Mi bebé tiene alergia al huevo y es lactante

Como ya sabéis, la Alergia a la Proteína de la Leche de Vaca (APLV) apareció en nuestras vidas con la llegada de nuestra hija. Ahora, resulta que nuestro bebé tiene alergia al huevo, que aunque es algo que sospechábamos, hemos confirmado recientemente.

Bueno, miento. No es algo de lo que realmente sospecháramos. Cuando a los dos meses de Arlet dejé de consumir proteína de leche, hubo una mejoría pero no total. Al ir al médico digestivo le comenté que también había habido una reacción alérgica a la soja, por lo que había dejado de consumirla. Y él me dijo que además de retirar soja también retirábamos huevo, pero por probar y descartar, no por sospecha.

Porque realmente no habíamos notado peor sintomatología tras comer tortillas, huevos fritos o pasta (sí, si os fijáis en las etiquetas la mayoría de macarrones llevan trazas de huevo). Quizás por la asiduidad de mi consumo, no lo sé. Por eso, la última doctora digestiva que nos atendió (telefónicamente, con esto del Coronavirus…) nos dijo de introducir el huevo en mi dieta de nuevo.

Empezamos por los alimentos cuyas etiquetas decían “puede contener trazas de huevo”. Estuve así un par de semanas y no hubo ningún cambio en ella. Entonces pasé a las etiquetas que decían “contiene trazas de huevo”, y aquí fue donde obtuvimos la confirmación de que nuestra bebé tiene alergia al huevo. Por eso volví a retirarlo por completo de mi dieta.

Signos y síntomas de la alergia al huevo en bebés lactantes

Tal y como sucede en el caso de la APLV, la alergia al huevo puede ser mediada, o no mediada, por IgE. Y según sea una, u otra, la sintomatología será diferente. En el caso de Arlet, todas sus alergias son no mediadas por inmunoglobulinas, por lo que sus síntomas son digestivos y empiezan al día siguiente más o menos.

¿Cómo detectar la alergia al huevo en bebés en estos casos? Pues con la historia clínica, fijándonos en los síntomas que presenta el niño.

  • Mucosidad en las cacas. Habíamos reducido mucho las cacas con moco, pero han vuelto a aparecer.
  • Gases. No tan exagerado como antes, pero han aumentado.
  • Retortijones. Tampoco parece que le duela tanto la tripa como al principio, pero se nota que tiene dolor.
  • Llanto. Acompañado de un gesto para retorcerse y seguidamente suelta un pedete.
  • Vómitos. Los teníamos más controlados, ya prácticamente habían desaparecido y sólo eran regurgitaciones, pero vuelve a hacer vómito en fuente.
  • Diarrea. De hacer una caca al día de consistencia normal para un bebé alimentado al pecho, ha pasado a hacer varias y más líquidas.
  • Sangre en las heces. Esta fue la pieza que me faltaba para encajar el puzzle de la alergia al huevo. Ya no eran imaginaciones mías.
  • Erupciones cutáneas, urticaria, prurito, lagrimeo, enrojecimiento ocular, irritación nasal, ros, dificultad respiratoria, asma, hipotensión, opresión torácica, palpitaciones, mareo, shock anafiláctico (con riesgo de muerte).

¿Qué pruebas podemos hacer para saber si mi bebé tiene alergia al huevo?

Dieta exenta de proteínas del huevo

Igual que con la APLV, cuando el bebé sólo toma leche materna, la madre debe dejar de comer cualquier alimento que contenga la proteína que causa la alergia. Si introducimos de nuevo el alimento a la dieta, y vuelven los síntomas, ¡blanco y en botella!

Cuando se tenga que hacer la sensibilización del niño al huevo directamente, con la prueba de tolerancia oral al huevo, hay que tener en cuenta que según el grado de alergia la reacción puede variar según la cantidad y la forma de cocinado (huevo crudo, tortilla poco hecha, muy hecha, en repostería…).

Prick test para la alergia al huevo o pruebas de función cutánea

En la parte anterior del antebrazo ponen una gotita con la proteína que se quiere confirmar si da alergia, y luego hacen un pinchacito para que entre en contacto con la sangre.

Puede parecer muy doloroso, pero ya os digo que el Prick test en bebés no duele, ella ni siquiera se quejó un poquito.

Las proteínas del huevo que suelen analizar en esta prueba son la ovomucoide, la ovoalbúmina, la ovotransferrina y la lisozima.

El RAST para el huevo o pruebas IgE específicas

En esta analítica de sangre se medirá la concentración de anticuerpos IgE. Si son elevados, y por tanto la prueba da positivo, se determina que hay una alergia al huevo mediada por IgE. Si es negativo, porque no hay concentración de anticuerpos, la prueba es negativa.

Como ocurre con las alergias, que la prueba sea negativa no significa que la alergia sea descartable, sino que es, en este caso, una alergia al huevo no mediada por IgE. Por eso en estos casos la historia clínica será la que determinará si el bebé tiene alergia al huevo, o no.

Tratamiento para la alergia al huevo en bebés y niños

Tratamiento preventivo o de evitación

Para la alergia al huevo el niño deberá hacer una dieta exenta de huevo, inclusive de trazas, o posibles trazas. Luego veremos los alimentos prohibidos y los alimentos permitidos.

En el caso de sea un bebé lactante el que tenga alergia al huevo, la madre será quien haga la dieta exenta. De este modo, las proteínas dejarán de pasar a través de la leche materna, provocando la alergia al bebé.

Se deben evitar también las trazas o posibles trazas de huevo, porque es posible que, como en nuestro caso, también le afecten. Por eso, es importante mirar bien todas las etiquetas de los productos que compramos. Aunque también hay casos de alergia al huevo, u otros alimentos, en los que las trazas de estos no afectan.

Tratamiento farmacológico

Hay casos en los que se deberá aplicar un tratamiento sintomático para la reacción de la alergia al huevo.

En este caso, los antihistamínicos, los corticoides, los broncodilatadores, o la adrenalina.

Inducción a la Tolerancia Oral del huevo

Mi bebé tiene alergia al huevo y es lactante

Si el niño no llega a superar la alergia por propia madurez, este tratamiento puede ser la solución. Con él, se consigue que el niño llegue a tolerar el alimento.

Con la Inmunoterapia Oral, se va aumentando poco a poco la cantidad de alimento consumido que el niño tolera sin tener reacción alérgica.

Alimentos permitidos cuando hay alergia al huevo

Todos aquellos en los que no haya huevo como ingrediente principal, o en trazas, o en posibles trazas. Hay que mirar bien el etiquetado, que ya no es tan complejo como hace años. A día de hoy, es obligatorio por ley que los alérgenos aparezcan en negrita (o en mayúsculas) en el listado de ingredientes.

No obstante, las trazas no son de obligada declaración, por eso hay que fiarse solamente de las empresas que “remiten a etiquetado”, porque son las que aseguran que sus etiquetas son fiables.

Si en la etiqueta no aparecen las trazas que contiene o puede contener ese producto, pero es una empresa que “remite a etiquetado”, podemos estar seguras de que no contiene alérgenos en trazas. Pero si la empresa no “remite a etiquetado”, habrá que preguntarle directamente por ese producto para que nos confirme si lleva trazas, o simplemente no comprarlo.

Lista de productos y alimentos prohibidos en la alergia al huevo

Hay que eliminar completamente el huevo de la dieta, tanto la clara como la yema, y en cualquier forma de cocción.

Al igual que pasa con la APLV, en la que no se recomienda consumir tampoco leche de otros animales, como la cabra o la oveja, en el caso de alergia al huevo de gallina, tampoco se recomienda comer huevos de codorniz, avestruz, pato, etc.

Hay ciertos alimentos que pueden contener proteína de huevo, y hay que ir con cuidado y mirar muy bien el etiquetado de:

  • Salsas (como la mayonesa).
  • Gelatinas.
  • Dulces: merengues, turrones, helados, flanes, cremas, caramelos, chucherías, bizcochos, magdalenas, galletas, pasteles, etc.
  • Cereales de desayuno.
  • Pasta al huevo, o pasta con trazas de huevo.
  • Embutidos.
  • Salchichas.
  • Patés.
  • Vino (algunos se aclaran con clara de huevo).
  • Cafés con crema (como el capuccino).

Alergia al huevo en bebés y vacunas

Hay algunas vacunas que pueden contener proteínas del huevo:

  • Triple vírica. Que incluye la rubeola, el sarampión y la parotiditis. Actualmente se administra a los 12 meses, y a los 3/4 años.
  • Gripe.
  • Fiebre amarilla.

Se recomienda vacunar a los niños alérgicos igualmente, por la baja probabilidad de desencadenar una reacción alérgica, ya que la posibilidad de que estas vacunas contengan proteínas del huevo es muy baja.

En cuanto a medicamentos, se tiene que evitar la administración de los que contienen lisozima.

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