preventive measures. The use of probiotics and desensitization immunotherapy are interesting emerging tracks. The role of community pharmacists in all these steps is discussed. It is indeed a nearby health professional involved both in improving prevention and in the optimization of the management. Its educational posture is crucial in assisting patients to help them better understand the CMPA and its treatment; as part of its new tasks, he can be integrated into therapeutic education programs to help allergic children and their families in a multidisciplinary context to better manage their daily life.

The Role of Avocados in Complementary and Transitional Feeding

Infant dietary patterns tend to be insufficient sources of fruits, vegetables, and fiber, as well as excessive in salt, added sugars, and overall energy. Despite the serious long-term health risks associated with suboptimal fruit and vegetable intake, a large percentage of infants and toddlers in the U.S. do not consume any fruits or vegetables on a daily basis. Since not all fruits and vegetables are nutritionally similar, guidance on the optimal selection of fruits and vegetables should emphasize those with the greatest potential for nutrition and health benefits. A challenge is that the most popularly consumed fruits for this age group (i.e., apples, pears, bananas, grapes, strawberries) do not closely fit the current general recommendations since they tend to be overly sweet and/or high in sugar. Unsaturated oil-containing fruits such as avocados are nutritionally unique among fruits in that they are lower in sugar and higher in fiber and monounsaturated fatty acids than most other fruits, and they also have the proper consistency and texture for first foods with a neutral flavor spectrum. Taken together, avocados show promise for helping to meet the dietary needs of infants and toddlers, and should be considered for inclusion in future dietary recommendations for complementary and transitional feeding.