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Feeding high-risk infants with family history of allergy
1Department of Pediatrics, University of Rome La Sapienza, Italy.
Insights
Cow's milk allergy (CMA) is increasingly common in infants. Managing CMA requires careful selection of hypoallergenic formulas, like soy protein or hydrolysate formulas, to ensure proper infant nutrition and development.
Area of Science:
- Pediatrics
- Allergology
- Nutrition Science
Background:
- Cow's milk (CM) formulas are widely used as breast milk substitutes.
- Cow's milk allergy (CMA) is a growing concern for infants.
- Managing CMA presents significant challenges for healthcare professionals.
Purpose of the Study:
- To review the challenges in managing cow's milk allergy (CMA) in infants.
- To discuss the criteria for selecting appropriate CM substitutes.
- To compare available CM substitutes like soy protein formulas (SPF) and hydrolysate formulas (HF).
Main Methods:
- Literature review on CM substitutes and CMA management.
- Analysis of nutritional adequacy and hypoallergenic properties of different formulas.
- Evaluation of availability, cost, and palatability of CM substitutes.
Main Results:
- CM is a primary nutrient source for infants, but CMA necessitates alternatives.
- Nutritional needs can be met with other foods, but hypoallergenic formulas are crucial for high-risk infants.
- Soy protein formulas (SPF) and hydrolysate formulas (HF) are the main available CM substitutes.
Conclusions:
- Selecting an adequate CM substitute is mandatory for infants with CMA or at high risk for allergies.
- The ideal substitute must be hypoallergenic, nutritionally complete, accessible, affordable, and palatable.
- Pediatricians face challenges in choosing among various hypoallergenic formulas due to information overload.
Abstract:
Since the turn of the century, CM (cow's milk) formulas have become progressively more common as breast milk substitutes when mother's milk is unavailable, and CM allergy (CMA) has thus gradually become a more common disorder. Therefore the management of CMA infants confronts pediatricians and allergists with one of the most demanding challenges. In the first year of life of many children, CM provides almost the entire dietary supply of proteins, carbohydrates, and fat; its high nutritional value and low cost should be noted. However, children with CMA can avoid CM without nutritional loss if nutrients are provided by other foods such as meat, fish, vegetables and fruit. Thus the choice of an adequate CM substitute for high-risk infants with family history of allergy is mandatory. The ideal CM substitute should be hypoallergenic; have an adequate nutritional value according to the infant's age; be easily available and inexpensive; and be palatable in order to obtain a good compliance. CM substitutes now available are soy protein formulas (SPF) and hydrolysate formulas (HF). Consequently pediatricians are now over-whelmed with a variety of information on new formulas called hypoallergenic and are faced with a difficult choice among them.