scholarly journals Partially Hydrolyzed Whey Protein: A Review of Current Evidence, Implementation, and Further Directions

2021 ◽  
Vol 5 (1) ◽  
pp. 53
Author(s):  
Badriul Hegar ◽  
Zakiudin Munasir ◽  
Ahmad Suryawan ◽  
I gusti Lanang Sidhiarta ◽  
Ketut Dewi Kumara Wati ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Infant Formula ◽  
Allergic Disease ◽  
Intact Protein ◽  
Current Evidence ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Breastfed Infants ◽  
Functional Gi Disorders

Background: Human milk is known to be the best nutrition for infants as it provides many health benefits. For non-breastfed infants, cow's milk based infant formula is the most optimal option to provide the needed nutrition. However, approximately 2-5% of all formula-fed infants experience cow’s milk allergy during their first year of life. Partially hydrolyzed whey formula (pHF-W) have been widely recommended to prevent the development of allergic disease in infants. However, according to epidemiological data, approximately half of the infants developing allergy are not part of the at-risk group.Objectives and Methods: This article aims to review the effects of pHF-W in preventing allergy, especially atopic disease, in all non-breastfed infants, as well as the safety aspect of pHF-W if used as routine formula. The role of pHF-W in the management of functional gastro-intestinal (GI) disorders is also reviewed.Results: Several clinical studies showed that pHF-W decrease the number of infants with eczema. The strongest evidence is provided by the 15-year follow up of the German Infant Nutritional Intervention study which showed reduction in the cumulative incidence of eczema and allergic rhinitis in pHF-W (OR 0.75, 95% CI 0.59-0.96 for eczema; OR 0.67, 95% CI 0.47-0.95 for allergic rhinitis) and casein extensively hydrolysed formula  group (OR 0.60, 95% CI 0.46-0.77 for eczema; OR 0.59, 95% CI 0.41-0.84 for allergic rhinitis), compared to CMF as a control, after 15 years of follow-up. pHF-W was also found to be beneficial in the management of functional GI disorders such as regurgitation, constipation and colic.Conclusions: The use of pHF-W in allergic infants has been recommended in various guidelines across the countries, as a primary prevention of allergic disease. One pHF-W has been approved by the US FDA and the European Commission's European Food Safety Authority (EFSA) for its safety and suitability as a routine infant formula for all healthy infants. According to the data obtained in the management of functional GI disorders, pHF-W is better tolerated than formula with intact protein. Further studies assessing the effect of routine use of pHF-W in a larger population of non-breastfed infants should also be conducted, in order to observe any potential harm and to determine the benefit and cost-effectiveness ratio.

Current evidence on the associations of breastfeeding, infant formula, and cow's milk introduction with type 1 diabetes mellitus: a systematic review

2012 ◽  
Vol 70 (9) ◽  
pp. 509-519 ◽  
Author(s):  
Evridiki Patelarou ◽  
Charis Girvalaki ◽  
Hero Brokalaki ◽  
Athena Patelarou ◽  
Zacharenia Androulaki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Infant Formula ◽  
Current Evidence ◽  
Cow’S Milk ◽  
Cow's Milk

scholarly journals A Pooled Analysis of Growth and Tolerance of Infants Exclusively Fed Partially Hydrolyzed Whey or Intact Protein-Based Infant Formulas

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Laura A. Czerkies ◽  
Brian D. Kineman ◽  
Sarah S. Cohen ◽  
Heidi Reichert ◽  
Ryan S. Carvalho
Keyword(s):  
Infant Formula ◽  
Pooled Analysis ◽  
Stool Frequency ◽  
Stool Consistency ◽  
Intact Protein ◽  
Cow’S Milk ◽  
Lower Probability ◽  
Infant Formulas ◽  
Cow's Milk ◽  
Significant Difference

Background. For infants who are partially or exclusively fed infant formula, many options exist with compositional differences between formulas making choices difficult for caregivers and healthcare professionals. The protein in routine infant formulas differs by the source, fraction of cow’s milk protein used, and degree of hydrolysis. All commercially available regulated infant formulas support growth and development, but different stool patterns have been observed based on formula composition. A pooled analysis of seven clinical trials was conducted to examine growth, stool consistency, and stool frequency of infants fed an intact cow’s milk-based formula (CMF) or a partially hydrolyzed whey formula (PHF-W) from a single manufacturer. Methods. Individual subject data from seven infant formula growth studies (3 CMF, 4 PHF-W) were pooled and analyzed. All studies included healthy, full-term, formula-fed infants enrolled at 14 days of age with outcomes assessed over 4 months. Gains in weight and length to 4 months were analyzed using linear regression accounting for clustering within study. Outcomes of caregiver-reported stool consistency and frequency were analyzed using a longitudinal multinomial model. Results. Data from 511 infants were included (197 CMF, 314 PHF-W). There were no differences in weight gain between groups. There was no difference in length gain in girls fed PHF-W while boys fed PHF-W had a significant difference of +0.016 cm/month compared to boys fed CMF. Infants fed PHF-W had a significantly higher probability of soft and lower probability of hard stools as compared to infants fed CMF at each time point (p<0.001). Stool frequency was similar between groups. Conclusions. Infants fed CMF and PHF-W exhibit appropriate growth with comparable gains in weight and length through 4 months. More soft and fewer hard stools are observed in infants fed PHF-W compared to CMF. This difference could help to inform decision-making when choosing an infant formula.

Follow-up or Weaning Formulas

PEDIATRICS ◽  
1989 ◽  
Vol 83 (6) ◽  
pp. 1067-1067
Author(s):  
Keyword(s):  
United States ◽  
Breast Milk ◽  
Infant Formula ◽  
Breast Feeding ◽  
Infant Nutrition ◽  
The United States ◽  
Solid Food ◽  
Cow’S Milk ◽  
Cow's Milk

A high level of success in infant nutrition has been achieved in the United States by breast-feeding as preferred, or by feeding with iron-fortified infant formulas. Minor controversies about feeding choices occur when infants are weaned from an all liquid diet to one containing a variety of solid foods. Weaning is not a single event but a process that takes place throughout a number of months, beginning optimally between 4 and 6 months of age. The nutritional objective is to achieve a varied diet with approximately 35% to 50% of energy coming from sources other than breast milk or infant formula. Variety remains the key to the diet, particularly for infants older than 6 months of age. Solid food must provide an adequate source of iron, trace minerals, and vitamins to replace and supplement those in that portion of breast milk or formula removed from the diet. Breast milk and fortified infant formula continue to be optimal for the milk segment of the diet during the second 6 months of life. The mother may choose to stop breast-feeding for a variety of reasons, however. The Committee on Nutrition has indicated that cow's milk could be substituted in the second 6 months of age provided that (1) the amount of milk calories consumed does not exceed 65% of total calories and (2) the solid food portion of the diet replace the iron and vitamins deficient in cow's milk. Recently "follow-up" feedings (formulas) have been marketed in the United States as they have been in Europe for many years.

MARKERS OF COW’S MILK ALLERGY PERSISTENCE: RESULTS OF A 5-YEAR FOLLOW-UP

2020 ◽  
Vol 99 (2) ◽  
pp. 88-95
Author(s):  
S.G. Makarova ◽  
◽  
A.A. Galimova ◽  
A.P. Fisenko ◽  
O.A. Ereshko ◽  
...  
Keyword(s):  
Cow’S Milk Allergy ◽  
Cow’S Milk ◽  
Milk Allergy ◽  
Cow's Milk ◽  
Cow's Milk Allergy

The Use of Whole Cow's Milk in Infancy

PEDIATRICS ◽  
1992 ◽  
Vol 89 (6) ◽  
pp. 1105-1109 ◽  
Author(s):  
Keyword(s):  
Breast Milk ◽  
American Academy ◽  
Infant Formula ◽  
Iron Status ◽  
The United States ◽  
Cow’S Milk ◽  
Cow's Milk ◽  
Solid Foods ◽  
American Academy Of Pediatrics ◽  
Iron Deficient

The pediatrician is faced with a difficult challenge in providing recommendations for optimal nutrition in older infants. Because the milk (or formula) portion of the diet represents 35% to 100% of total daily calories and because WCM and breast milk or infant formula differ markedly in composition, the selection of a milk or formula has a great impact on nutrient intake. Infants fed WCM have low intakes of iron, linoleic acid, and vitamin E, and excessive intakes of sodium, potassium, and protein, illustrating the poor nutritional compatibility of solid foods and WCM. These nutrient intakes are not optimal and may result in altered nutritional status, with the most dramatic effect on iron status. Infants fed iron-fortified formula or breast milk for the first 12 months of life generally maintain normal iron status. No studies have concluded that the introduction of WCM into the diet at 6 months of age produces adequate iron status in later infancy; however, recent studies have demonstrated that iron status is significantly impaired when WCM is introduced into the diet of 6-month-old infants. Data from studies abroad of highly iron-deficient infant populations suggest that infants fed partially modified milk formulas with supplemental iron in a highly bioavailable form (ferrous sulfate) may maintain adequate iron status. However, these studies do not address the overall nutritional adequacy of the infant's diet. Such formulas have not been studied in the United States. Optimal nutrition of the infant involves selecting the appropriate milk source and eventually introducing infant solid foods. To achieve this goal, the American Academy of Pediatrics recommends that infants be fed breast milk for the first 6 to 12 months. The only acceptable alternative to breast milk is iron-fortified infant formula. Appropriate solid foods should be added between the ages of 4 and 6 months. Consumption of breast milk or iron-fortified formula, along with age-appropriate solid foods and juices, during the first 12 months of life allows for more balanced nutrition. The American Academy of Pediatrics recommends that whole cow's milk and low-iron formulas not be used during the first year of life.

Gastroduodenal Motility in Neonates: Response to Human Milk Compared With Cow's Milk Formula

PEDIATRICS ◽  
1987 ◽  
Vol 80 (3) ◽  
pp. 434-438
Author(s):  
T. Tomomasa ◽  
P. E. Hyman ◽  
K. Itoh ◽  
J. Y. Hsu ◽  
T. Koizumi ◽  
...  
Keyword(s):  
Breast Milk ◽  
Human Milk ◽  
Infant Formula ◽  
High Amplitude ◽  
Cow’S Milk ◽  
Milk Formula ◽  
Wave Form ◽  
Fasting State ◽  
Cow's Milk ◽  
Gastroduodenal Motility

It is known that breast milk empties more quickly from the stomach than does infant formula. We studied the difference in gastroduodenal motility between neonates fed with human milk and those fed with infant formula. Twenty-four five-to 36-day-old neonates were fed with mother's breast milk or with a cow's milk-based formula. Postprandlial gastroduodenal contractions were recorded manometrically for three hours. Repetitive, high-amplitude nonmigrating contractions were the dominant wave form during the postprandial period. The number of episodes, duration, amplitude, and frequency of nonmigrating contractions were not different following the different feedings. The migrating myoelectric complex, which signals a return to the interdigestive (fasting) state, appeared in 75% of breast milk-fed infants but only 17% of formula-fed infants (P &lt; .05) within the three-hour recording period. Because contractions were similar following the two meals, but a fasting state recurred more rapidly in breast-fed infants, we conclude that factors other than phasic, nonpropagated antroduodenal contractions were responsible for the differences in gastric emptying between breast milk and formula.

scholarly journals The Role of Hydrolyzed Formula in Allergy Prevention

2017 ◽  
Vol 70 (Suppl. 2) ◽  
pp. 38-45 ◽  
Author(s):  
Michael D. Cabana
Keyword(s):  
Allergic Rhinitis ◽  
Food Allergy ◽  
Infant Formula ◽  
Allergic Disease ◽  
Clinical Studies ◽  
Atopic Disease ◽  
Allergy Prevention ◽  
Preventive Effect ◽  
History Of ◽  
Hydrolyzed Formula

Asthma, eczema, food allergy, and allergic rhinitis are some of the most common pediatric, chronic conditions in the world. Breastfeeding is the optimal way to feed all infants. For those infants who are exposed to infant formula, some studies suggest that certain partially hydrolyzed or extensively hydrolyzed formulas may decrease the risk of allergic disease compared to nonhydrolyzed formulas for children with a family history of atopic disease. Overall, there is some evidence to suggest that partially hydrolyzed whey formulas and extensively hydrolyzed casein formulas may decrease the risk of developing eczema for infants at high risk of allergic disease. The evidence for a preventive effect of hydrolyzed formulas on allergic rhinitis, food allergy, and asthma is inconsistent and insufficient. Finally, the qualitative changes to the peptides by the method of hydrolysis, not just the degree of protein hydrolysis, may have a large influence on the preventive effect of a particular infant formula for the potential risk of allergic disease. As a result, it may be difficult to generalize findings from clinical studies using a specific infant formula to other infant formulas from different manufacturers using different methods of hydrolysis. Further clinical studies are needed to help clinicians identify which infants may benefit from early intervention, as well as which specific hydrolyzed formulas are best suited to decrease the risk of future allergic disease.

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