Documente Academic
Documente Profesional
Documente Cultură
Immunology)
New evidence in
formula selection
Characteristic of Allergic
Diseases
In Children in Yogyakarta
(2014)
33.8%
1. AR:
Allergic
Rhinitis
17.3%
9.1%
2. DA:
Dermatitis
Atopic
3. Asthma
N:
2.
3.
4.
shrimp
11.8 %
crab 10.9 %
cocroach
8.7%
5.
dog
8.4%
6.
cat
7.6%
7.
tree
4.2%
8.
cotton
8.
grass 3.8%
9.
tomatoes
4.0 $
3.8 %
10. milk
3.3 %
11 . pineapple
3.1 %
2.2 %
1.8 %
21.3%
Partially breast
feeding
No breast feeding
CMPA-suspected
symptoms
Protein
Lactos Fat
a
1. Partially
H.
Partially N
H
2. Free
Lactose,
Indication
Prevention
0%/
N
Glucos
a
polym
er
Lact.
Intolerance
Diarhea
3. Extensive Extensiv N
H.
e casein
Prevention
CMA
4. Extensive Extensiv N
&
e Casein
MCT55 CMA
%
Fat Malabs
RECOMMENDATION
Indonesia Paediatrion Association
(IDAI)
AVALABILITY
TASTE
Amino Acid Formula
: Verry bitter &
fishy
Extensive Hydrolize F. : Very bitter
Partiall Hydrolize F.
: Bitter
Soy Formula
: Quite nice
Cows Milk Formula : Nice
Indonesian Income
per Capita: Rp.
85.000/day
Europe Income
per Capita ??
9/14/2011
Soy Allergy ?
10%
Aluminium
Kandungan AL > pada formula kedelai > formula susu
sapi dan ASI.
Formula kedelai 200 mL/kg/hari hanya <0,5 mg/kg/hari.
Msh << tolerable intake ( FAO/WHO): 1 mg/kg/hari
American Academic Pediatric (AAP): bukan masalah
keamanan bagi bayi kecuali pada bayi prematur atau bayi
dengan gagal ginjal.
ESPGHAN Committee on Nutrition. J Ped Gastroenterol Nutr. 2006;42:352-61
Vandenplas Y, Castrellon P G, Rivas R, Gutierrex C J, Garcia L D, Jimenez J E, Anzo A,
Hegar B, Alarcon P. British Journal of Nutrition 2013 1:21
Soy Nutrtition?
Fitoestrogen ??
Isoflavon dalam bentuk genistein, daidzein dan glycitein
dampak perk seksual, reproduksi, neuroendokrin,
neurobehaviour, dan fungsi tyroid.
Pada kajian ilmiah: fitoestrogen dalam kedelai efek
estrogen yang lemah.
Kajian metaanalis:
pola pertumbuhan, metabolisme, tulang, reproduksi,
endokrin, sistem imun, dan fungsi neurologi sama susu
formula sapi
Fitat ??
Isolat protein kedelai mengandung fitat
sebesar 1-2%, yang dapat mengganggu
absorpsi mineral dan trace elements.
Reduksi kandungan fitat telah dilakukan
pada semua produk formula dengan
isolat protein kedelai
sehingga meningkatkan absorpsi
dan availabilitas zink, tembaga, dan
mineral lain .
IDAI 2014
Background:
human resources, SPT availability, formula selection: taste, access
and financial aspects
INDONESIA DATA
CMPA - Symptoms
Indonesian Data
Body systems affected in an observational study among Indonesian infants above 6 months with
symptoms suggestive adverse reaction to cows milk protein, 2011-2012
Results symptoms
resolution
Conclusions
31
Label Reading
Milk
Milk
Artificial butter flavor, butter, buttermilk
Casein (rennet), caseinates (calcium, magnesium,
potassium, and sodium)
Ghee
Hydrolysates (casein, milk, protein, and whey)
Lactalbumin, lactoglobulin, lactose (may contain),
lactulose
Milk solids, milk powder, nonfat dry milk powder
Whey
Label ingredients that may indicate the presence of
milk protein
Chocolate
32
Flavorings (artificial, caramel, and natural)