Use of donkey milk in infant feeding

There are still few literature about the role of donkey milk (DM) in human nutrition and increasing knowledge is crucial in order to provide practical advice for DM consumption. The aim of this study was to monitor nutritional quality, hygiene and health risks, and the impact of DM in the feeding of children with cow’s milk protein allergy (CMPA). DM was supplied by a farm located in central Italy, conforming with EU regulation 853/2004. Eighteen pasteurised milk samples (at 65 °C for 30min) were taken monthly. Pasteurised DM showed a total average viable count of 4332.22 CFU/mL (±3046.78), a slightly alkaline pH (7.12±0.17), a lactose percentage of 6.83±0.34, a total protein percentage of 1.63±0.19, while casein was 0.81%±0.11. Fat percentage (0.51±0.52) was lower compared to ruminant milk and about 48% of the total milk fatty acids were unsaturated. In addition, DM contained 7.52±2.49 g/100 g of fat of n3 linolenic acid. Eighty-one children with CMPA referred to the Allergy Unit of the Anna Meyer Children’s Hospital were recruited. They underwent to an allergological work-up including an oral food challenge (OFC) with DM; during the OFC the palatability of the milk was also evaluated. In children ≥3 years of age, DM palatability was assessed with a specific Wong-Baker modified pain scale, while in children <3 years of age it was assessed through the physician’s judgment. The results of the allergological work-up showed that DM did not caused allergic reactions in the 98.7% of patients, in addition, a good palatability of the milk was found. DM was included for six months in nutritional plans for 16 children with IgE-mediate CMPA (mean age of 20±18.4 months at the beginning of the study) and six with Food Protein-Induced Enterocolitis Syndrome (mean age of 5.33±1.75 months). The daily dose of DM varied from a maximum of 1000mL to a minimum 200– 250mL according to the age of the children. Given the low fat of DM, the diet of the children was supplemented with extra virgin olive oil (EVO) according to the age (from a minimum of 1.5 g of EVO and 1.5 g of Medium Chain Triglycerides vegetable oil in each 100mL of milk to a maximum of 8–10mL of EVO added to the daily meals). All the children that underwent to the nutritional plans were monitored twice (at the beginning and at the end of the study) for the auxological parameters. The results showed that DM did not change the normal growth rate of allergic children.