REVIEW ER 'S CONCLUSIONS There is no evidence to support feeding with a hydrolysed formula for the prevention of allergy in preference to exclusive breast feeding .
In high risk infants who are unable to be completely breast fed , there is evidence that prolonged feeding with a hydrolysed compared to a cow 's milk formula reduces infant and childhood allergy and infant CMA .
BACKGROUND Allergies and food reactions are common and may be associated with foods including adapted cow 's milk formulas .
Formulas containing hydrolysed proteins have been used to treat infants with allergy or food intolerance , and have been advocated for prevention of allergy and food intolerance in infants .
OBJECTIVES To determine whether use of hydrolysed formulas for infant feeding prevents allergy and food intolerance .
If hydrolysed formulas are effective , to determine what type of hydrolysed formula is most effective including extensively and partially hydrolysed formulas .
To determine which infants benefit including infants at low or high risk of allergy and infants receiving early , short term or prolonged formula feeding .
Intolerance of cow's milk and chronic constipation in children
Background : Chronic diarrhea is the most common gastrointestinal symptom of intolerance of cow 's milk among children . On the basis of a prior open study , we hypothesized that intolerance of cow 's milk can also cause severe perianal lesions with pain on defecation and consequent constipation in young children . Methods : We performed a double-blind , crossover study comparing cow 's milk with soy milk in 65 children ( age range , 11 to 72 months ) with chronic constipation ( defined as having one bowel movement every 3 to 15 days ) . All had been referred to a pediatric gastroenterology clinic and had previously been treated with laxatives without success ; 49 had anal fissures and perianal erythoma or edema . After 15 days of observation , the patients received cow 's milk or soy milk for 2 weeks . After a one week washout period , the feedings were reversed . A response was defined as eight or more bowel movements during a treatment period . Results : Forty-four of the 65 children ( 68 percent ) had a response while receiving soy milk .  Anal fissures and pain with defecation resolved . None of the children who received cow 's milk had a response . In all 44 children with a response , the response was confirmed with a double blind challenge with cow 's milk . Children with a response had a higher frequency of coexistent rhinitis , dermatitis , or bronchospasm than those with no response ( 11 of 44 children vs. 1 of 21 , P = 0.05 ) ; they were also more likely to have anal fissures and erythema or edema at base line ( 40 of 44 vs. 9 of 21 , P < 0.001 ) , evidence of inflammation of the rectal mucosa on biopsy ( 26 of 44 vs. 5 of 21 , P = 0.008 ) , and signs of hypersensitivity , such as specific IgE antibodies to cow's-milk antigens ( 31 of 44 vs. 4 of 21 , p < 0.001 ) . Conclusions : In young children , chronic constipation can be a manifestation of intolerance of cow 's milk
REVIEW ER 'S CONCLUSIONS There is no evidence to support feeding with a hydrolysed formula for the prevention of allergy in preference to exclusive breast feeding .
In high risk infants who are unable to be completely breast fed , there is evidence that prolonged feeding with a hydrolysed compared to a cow 's milk formula reduces infant and childhood allergy and infant CMA .
BACKGROUND Allergies and food reactions are common and may be associated with foods including adapted cow 's milk formulas .
Formulas containing hydrolysed proteins have been used to treat infants with allergy or food intolerance , and have been advocated for prevention of allergy and food intolerance in infants .
OBJECTIVES To determine whether use of hydrolysed formulas for infant feeding prevents allergy and food intolerance .
If hydrolysed formulas are effective , to determine what type of hydrolysed formula is most effective including extensively and partially hydrolysed formulas .
To determine which infants benefit including infants at low or high risk of allergy and infants receiving early , short term or prolonged formula feeding .