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Allergenicity of a whey hypoallergenic formula in genetically at risk babies: four case reports
1Department of Pediatrics, Allergy and Clinical Immunology Division, University of Rome La Sapienza, Rome, Italy.
Insights
Partially whey hydrolysate formula (PWHF) may sensitize genetically predisposed infants to cow
Area of Science:
- Pediatric Allergy and Immunology
- Infant Nutrition
Background:
- Hydrolyzed formulas (HF) aim to reduce cow's milk (CM) protein allergenicity for infants with CM allergy (CMA).
- Whey HFs have recently shown allergic reactions in high-risk infants for CMA prevention.
Observation:
- Four exclusively breast milk-fed infants experienced anaphylaxis after reintroduction of a partially whey hydrolysate formula (PWHF).
- Infants showed no allergic symptoms while exclusively breast milk-fed.
Findings:
- Sensitization to PWHF appears to occur within the first days of life.
- PWHF may be allergenic and sensitizing in genetically predisposed infants, triggering IgE-mediated immune responses.
Implications:
- Partially whey hydrolysate formulas may pose sensitization risks beyond already allergic individuals.
- Maternal dietary modifications during breastfeeding can complement infant feeding strategies.
Background:
Hydrolysate formulas (HF) have been developed with the goal of reducing the allergenicity of cow's milk (CM) proteins, thus providing a suitable formula for feeding babies with CM allergy (CMA).
Objective:
More recently, whey HFs have provoked 208 reactions in babies at high risk of atopy when given for CMA prevention.
Material And Methods:
We report the clinical and immunologic findings of four babies apparentlly sensitized by a partially whey hydrolysate formula (PWHF) in the nursery. They were exclusively BM (breast milk)-fed by their mothers avoiding highly allergenic foods, but experienced anaphylaxis after a re-feeding with the PWHF.
Results:
Sensitization to PWHF seems to have occurred in the first days of life. No baby suffered from allergic symptoms during BM-feeding.
Discussion:
These case reports suggest that a PWHF may be allergenic not only in an already sensitized subject, but also sensitizing in a genetically predisposed baby being immunogenic in the IgE system. These data strongly indicate that maternal diets during BM-feeding, in two instances suggested by family doctors, are effective as a BM complement.
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