Multiple Food Allergy and Intolerance

Food allergy is an adverse clinical reaction to food due to any type of abnormal immune response to food protein.

Food intolerance is a reproducible adverse reaction to the ingestion of food or to any of it’s components ie proteins, carbohydrates, fats and additives. Such adverse reactions include metabolic reactions, enzyme deficiencies etc.

In more than 50% of children with food allergy, adverse reactions to more than one food are seen. Children with allergy to several common food proteins like cow's milk, egg and peanut are termed as having “oligo” food allergy.

Multiple food protein intolerant (MFPI) infants are distinguished from “oligo” food allergic patients due to their intolerance of soy and extensively hydrolysed formula, in addition to a range of other food proteins. Infants with MFPI often come from families with an atopic (allergic) history. MFPI is also recognised to occur in breast-fed infants. Most infants with MFPI tolerate low-allergen foods such as grain, vegetables, fruits, and meats in the second year of life.

A better prognosis is associated with an earlier diagnosis, predominant digestive symptoms and the absence of associated allergy to other foods. Therefore in infants with late diagnosed MFPI, dietary exclusions are often required up to 3 years of age.

Infants with multiple food protein intolerance may be also allergic to soy, extensively hydrolysed formulae (eHF) and a wide range of other foods. They have complex nutritional problems and should be distinguished from those with sensitivity to common food proteins such as cow’s milk, egg and peanut but who tolerate eHF and soy.
Infants with intolerance to extensively hydrolysed formula and soy can be safely and effectively treated with amino acid-based formulae.