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 .
Cow's milk protein intolerance in infants under 1 year of age: A prospective epidemiological study
Incidence and clinical manifestation of cow 's milk protein intolerance ( CMPI ) were studied in 1158 unselected newborn infants followed prospect ively from birth to 1 year of age . No food changes were required in 914 infants who were used as healthy controls . When CMPI was suspected ( 211 infants ) , diagnostic dietary interventions according to a st and ard protocol were performed . After exclusion of lactose intolerance , two positive cow 's milk elimination/challenge tests were considered diagnostic of CMPI . Two hundred and eleven symptomatic infants were examined for possible CMPI . A large group of 80 infants improved on a lactose reduced formula . In 87/211 infants CMPI was excluded ( sick controls ) . Finally CMPI was proven in 26 infants . The calculated incidence rate for CMPI was 2.8 % . The principal symptoms in infants with CMPI were gastrointestinal , dermatological and respiratory in 50 % , 31 % and 19 % respectively . A positive family history for atopy ( first or second degree relatives ) was more frequent in either CMPI infants ( 65 % ) , or sick controls ( 63 % ) when compared to either healthy controls ( 35 % ) or infants improving on a low lactose formula ( 51 % ) . Differences between patients with CMPI and sick controls were only found for the presence of atopy in at least 2 first degree relatives [ ( 5/26 in CMPI infants and 4/87 in sick controls ( P<0.05 ) ] and for multiorgan involvement [ 10/26 infants with CMPI as opposed to 12/87 in the sick control group ( P<0.02 ) ] . These statistical differences are too weak to be of clinical value
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 .