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 .
Effect of maternal diet during lactation on development of bovine insulin-binding antibodies in children at risk for allergy.
BACKGROUND The role of exposure to dietary antigens through maternal milk is intriguing , because it may result either in immunization or in tolerance . Exposure to cow 's milk proteins results in antibody formation against bovine insulin in infants at risk for type 1 diabetes . OBJECTIVE To study the appearance of IgG antibodies to bovine and human insulin in infants with an atopic family history whose mothers followed a cow 's milk-free diet during the first 3 months of lactation . METHODS In a prospect i ve cohort study on prevention of food allergies , 123 infants were exclusively breast-fed or received supplementation with a hydrolyzed casein-based formula ( Nutramigen ) until the age of 6 months . The mothers either avoided cow 's milk during the first 3 months of lactation ( diet group ) or had an unrestricted diet ( nondiet group ) . The levels of IgG antibodies to bovine and human insulin were determined by enzyme immunoassay at 3 , 6 , 12 , and 18 months and at 4 years . In addition , cord blood was obtained at birth and a maternal sample at delivery . RESULTS At 3 months , IgG antibodies to bovine insulin were low in both dietary groups ( median levels 0.150 and 0 . 114 optical density units in the diet and nondiet groups ) . After exposure to dietary insulin , IgG antibodies to bovine insulin increased in both groups , reaching a peak at 12 months in the nondiet group and at 18 months in the diet group . At 18 months , IgG antibodies to bovine insulin were lower in infants in the nondiet group than in infants in the diet group ( 0.287 vs 0.500 , P<.0001 ) . At 4 years , the antibodies no longer differed between the groups . CONCLUSION The exposure to cow 's milk proteins through breast milk during the first 3 months of life result ed in decreased levels of antibodies to dietary bovine insulin at 18 months of age , suggesting a role for breast milk antigens in early tolerance induction
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 .