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The long-term effect of a partial whey hydrolysate formula on the prophylaxis of atopic disease
Y Vandenplas1, B Hauser, C Van den Borre
1Academic Children's Hospital, Free University of Brussels, Belgium.
Insights
A partial whey-hydrolysate formula significantly reduced cow's milk protein (CMP) sensitivity and atopic manifestations in high-risk infants compared to regular cow's milk formula up to age five. This highlights early formula choice importance for preventing infant allergies.
Area of Science:
- Pediatric Allergy and Immunology
- Nutritional Science
- Clinical Research
Background:
- Infants with a family history of atopy are at higher risk for developing allergic diseases.
- Cow's milk protein (CMP) sensitivity is a common trigger for atopic manifestations in infants.
- Early feeding interventions may play a role in preventing or reducing the incidence of infant allergies.
Purpose of the Study:
- To investigate the long-term effect of a partial whey-hydrolysate formula versus a regular cow's milk formula on atopic manifestations.
- To assess the prevalence of cow's milk protein (CMP) sensitivity in "at risk" infants fed different formulas.
Main Methods:
- A randomized controlled trial involving 58 non-breastfed "at risk" infants.
- Infants were assigned to receive either a partial whey-hydrolysate formula or a regular cow's milk formula for the first 6 months.
- Atopic manifestations and CMP sensitivity were assessed up to 5 years of age.
Main Results:
- Significantly lower prevalence of CMP sensitivity at 6 months in the hydrolysate group (7% vs. 43%).
- Cumulative atopic manifestations were significantly reduced in the hydrolysate group at 12, 36, and 60 months.
- Reduced incidence of eczema, non-infectious diarrhea, and "allergic" colic observed in the hydrolysate group during the first year.
Conclusions:
- Early introduction of a partial whey-hydrolysate formula can significantly decrease CMP sensitivity and atopic manifestations in high-risk infants.
- The benefits of hydrolysate formula extend beyond infancy, suggesting a long-term protective effect against atopic diseases.
- Formula selection in early infancy is crucial for managing and potentially preventing allergic conditions in susceptible infants.
Abstract:
At the age of 5 years, the prevalence of atopic manifestations was analysed in 58 formula-fed "at risk" infants because of a history of atopic disease in at least two first degree relatives. Infants were randomly assigned to receive either a partial whey-hydrolysate formula (n: 28) or a regular cow's milk formula (n: 30) during the first 6 months of life; thereafter, feeding was unrestricted. Only non-breastfed infants were included. The groups did not differ in risk factors or in known confounding factors possibly influencing the incidence of manifestations suggestive of atopic disease. At 6 months, the prevalence of cow's milk protein (CMP) sensitivity was significantly decreased in the hydrolysate group (7% versus 43%; P: 0.002). At the age of 12 (21% versus 53%; P: 0.029), 36 (25% versus 57%; P: 0.018) and 60 months (29% versus 60%; P: 0.016) there was still a significant difference in the number of atopic manifestations, if calculated cumulatively. There was no difference between the groups if only the new cases after the age of 6 months were considered. Eczema was less frequent in the whey-hydrolysate group, but only during the 1st year of life, suggesting a decreased prevalence of CMP sensitivity. During the first 6 months, diarrhoea of non-infectious origin occurred in 8/30 infants (27%) of the adapted formula group, and in no infant in the hydrolysate group. "Colic as single manifestation" was considered of "allergic" origin in 1/28 infants in the hydrolysate group, and in 4/30 infants in the adapted formula group.(ABSTRACT TRUNCATED AT 250 WORDS)