Allergy is a peculiar disease. For millions of Filipinos, allergy is a year-round lifetime misery. It is not caused by exotic microbe, but by common place substances of everyday life. It is not the sluggishness but the overzealousness of the body’s defense system that brings about the body’s unused reactions. Dust, pollen, insect bites, cosmetics, food and air pollution are among the common culprits. 
Any foreign substance introduced into the body has an allergy-provoking potential. Since food is the first foreign molecule encountered by babies, food is the most common cause of allergy among babies. The first time baby is exposed to intact undigested food, he or she will not immediately experience allergy symptoms. But the immune system is triggered into producing an antibody called immunoglobin E (IgE) that sensitizes the body against the foreign substance. This sensitization leads to an allergic reaction when the baby is again exposed to that same food. Subsequently, the baby is in the state of hypersensitivity causing the release of histamines, leukotrienes and other chemicals into the circulation, bringing about food allergic reactions. The baby becomes weak, hypotensive and may lose consciousness. If not treated properly, anaphylactic shock can be fatal. Most food allergens are protein in nature. Normally, protein in food is not absorbed intact into the circulation. Such protein is broken down through the action of hydrochloric acid in the stomach and enzymes in the intestines during digestion resulting in free amino acids and small peptides which no longer have specific protein identities. The allergy-provoking potential has been destroyed. However, during the first few days of life, the enzyme system is immature and the gastrointestinal lining is permeable to large undigested food particles. This may be absorbed through the intestinal wall sensitizing the baby. Thus, feeding intact food protein too early, before the gut is ready for it, can increase the sensitization. Experts agree that the earlier in life the allergy begins, the more severe it will be and the longer it stays. Cow’s milk, egg, fish, soya and wheat are the most common allergens among babies. A positive family history of even just one allergic parent doubles the risk for food allergy. If no family member has allergy, there is still 5-15% chance that allergy can occur. On the other hand, non-food allergens can enhance the manifestation of food allergy. These are viral infections, pet animals, tobacco, molds and dust mites. Acute diarrhea in the first months of life scrape off the intestinal lining, facilitating the penetration of food and consequently sensitization to food protein. Can food allergy be prevented during infancy? Yes. The link between breastfeeding and artificial feeding with eczema was first documented in 1936. More babies who are formula-fed had eczema than those who were breast-fed. Exclusive breastfeeding for at least six months is the key to prevention but both mother and baby should avoid common food allergens during the last trimester of pregnancy and while breastfeeding to avoid “transplacental sensitization” and passage of allergens through milk. Today, there is a good evidence that if mothers cannot breastfeed or before breastfeeding is established, a hydrolyzed or hypoallergenic formula is a suitable alternative. In this approach, sensitization to intact cow’s milk protein is avoided. According to experts, the longer you can keep the allergen away from the baby, the better it is. Thus, it would be best to delay as much as possible cow’s milk based formulas. Weaning solid foods must also be delayed until the baby is six month’s old. Even then, only the least allergenic food like rice, banana, papaya, squash, sayote, etc. are allowed. Breastfeeding should still continue after six months until such time when the physician decides to challenge the baby with intact milk protein. Obviously, breastmilk is still the best for babies!
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