i

Estimada comunidad de la Revista Chilena de Enfermería, les informamos que continuamos recibiendo artículos para su publicación este 2025,
con sistema de publicación continua en temas de Enfermería y Ciencias de la Salud;
y un tiempo promedio de publicación de nueve semanas desde el envío del artículo hasta su publicación. (NORMAS PARA AUTORES)

Experiencia de madres al cuidado de hijos con alergia a la proteína de leche vacuna

Autores/as

Descargar

Resumen

Introducción: La alergia a la proteína de la leche de vaca es una condición inmunomediada que se presenta con mayor frecuencia durante el primer año de vida, lo que tensiona procesos de cuidado de las madres. La prevalencia estimada mundial es entre 2% y 7,5%, mientras que en Chile los estudios siguen siendo incipientes. Las manifestaciones clínicas predominan a nivel gastrointestinal, aunque también se observan síntomas cutáneos y sistémicos. Objetivo: Develar la experiencia de madres al cuidado de niños y niñas diagnosticados con alergia a la proteína de la leche de vaca. Metodología: Estudio cualitativo con enfoque fenomenológico con un muestreo intencionado. Se realizaron entrevistas en profundidad vía online a nueve madres. El análisis siguió los lineamientos de Helen Streubert. Resultados: Emergieron tres unidades de significado: búsqueda diagnóstica, adaptación familiar y percepción de mejoras al sistema de salud. Las subunidades revelaron experiencias de policonsulta médica, incertidumbre frente a los síntomas, impacto económico, reorganización alimentaria y ausencia de apoyo psicológico. Se evidenció desconocimiento clínico sobre alergia a la proteína de la leche de vaca en atención primaria y barreras de acceso a especialistas médicos. Conclusiones: La experiencia de cuidar a un niño con alergia a la proteína de la leche de vaca implica transformaciones profundas en la dinámica familiar. La falta de orientación profesional adecuada obliga a los cuidadores a asumir decisiones clínicas sin respaldo. Se sugiere fortalecer el rol del profesional de enfermería en la pesquisa y acompañamiento, además de incorporar estrategias educativas y comunitarias desde atención primaria.

Palabras clave:

Hipersensibilidad a la Leche , Conducta Materna , Niño , Madres , Nutrición del Niño

Referencias

Fiocchi A, Brożek JL, Schünemann HJ, Bahna SL, von Berg A, Beyer K, et al. World Allergy Organization (WAO) diagnosis and rationale for action against cow’s milk allergy (DRACMA) guidelines. World Allergy Organ J. 2022. 15(1):100609. https://doi.org/10.1016/j.waojou.2021.100609

Cordero RC, Prado SF, Bravo JP. Actualización en manejo de alergia a la proteína de leche de vaca: fórmulas lácteas disponibles y otros brebajes. Rev Chil Pediatr. 2018;89(3):310–317.

http://dx.doi.org/10.4067/S0370-41062018005000503

Sicherer SH, Sampson HA. Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133(2):291-307. https://doi.org/10.1016/j.jaci.2013.11.020

Meyer R, Chebar-Lozinsky A, Fleischer DM, Vieira MC, Du-Toit G, Vandenplas Y, Dupont C, Knibb R, Uysal P, Cavkaytar O, Nowak-Wegrzyn A, Shah N, Venter C. Diagnosis and management of Non-IgE gastrointestinal allergies in breastfed infants-An EAACI Position Paper. Allergy. 2020; 75(1):14-32. https://doi.org/10.1111/all.13947

Flom JD, Sicherer SH. Epidemiology of cow’s milk allergy. Nutrients. 2019;11(5):1051.

https://doi.org/10.3390/nu11051051

Ministerio de Salud. Guía Clínica: Diagnóstico y Manejo de Alergia Alimentaria en Niños. Santiago: MINSAL; 2020. https://diprece.minsal.cl/wrdprss_minsal/wp-content/uploads/2021/03/2020.12.21_Guia_clinica_Alergia_Alimentaria_en_ninos.pdf

Greer FR, Sicherer SH, Burks AW. The effects of early nutritional interventions on the development of atopic disease in infants and children. Pediatrics. 2008;121(1):183–191. https://doi.org/10.1542/peds.2019-0281

Ministerio de Salud. Lactancia materna exclusiva como factor protector en enfermedades alérgicas. Santiago: MINSAL; 2021. https://www.minsal.cl/lactancia-materna-exclusiva-factor-protector-enfermedades-alergicas

Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Beyer K, Bindslev-Jensen C, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014;69(8):1008–1025. https://doi.org/10.1111/all.12429

Organización Panamericana de la Salud. Informe de Salud en las Américas 2022. Washington, D.C.: OPS; 2022. https://www.paho.org/es/documentos/salud-americas-2022

Streubert H, Carpenter D. Qualitative research in nursing: Advancing the humanistic imperative. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011. Z Chapter 5th, Phenomenology as Method; p. 72-94.

Guba EG, Lincoln YS. Fourth generation evaluation. 1st ed. Newbury Park (CA): Sage Publications; 1989. 294 p.

Emanuel E. ¿Qué hace que la investigación clínica sea ética? Siete requisitos éticos. En: Investigación en sujetos humanos: experiencia internacional. Santiago de Chile: Programa Regional de Bioética OPS/OMS; 1999. p. 33–46.

Protudjer JLP, Bilaver LA. Editorial: The socio-economic burden of food allergy: from households to healthcare systems. Front Allergy. 2025;6:1608998. https://doi.org/10.3389/falgy.2025.1608998

Cawood AL, Meyer R, Grimshaw KE, Sorensen K, Acosta-Mena D, Stratton RJ. The health economic impact of cow's milk allergy in childhood: A retrospective cohort study. Clin Transl Allergy. 2022;12(9):e12187. https://doi.org/10.1002/clt2.12187

Gruenberg M. Misdiagnosed as a "High-Need Baby": Delayed Diagnosis of Cow’s Milk Protein Allergy in an Exclusively Breastfed Infant. Int J Clin Case Rep Rev. 2025;5(5):e783. https://doi.org/10.31579/2690-4861/783

El-Hodhod MA, El-Shabrawi MHF, AlBadi A, Hussein A, Almehaidib A, Nasrallah B, et al. Consensus statement on the epidemiology, diagnosis, prevention, and management of cow's milk protein allergy in the Middle East: a modified Delphi-based study. World J Pediatr. 2021;17(6):576–589. https://doi.org/10.1007/s12519-021-00476-3

Vandenplas Y, Broekaert I, Domellöf M, Indrio F, Lapillonne A, Pienar C, et al. An ESPGHAN position paper on the diagnosis, management and prevention of cow's milk allergy. J Pediatr Gastroenterol Nutr. 2023;76(3):386–413. https://doi.org/10.1097/MPG.0000000000003897

Fong AT, Ahlstedt S, Golding MA, Protudjer JLP. The economic burden of food allergy: what we know and what we need to learn. Curr Treat Options Allergy. 2022;9(3):169–186. https://doi.org/10.1007/s40521-022-00306-5

Bahbah WA, Abo Hola AS, Bedair HM, Taha ET, El Zefzaf HMS. Serum eosinophil-derived neurotoxin: a new promising biomarker for cow’s milk allergy diagnosis. Pediatr Res. 2024;96:1812-1821. https://doi.org/10.1038/s41390-024-03260-x

Westwell-Roper C, To S, Andjelic G, Lu C, Lin B, Soller L, et al. Food-allergy-specific anxiety and distress in parents of children with food allergy: A systematic review. Pediatr Allergy Immunol. 2022;33(1):e13695. https://doi.org/10.1111/pai.13695

Cummings AJ, Knibb RC, King RM, Lucas JS. The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy. 2020;65(8):933–945. https://doi.org/10.1111/j.1398-9995.2010.02342.x

Cortes A, Castillo A, Sciaraffia A. Food allergy: Children's symptom levels are associated with mothers' psycho-socio-economic variables. J Psychosom Res. 2018;104:48-54. https://doi.org/10.1016/j.jpsychores.2017.11.009

Gunnarsson NV, Golding MA, Middelveld R, Protudjer JLP. A scoping review of the caregiver burden of pediatric food allergy. Ann Allergy Asthma Immunol. 2021;127(5):536-547. https://doi.org/10.1016/j.anai.2021.04.034

Nocerino R, Aquilone G, Stea S, Rea T, Simeone S, Paparo L, Vetrano G, Berni Canani R. The Burden of Cow's Milk Protein Allergy in the Pediatric Age: A Systematic Review of Costs and Challenges. Healthcare. 2025;13(8):888. https://doi.org/10.3390/healthcare13080888

Meyer R, Venter C, Bognanni A, Szajewska H, Shamir R, Nowak-Wegrzyn A, et al. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guideline update – VII – Milk elimination and reintroduction in the diagnostic process of cow's milk allergy. World Allergy Organ J. 2023;16(7):100785. https://doi.org/10.1016/j.waojou.2023.100785

Bingemann TA, LeBovidge J, Bartnikas L, Protudjer JLP, Herbert LJ. Psychosocial Impact of Food Allergy on Children and Adults and Practical Interventions. Curr Allergy Asthma Rep. 2024;24(3):107–119. https://doi.org/10.1007/s11882-023-01121-x

Zamanillo-Campos R, Alonso LC, Martín MJF. Nutritional counseling for cow’s milk protein allergy in infants from birth to 2 y of age: Scoping review. Nutrition. 2022;98:111637. https://doi.org/10.1016/j.nut.2022.111633

Paquete AT, Martins R, Connolly MP. Managing cow’s milk protein allergy in Indonesia: A cost-effectiveness analysis of hypoallergenic milk formulas from the private payers’ perspective. J Health Econ Outcomes Res. 2022;9(2):88–96 https://doi.org/10.36469/001c.36407

Martins R, Connolly MP. Cost-effectiveness analysis of hypoallergenic milk formulas for the management of cow’s milk protein allergy in the United Kingdom.

J Health Econ Outcomes Res. 2021;8(2):96–104. https://doi.org/10.36469/jheor.2021.26010

Fakih‐Botero I, Cerchiaro‐Mejia MC, Rodríguez‐Martínez CE. Out‐of‐pocket expenses and parent reported quality of life in children with cow's milk protein allergy in Bogotá, Colombia. J Pediatr Gastroenterol Nutr. 2024;79(1):18-25. https://doi.org/10.1002/jpn3.12203

Vandenplas Y, Belohlavkova S, Enninger A, Frühauf P, Heine RG, Miqdady M, et al.

How are infants suspected to have cow's milk allergy managed? A real-world study report. Nutrients. 2021;13(9):3027. https://doi.org/10.3390/nu13093027

Thompson G, Zhelev Z, Peters J, Khalid S, Briscoe S, Shaw L, et al. Symptom scores in the diagnosis of pediatric cow's milk protein allergy: A systematic review. Pediatr Allergy Immunol. 2023;32(7):1497-1507. https://doi.org/10.1111/pai.13537

Martín-Masot R, Díaz-Martín JJ, Santamaría-Orleans A, Navas-López VM. Spanish pediatricians' positions regarding prevention, diagnosis, nutritional management, and challenges in cow's milk protein allergy. Nutrients. 2023;15(16):3586. https://doi.org/10.3390/nu15163586

Toca MC, Morais MB, Vázquez-Frías R, Becker-Cuevas DJ, Boggio-Marzet CG, Delgado-Carbajal L, , et al. Consensus on the diagnosis and treatment of cow's milk protein allergy of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition. Rev Gastroenterol Mex (Engl Ed). 2022;87(2):235-250. https://doi.org/10.1016/j.rgmxen.2022.01.002

Bingemann TA, LeBovidge J, Bartnikas L, Protudjer JLP, Herbert LJ.

Psychosocial impact of food allergy on children and adults and practical interventions.

Curr Allergy Asthma Rep. 2024;24:107–119. https://doi.org/10.1007/s11882-023-01121-x

Knibb RC, Herbert LJ, Jones CJ, Protudjer JLP, Screti C, Roleston C, et al.

Global availability and uptake of psychological services for adults, caregivers and children with food allergy. Allergy. 2024;79(10):2787-2797. https://doi.org/10.1111/all.16204

Sugunasingha N, Jones FW, Jones CJ. Interventions for caregivers of children with food allergy: a systematic review. Pediatr Allergy Immunol. 2020;31(7):805-812. https://doi.org/10.1111/pai.13255

Pecoraro L, Mastrorilli C, Arasi S, Barni S, Caimmi D, Chiera F, et al.

Nutritional and psychosocial impact of food allergy in pediatric age. Life 2024;14(6):695.https://doi.org/10.3390/life14060695

Zepeda-Ortega B, Goh A, Xepapadaki P, Sprikkelman A, Nicolaou N. Huerta Hernandez RE, et al. Strategies and future opportunities for the prevention, diagnosis, and management of cow milk allergy. Front Immunol. 2021;12:608372. https://doi.org/10.3389/fimmu.2021.608372