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Q:

9/26/2018
A 5 month-old tolerated Gerber good start formula till one year of age. She was switched to Nido which she vomited and developed urticarial lesions. Similar reaction happened with 2% cow’s milk. Now on Gerber good start grow 3 which she is tolerating well. Small amounts of ice cream and yogurt are tolerated as well.

Labs: Invitro test shows class 3 (high) IgE antibodies to alpha lactalbumin, beta lactoglobulin, cow milk protein and casein. Negative for Soy.

How can the intolerance to regular milk/Nido and tolerance to good start be explained?

A:

It is likely that your patient's tolerance to the Good Start formulas relate to their partially hydrolyzed protein. A similar example was published in JACI In Practice in 2015 (1). Importantly, not all cow's milk allergic patients will similarly tolerate this.

1. Lee, T. D., G. Gimenez, G. Grishina, M. Mishoe, H. A. Sampson, and S. Bunyavanich. "Profile of a Milk-Allergic Patient Who Tolerated Partially Hydrolyzed Whey Formula." J Allergy Clin Immunol Pract 3, no. 1 (Jan-Feb 2015): 116-8.

Hope you find this information helpful.

Sincerely,
Daniel Jackson, MD FAAAAI

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