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 .
Environmental factors and symptoms in infants at high risk of allergy.
STUDY OBJECTIVE : To identify environmental determinants of six symptoms associated with allergic disease in infancy . DESIGN : Infants were participants in a prospect i ve r and omised controlled trial of feeding practice s in families with a history of atopy . SETTING : Infants were recruited in two maternity hospitals in S Wales and followed up in the community for 1 year . PARTICIPANTS : Mothers of 519 infants agreed to participate , but 36 were excluded ( mainly for moving home or failing to attend for follow-up ) , leaving 483 in the study ( 253 male , 230 female ) . Infants were followed up and examined for evidence of allergic disease at 3 , 6 , and 12 months . MEASUREMENTS AND MAIN RESULTS : At each examination , mothers were question ed about episodes of illness in the infant , and the data presented relate to ( reported and observed ) eczema and nasal discharge , and ( reported ) wheeze , prolonged colds , diarrhoea and vomiting . Mothers kept a diary with details of feeding for the first 6 months . All homes were visited by a nurse who took sample s of dust for dust mite antigen analysis . Extensive socio-demographic data were collected . None of the factors studied showed a convincing relationship with eczema . In a multiple logistic regression analysis breast feeding appeared to protect against wheeze , nasal discharge , colds , vomiting and diarrhoea . Having more siblings increased the likelihood of prolonged colds , and ( together with overcrowding ) of wheeze and nasal discharge . Maternal smoking and low social class were associated with wheeze , and house dust antigen with prolonged colds . Respiratory symptoms were associated with some aspects of housing but these could not be distinguished clearly from other social factors . Babies born in Autumn were at increased risk of wheeze , vomiting and diarrhoea . CONCLUSIONS : Environmental factors play an important part in determining risk of symptoms in potentially atopic babies . These factors are in principle open to manipulation
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 .