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The Role of Hydrolyzed Formula in Allergy Prevention
1Department of Pediatrics, Epidemiology and Biostatistics and Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA.
Insights
Certain hydrolyzed infant formulas may reduce eczema risk in high-risk infants. However, evidence for preventing other allergic diseases like asthma is inconsistent, necessitating further research into specific formula types.
Area of Science:
- Pediatrics
- Allergology
- Nutrition Science
Background:
- Asthma, eczema, food allergy, and allergic rhinitis are prevalent chronic pediatric conditions.
- Breastfeeding is recommended, but infant formula is used for some infants.
- Hydrolyzed infant formulas are explored for allergy prevention in at-risk children.
Purpose of the Study:
- To review the evidence on hydrolyzed infant formulas for preventing allergic diseases in children.
- To assess the impact of different hydrolysis methods and degrees on formula efficacy.
- To identify gaps in current research regarding hydrolyzed formulas and allergy prevention.
Main Methods:
- Systematic review of clinical studies on hydrolyzed infant formulas.
- Analysis of studies comparing partially or extensively hydrolyzed formulas to non-hydrolyzed formulas.
- Evaluation of evidence for specific allergic conditions: eczema, allergic rhinitis, food allergy, and asthma.
Main Results:
- Partially hydrolyzed whey and extensively hydrolyzed casein formulas show some evidence for reducing eczema risk in high-risk infants.
- Evidence for preventing allergic rhinitis, food allergy, and asthma with hydrolyzed formulas is inconsistent and insufficient.
- The method of peptide modification during hydrolysis, not just the degree, may influence preventive effects.
- Generalizing findings across different hydrolyzed formulas is challenging due to varying manufacturing processes.
Conclusions:
- Hydrolyzed formulas may offer some protection against eczema in high-risk infants.
- More research is needed to confirm benefits for other allergic diseases and identify optimal formulas.
- Understanding the qualitative changes in peptides is crucial for developing effective hypoallergenic formulas.
Abstract:
Asthma, eczema, food allergy, and allergic rhinitis are some of the most common pediatric, chronic conditions in the world. Breastfeeding is the optimal way to feed all infants. For those infants who are exposed to infant formula, some studies suggest that certain partially hydrolyzed or extensively hydrolyzed formulas may decrease the risk of allergic disease compared to nonhydrolyzed formulas for children with a family history of atopic disease. Overall, there is some evidence to suggest that partially hydrolyzed whey formulas and extensively hydrolyzed casein formulas may decrease the risk of developing eczema for infants at high risk of allergic disease. The evidence for a preventive effect of hydrolyzed formulas on allergic rhinitis, food allergy, and asthma is inconsistent and insufficient. Finally, the qualitative changes to the peptides by the method of hydrolysis, not just the degree of protein hydrolysis, may have a large influence on the preventive effect of a particular infant formula for the potential risk of allergic disease. As a result, it may be difficult to generalize findings from clinical studies using a specific infant formula to other infant formulas from different manufacturers using different methods of hydrolysis. Further clinical studies are needed to help clinicians identify which infants may benefit from early intervention, as well as which specific hydrolyzed formulas are best suited to decrease the risk of future allergic disease.
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