Taste Issues of Amino Acid-Based and Rice-Based Formulas in Cow's Milk Allergy

In managing infants with cow's milk protein allergy (CMPA), amino acid-based or rice-based formulas are commonly prescribed when dairy products are eliminated. However, poor taste frequently leads to formula refusal. This retrospective cross-sectional study aimed to assess the palatability and acceptability of such formulas in infants with CMPA. The primary outcome measure was the proportion of infants accepting the prescribed formula within the first 7 days of initiation. A total of 102 patients from the Pediatric Allergy and Immunology Clinic of Manisa City Hospital were included. Infants diagnosed with immunoglobulin E (IgE)-mediated or non-IgE-mediated CMPA (excluding other allergic diseases) were given a milk-free diet supported by formulas like Neocate Numil, Aptamil Pregomin-Numil, Alfamino-Nestlé, or rice-based Evolvia RP-Montero. Overall, 43.1% (44/102) had IgE-mediated and 56.9% (58/102) had non-IgE-mediated allergies. Among first-time formula users, 47.1% (48/102) (95% confidence interval [CI]: 37.1-57.2) accepted the formula, increasing to 50% (51/102) (95% CI: 39.9-60.1) after switching. No significant differences in formula acceptance were observed based on gender, age, allergy type, or breastfeeding status. Taste remains a major barrier, as roughly half of infants reject these formulas regardless of demographic or clinical factors.