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Extensively and partially hydrolysed infant formulas for allergy prophylaxis
G Oldaeus1, K Anjou, B Björkstén
1Department of Paediatrics, Länssjukhuset Ryhov, Jönköping, Sweden.
Insights
Extensively hydrolyzed (N) formula significantly reduced atopic symptoms in high-risk infants compared to partially hydrolyzed (PH) and regular (RM) formulas. This allergy prevention effect was observed up to 18 months of age.
Area of Science:
- Pediatrics
- Allergy and Immunology
- Nutrition
Background:
- Infant feeding practices play a crucial role in allergy development.
- Hydrolyzed formulas are explored for their potential to prevent allergies in high-risk infants.
Purpose of the Study:
- To assess the allergy preventive effect of extensively hydrolyzed (N) and partially hydrolyzed (PH) cow's milk formulas compared to a regular formula (RM).
Main Methods:
- A randomized controlled trial involving 155 infants with a family history of allergy.
- Infants were assigned to N, PH, or RM formula groups.
- Atopic symptoms and skin prick test results were monitored up to 18 months.
Main Results:
- Cumulative incidence of atopic symptoms at 18 months was 51% (N), 64% (PH), and 84% (RM).
- Significantly fewer atopic symptoms were observed in the N group compared to RM (6-18 months) and PH (up to 9 months).
- At 9 months, 10% of infants in the N group had positive egg skin prick tests versus 33% in the PH group.
Conclusions:
- An extensively hydrolyzed formula demonstrated an allergy preventive effect in high-risk infants during the first 18 months of life.
- A partially hydrolyzed formula did not show a significant allergy preventive effect in this cohort.
- Findings support the use of extensively hydrolyzed formulas for allergy prevention in at-risk infants.
Abstract:
The allergy preventive effect of extensively (N) and partially (PH) hydrolysed cows' milk formulas compared with a regular formula (RM) was assessed in 155 infants with a family history of allergy. No cows' milk was given during the first nine months of life and no egg and fish up to 12 months of age. Breast feeding mothers avoided the same foods. At weaning the infants were randomised to one of the formula groups. The cumulative incidence of atopic symptoms at 18 months was 51, 64, and 84% in the N, PH, and RM groups, respectively. From 6 to 18 months there were significantly less cumulative atopic symptoms in the N group compared with the RM group, and significantly less than the PH group up to 6 (N = 25%; PH = 46%) and 9 months (N = 34%, PH = 58%). At 9 months significantly fewer infants in the N group (10%) than in the PH group (33%) had a positive skin prick test to eggs. The findings support an allergy preventive effect of an extensively hydrolysed formula, but not of a partially hydrolysed formula, during the first 18 months of life of high risk infants.