scholarly journals Should we continue to counsel families to use hydrolyzed formulas as a means of allergy prevention in high-risk infants?

2019 ◽  
Vol 25 (2) ◽  
pp. 79-81
Author(s):  
Megan Burke ◽  
Edmond S Chan ◽  
Elissa M Abrams
Keyword(s):  
High Risk ◽  
Position Statement ◽  
Cow’S Milk ◽  
Milk Formula ◽  
Allergy Prevention ◽  
Recent Systematic Review ◽  
Cow's Milk ◽  
High Risk Infants ◽  
Hydrolyzed Formula ◽  
Over Time

Abstract The prevalence of food allergy in North America is high, and has increased over time. As a result, focus has shifted from treatment to allergy prevention. Previous studies have suggested that hydrolyzed formula may prevent atopic dermatitis in high-risk infants. As a result, multiple international guidelines including the Canadian Paediatric Society (CPS) position statement on allergy prevention recommend the use of hydrolyzed formula as a means of allergy prevention in mothers who are not breastfeeding or using donor breastmilk. However, a recent systematic review has not supported an association between use of hydrolyzed formula and allergy prevention. In addition, studies are emerging supporting the use of early and regular cow’s milk formula as a means of cow’s milk allergy prevention.

scholarly journals Prebiotic‐supplemented partially hydrolysed cow's milk formula for the prevention of eczema in high‐risk infants: a randomized controlled trial

Allergy ◽  
2016 ◽  
Vol 71 (5) ◽  
pp. 701-710 ◽  
Author(s):  
R. J. Boyle ◽  
M. L.‐K. Tang ◽  
W. C. Chiang ◽  
M. C. Chua ◽  
I. Ismail ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
High Risk ◽  
Controlled Trial ◽  
Cow’S Milk ◽  
Milk Formula ◽  
Cow's Milk ◽  
Randomized Controlled ◽  
High Risk Infants

scholarly journals Dietary exposures and allergy prevention in high-risk infants

2021 ◽  
Vol 26 (8) ◽  
pp. 504-505
Author(s):  
Elissa M Abrams ◽  
Julia Orkin ◽  
Carl Cummings ◽  
Becky Blair ◽  
Edmond S Chan
Keyword(s):  
Food Allergy ◽  
High Risk ◽  
Food Allergies ◽  
Allergy Prevention ◽  
Severe Reaction ◽  
Omega 3 ◽  
Atopic Condition ◽  
Specific Formula ◽  
High Risk Infants ◽  
Hydrolyzed Formula

Abstract Infants at high risk for developing a food allergy have either an atopic condition (such as eczema) themselves or an immediate family member with such a condition. Breastfeeding should be promoted and supported regardless of issues pertaining to food allergy prevention, but for infants whose mothers cannot or choose not to breastfeed, using a specific formula (i.e., hydrolyzed formula) is not recommended to prevent food allergies. When cow’s milk protein formula has been introduced in an infant’s diet, make sure that regular ingestion (as little as 10 mL daily) is maintained to prevent loss of tolerance. For high-risk infants, there is compelling evidence that introducing allergenic foods early—at around 6 months, but not before 4 months of age—can prevent common food allergies, and allergies to peanut and egg in particular. Once an allergenic food has been introduced, regular ingestion (e.g., a few times a week) is important to maintain tolerance. Common allergenic foods can be introduced without pausing for days between new foods, and the risk for a severe reaction at first exposure in infancy is extremely low. Pre-emptive in-office screening before introducing allergenic foods is not recommended. No recommendations can be made at this time about the role of maternal dietary modification during pregnancy or lactation, or about supplementing with vitamin D, omega 3, or pre- or probiotics as means to prevent food allergy.

scholarly journals Economic Burden of Atopic Dermatitis in High-Risk Infants Receiving Cow's Milk or Partially Hydrolyzed 100% Whey-Based Formula

2015 ◽  
Vol 166 (5) ◽  
pp. 1145-1151.e3 ◽  
Author(s):  
Abhijeet Bhanegaonkar ◽  
Erica G. Horodniceanu ◽  
Xiang Ji ◽  
Patrick Detzel ◽  
Mark Boguniewicz ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
High Risk ◽  
Economic Burden ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
High Risk Infants

scholarly journals Systemic reaction to an extensively hydrolyzed formula in an infant with cow’s milk anaphylaxis

2020 ◽  
Vol 2 (2) ◽  
pp. 164-167
Author(s):  
Alvaro Flores ◽  
Yudy K. Persaud
Keyword(s):  
Systemic Reaction ◽  
Signs And Symptoms ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Formula ◽  
Protein Chain ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy ◽  
Hydrolyzed Formula

Background: Cow’s milk allergy is the most common cause of food allergy in young children. Ingestion of milk products in children with a milk protein allergy can lead to anaphylaxis and must be avoided. Some guidelines suggest the use of an extensively hydrolyzed formula (EHF) in these cases; however, rare allergic reactions can still occur. Here, we presented a 3-month-old boy who developed anaphylaxis to a cow’s milk formula. Subsequently, he developed a rare systemic reaction to soy and to an EHF. Case: The patient had an unremarkable medical history and presented with signs and symptoms consistent with anaphylaxis after being fed cow’s milk formula for the first time. Symptoms included immediate vomiting, wheezing, stridor, angioedema of eyelids and lips. Although intramuscular epinephrine was given, the patient continued to clinically deteriorate, becoming more lethargic and necessitating admission to the pediatric intensive care unit. Subsequently, a trial of soy formula ingestion reproduced the symptoms and an EHF was given. However, immediately after taking an EHF, he developed facial angioedema and diffuse urticarial lesions. Conclusion: In most patients with a cow’s milk allergy, an extensively based formula can be tolerated safely due to a hydrolyzed protein chain. However, medical providers must be vigilant when switching formula because a rare systemic allergic reaction to EHF can still occur.

scholarly journals Cow’s milk allergy in patients with diarrhea

2016 ◽  
Vol 44 (6) ◽  
pp. 239 ◽  
Author(s):  
Nanis S Marzuki ◽  
Arwin AP Akib ◽  
I Boediman
Keyword(s):  
Acute Diarrhea ◽  
Chronic Diarrhea ◽  
Elimination Diet ◽  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Formula ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy ◽  
Hydrolyzed Formula

Background Cow’s milk allergy (CMA) might be one of the causesof diarrhea in children. Previous prospective studies found theprevalence of CMA in children aged 0-3 years between 1.1-5.2%,but data about the prevalence of CMA in children with diarrheawas very limited.Objective This study intended to estimate the prevalence of CMAin children with diarrhea.Methods Children aged 0-3 years, who came with diarrhea andconsumed milk formula were selected for further evaluation. Adiagnostic procedure was developed i.e., elimination diet with par-tially hydrolyzed formula (pHF) for 2 weeks, and then open milkchallenge. If diarrhea was not resolved with pHF, the children weregiven extensively hydrolyzed formula, or soy-based formula.Results Ninety-nine children participated in this study, 87 camewith acute diarrhea and 12 with chronic diarrhea. There were 3children (2 children with acute diarrhea and one with chronicdiarrhea) who reacted to the milk challenge.Conclusion The estimated prevalence of CMA in children withdiarrhea in our study was 3%

scholarly journals Knowledge and practice of pediatricians and nutritionists regarding treatment of cow’s milk protein allergy in infants

2018 ◽  
Vol 31 (6) ◽  
pp. 535-546
Author(s):  
Dayane Pêdra Batista de FARIA ◽  
Ana Paula Bidutte CORTEZ ◽  
Patrícia da Graça Leite SPERIDIÃO ◽  
Mauro Batista de MORAIS
Keyword(s):  
Milk Protein ◽  
Cow’S Milk ◽  
Milk Formula ◽  
Educational Strategies ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Cow's Milk ◽  
Allergy Treatment ◽  
Cow’S Milk Protein ◽  
Hydrolyzed Formula

ABSTRACT Objective This study evaluated the knowledge and practices of pediatricians and nutritionists about cow’s milk protein allergy in infants, with an emphasis on issues related to the exclusion diet and nutritional status. Methods A cross-sectional, descriptive study was performed with a convenience sample of 204 pediatricians and 202 nutritionists randomly invited in scientific events in the city of São Paulo, from November 2014 to March 2016. Results Between 1.5% and 21.0% of respondents indicated inadequate products for the treatment of cow’s milk protein allergy, including goat’s milk, beverages or juices based on soy extract, lactose-free milk formula and partially hydrolyzed formula. The daily calcium recommendation for children between zero and 36 months of age was correctly indicated by 27.0% of pediatricians and 46.0% of nutritionists (p=0.001). Additionally, 96.1% of pediatricians and 82.7% of dietitians (p<0.001) provided guidance on about labels of industrialized products. Conclusion Pediatricians and nutritionists present gaps in knowledge about cow’s milk protein allergy treatment in infants and educational strategies that increase the knowledge of the professionals are important for the management of cow’s milk protein allergy.

scholarly journals The effect of diet in infancy on asthma in young adults: the Merthyr Allergy Prevention Study

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-215040
Author(s):  
Sadiyah Hand ◽  
Frank Dunstan ◽  
Ken Jones ◽  
Iolo Doull
Keyword(s):  
High Risk ◽  
Allergic Disease ◽  
Clinical Assessment ◽  
Intervention Group ◽  
Cow’S Milk ◽  
Allergy Prevention ◽  
Prevention Study ◽  
Cow's Milk ◽  
Soya Milk ◽  
Increased Risk

IntroductionEarly infant diet might influence the risk of subsequent allergic disease.MethodsThe Merthyr Allergy Prevention Study (MAPS) was a randomised controlled trial in infants at high risk of allergic disease. The trial determined whether a cow’s milk exclusion diet for the first 4 months of life decreased the risk of allergic disease including asthma compared with a normal diet. A soya milk preparation was offered to those in the intervention group. A standardised questionnaire for allergic disease was completed at ages 1, 7, 15 and 23 years, with clinical assessment at 1, 7 and 23 years. The effect of the intervention on the risk of atopy, asthma and wheeze at age 23 years was determined.Findings487 subjects entered the study; at age 23 years 299 completed the questionnaire, of which 119 attended clinical assessment. Subjects randomised to the intervention group had a significantly increased risk of atopy (adjusted OR 2.97, 95% CI 1.30 to 6.80; p=0.01) and asthma (OR 2.07, 95%CI 1.09 to 3.91; p=0.03) at age 23 years, but not wheeze (OR 1.43, 95%CI 0.87 to 2.37; p=0.16). Earlier exposure to cow’s milk was associated with a decreased risk of wheeze and asthma at age 23 years, while earlier exposure to soya milk was associated with an increased risk of atopy and asthma.InterpretationIn infants at high risk of allergic disease, either cow’s milk exclusion or early soya milk introduction for the first 4 months of life increases the risk of atopy, wheeze and asthma in adulthood.

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