We found no evidence to support short-term or prolonged feeding with a hydrolysed formula compared with exclusive breast feeding for prevention of allergic disease .
Very low- quality evidence indicates that short-term use of an EHF compared with a CMF may prevent infant CMA .
Further trials are recommended before implementation of this practice .We found no evidence to support prolonged feeding with a hydrolysed formula compared with a CMF for prevention of allergic disease in infants unable to be exclusively breast fed
BACKGROUND Infant formulas containing hydrolysed proteins have been widely advocated for preventing allergic disease in infants , in place of st and ard cow 's milk formula ( CMF ) .
However , it is unclear whether the clinical trial evidence supports this .
OBJECTIVES To compare effects on allergic disease when infants are fed a hydrolysed formula versus CMF or human breast milk .
If hydrolysed formulas are effective , to determine what type of hydrolysed formula is most effective , including extensively or partially hydrolysed formula ( EHF/PHF ) .
To determine whether infants at low or high risk of allergic disease , and whether infants receiving early short-term ( first few days after birth ) or prolonged formula feeding benefit from hydrolysed formulas .
Dietary manipulation of beta cell autoimmunity in infants at increased risk of type 1 diabetes: a pilot study
Aims /hypothesisWe aim ed to assess the feasibility of a dietary intervention trial with weaning to hydrolysed formula in infants at increased risk of type 1 diabetes and to study the effect of the intervention on the emergence of diabetes-associated autoantibodies in early childhood . Methods We studied 242 newborn infants who had a first-degree relative with type 1 diabetes and carried risk-associated HLA-DQB1 alleles . After exclusive breastfeeding , the infants underwent a double-blind , r and omised pilot trial of either casein hydrolysate ( Nutramigen ; Mead Johnson ) or conventional cow ’s milk-based formula  until the age of 6–8 months . During a mean observation period of 4.7 years , autoantibodies to insulin , anti-glutamic acid decarboxylase and insulinoma-associated antigen-2 were measured by radiobinding assays , and islet cell antibodies ( ICA ) by immunofluorescence . Results The feasibility of screening and identifying a cohort of first-degree relatives with HLA-conferred disease susceptibility , enrolling them in a dietary intervention trial and following them for seroconversion to autoantibody positivity is established . The cumulative incidence of autoantibodies was somewhat smaller in the casein hydrolysate vs control formula group , suggesting the need for a larger well-powered study . After adjustment for duration of study formula feeding , life-table analysis showed a significant protection by the intervention from positivity for ICA ( p=0.02 ) and at least one autoantibody ( p=0.03 ) . Conclusions /interpretationThe present study provides the first evidence ever in man , despite its limited power , that it may be possible to manipulate spontaneous beta cell autoimmunity by dietary intervention in infancy
We found no evidence to support short-term or prolonged feeding with a hydrolysed formula compared with exclusive breast feeding for prevention of allergic disease .
Very low- quality evidence indicates that short-term use of an EHF compared with a CMF may prevent infant CMA .
Further trials are recommended before implementation of this practice .We found no evidence to support prolonged feeding with a hydrolysed formula compared with a CMF for prevention of allergic disease in infants unable to be exclusively breast fed
BACKGROUND Infant formulas containing hydrolysed proteins have been widely advocated for preventing allergic disease in infants , in place of st and ard cow 's milk formula ( CMF ) .
However , it is unclear whether the clinical trial evidence supports this .
OBJECTIVES To compare effects on allergic disease when infants are fed a hydrolysed formula versus CMF or human breast milk .
If hydrolysed formulas are effective , to determine what type of hydrolysed formula is most effective , including extensively or partially hydrolysed formula ( EHF/PHF ) .
To determine whether infants at low or high risk of allergic disease , and whether infants receiving early short-term ( first few days after birth ) or prolonged formula feeding benefit from hydrolysed formulas .