Tolerability of partially and extensively hydrolysed milk formulas in children with cow's milk allergy

Area of Science:

• Pediatric Allergy and Immunology
• Clinical Nutrition
• Gastroenterology

Background:

• Cow's milk allergy (CMA) is a common condition in infants and children.
• The safety and tolerability of hydrolyzed formulas for CMA management require further investigation.
• Partially hydrolyzed formulas (pHFs) are often used, but their efficacy in CMA is not fully established.

Purpose of the Study:

• To evaluate the tolerability of different types of hydrolyzed cow's milk protein-based formulas in children with diagnosed CMA.
• To compare the allergic tolerance to partially hydrolyzed formula (pHF), extensively hydrolyzed formula (eHF), and regular cow's milk formula (rCMF).

Main Methods:

• A three-period, double-blind, crossover study design was employed.
• Twenty-five children diagnosed with CMA underwent controlled food challenges with eHF, pHF, and rCMF.
• The primary outcome measured was the rate of tolerance to a 20.0 mL formula challenge.

Main Results:

• Children with CMA demonstrated significantly higher tolerance rates to pHF (16/25) and eHF (22/25) compared to rCMF (2/25).
• Allergic symptom scores were significantly lower for both pHF and eHF when compared to rCMF.
• No significant difference in symptom scores was observed between pHF and eHF.

Conclusions:

• Partially and extensively hydrolyzed formulas are better tolerated and safer than regular cow's milk formula for children with CMA.
• pHFs may be considered for children with mild CMA, pending further multi-center confirmation.
• Caution is advised with food challenge tests for hydrolyzed formulas in children with CMA due to potential reactions.