Introduction and background

Until recently Allergy to cow's milk was debating the issue to which doctors treated differently. In some textbooks of paediatrics this question either not discussed at all, or was mentioned in connection with symptoms of diseases of the gastrointestinal tract. Some clinicians do not consider Allergy to cow's milk disease, and therefore do not tend to put such a diagnosis. On the other hand, among pediatricians and to a lesser extent therapists are doctors who are willing to "stamp" diagnosis "increased sensitivity to milk" and recommended to exclude from the food cow's milk in all cases when the child's digestive disorders, disorders of respiratory tract, or skin rash. Among the reasons for such a sharp disagreement can identify two main. First, the symptoms of Allergy to cow's milk is very diverse; many of them can be symptoms of other illnesses. Secondly, there is no reliable laboratory diagnostic method. The awareness of the General population in questions of Allergy to cow's milk is very small, although in recent years it has grown. Quite often parents with disbelief that the reason of illness of the child can be milk. According to the traditional approach, cow's milk is not just desirable food and the ideal food and necessary element in the child's diet.
Hippocrates (460-370 gg BC) one of the first discovered that cow's milk can cause gastric upset and hives [1]. Later, Galen (129-199) described the case of Allergy to goat milk [2]. Although the man began to eat milk ruminants from the beginning of its business activities, the main food of the children in those days was still breast milk. When the mother could not feed her baby, used exclusively to help the nurse.
In XVII-XVIII centuries, the demand for nurses was very great. In European countries, women from higher social strata sought to hire a nurse, arguing that breastfeeding can ruin the shape or damage to health. According to Wickes [3], breast-feeding has lost popularity among wealthy women mainly because that prevented them to lead a secular life. From about the middle of the XVIII century child feeding milk of animals is becoming quite common, and preference is given goat and donkey milk instead of cow milk.
In the beginning of XX century in the German medical literature there are the first messages about allergies to milk [4]. In 1905 Schlossman [5] described the case of a sharp shock as a result of taking cow's milk. In the same year Finkelstein [6] reported the case of death after intake of cow's milk; this author for the first time suggested oral giposencibilization. In 1908 in French literature were described severe reactions to cow's milk [7]. The message about idiosyncrasy to cow's milk appeared in Swedish literature in 1910 [8]. One of the earliest American works on this subject was article Talbot [9], published in 1916 In English literature such work was not up to 40-ies [10]. Since that time, more and more doctors began to realize the reality of Allergy to cow's milk. Published a great number of papers, confirming the seriousness of the problem allergies to milk, which may affect various body systems and which may manifest a wide variety of symptoms.
In the literature there is no clear common terminology to describe the symptoms that appear as a result of taking milk. The terms "intolerance" and "sensitization", "sensitivity" and "Allergy" is sometimes used interchangeably, or they are used as synonyms. The term "intolerance" is the most common and in the strict sense refers to any adverse reaction. We prefer to use the term only in the description of such conditions, which are based on immune mechanisms, and the terms "sensitivity" and "Allergy" to apply if there is strong evidence indicating immunological the nature of the process. Adverse reactions to cow's milk can be caused by various mechanisms, including:
1) enzymatic (for example, the lack of lactase, which may be congenital or develops secondarily as a result of various gastrointestinal diseases, including Allergy to cow's milk; another condition associated with lack of a specific enzyme, where the intake of milk is harmful, is galactosemia;
2) immune manifested allergic reaction to cow's milk proteins. Reactions can develop either locally in the gastrointestinal tract, or long-shock the body - in the respiratory tract or the skin. Immunological manifestations sometimes include a sensitivity of the immediate type, reaction type of the phenomenon artusa and in some cases the reactions of cellular immunity.
In fact, as a rule, simultaneously various immune mechanisms; more more on this in Chapter IV ("Pathogenesis"). Investigation of the mechanisms underlying allergies to milk, requires high qualification of specialists, as well as significant cost. Currently quite difficult to identify any single predominant immune mechanism, and delete the others.
List of literature
1. Chabot R. Pediatric Allergy. New York; McGraw-Hill, 1951.
2. O'keefe E. S. The history of pediatric allergy.- In: The Allergic Child/Ed. Speer F.. New York: Harper & Row, 1963, p. 3.
3. Wickes 1. G. A history of infant feeding. II. The seventeenth and eighteenth centuries. - Arch. Dis. Child, 1953, 28, 232-240.
4. Hamburger F. Biologisches Uber die Eiweisskorper dcr Kuhinilch und Ubcr Sauglingseinahurng. - Wien. Klin. Wschr., 1901, 14, 1202.
5. Schlossmati A. Ueber die Giftwirkung des Artfremden Eiweisses in der Milch auf den Orgar.ismus des Sauglings. - Arch. Kinderheilkd, 1905, 41, 99-103.
6. Finkilstein H. Kuhinilch als Ursache akuter Ernahrungslorungen bei Sauglingen. - Monatsschr Kinderheilkd, 1905,4,65-72.
7. Hutinel V. Intolerance for milk and anaphylaxis in nurslings. - La Clinique, 1908, 15, 227.
8. Wernstedt W. The causes of inferiority of cow''s milk as food for beeble children: Infantile idiosyncrasy to cow''s milk. - Hygeia, 1910, 72, 629 - 644.
9. Talbot F. B. Idiosyncrasy to cow''s milk: Its relation to anaphylaxis. Boston Med. Surg. J., 1916, 175, 409-410.
10. Brodribb //. 5. Allergic vomiting in infants. - Arch. Dis. Child. 1944, 19, 140-142.