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 .
Manchester Asthma and Allergy Study: low-allergen environment can be achieved and maintained during pregnancy and in early life.
BACKGROUND Early exposure to dust mite allergens may be critical for primary sensitization . Reducing exposure may offer a realistic chance for primary prevention of sensitization and asthma , but it is essential to implement measures that can achieve and maintain the low-allergen environment . OBJECTIVE Our purpose was to assess the effectiveness of mite allergen avoidance measures in achieving and maintaining a low-allergen environment during pregnancy and in the first year of life . METHODS The Manchester Asthma and Allergy Study is a prospect i ve , prenatally r and omized study that follows the development of asthma and atopy in a cohort of infants at high risk ( both parents atopic ) who are r and omly allocated to full mite allergen avoidance or to a normal regimen . Avoidance measures comprise ( 1 ) mite-proof covers ( mattress , pillow , and quilt ) for parental bed , ( 2 ) high-filtration vacuum cleaner , ( 3 ) vinyl flooring in infant 's bedroom , ( 4 ) new crib and portable crib mattresses encased in mite-proof material , ( 5 ) benzyl benzoate ( Acarosan ) applied on carpets and soft furniture , ( 6 ) bed linens washed in hot water weekly , and ( 7 ) washable soft toys . Dust sample s from the parental bed , bedroom floor , living room floor , infant 's mattress , and nursery floor were collected between the 10th and 14th weeks of pregnancy , immediately after birth , and then at age 6 months and 1 year , and Der p 1 levels were determined by mAb-based ELISA . RESULTS Recovered Der p 1 from maternal mattress was reduced by 97 . 25 % ( 95 % confidence interval [ CI ] 95.25%-98.41 % ) during the second and third trimesters of pregnancy , with the effect persisting for 6 months ( 98 % reduction , 95 % CI 97.25%-99.1 % ) and 12 months ( 97.6 % reduction , 95 % CI 95.7%-98.6 % ) after the birth ( active vs control , P < .000001 ) . Total Der p 1 from bedroom floor in the active group was reduced by 53.7 % ( 95 % CI 25.7%-71.2 % ) in sample s collected within 4 weeks of the child 's birth , with the percentage reduction being 62 . 8 % ( 95 % CI 39.3%-77.2 % ) at 6 months and 26.5 % ( 95 % CI -24 % to 57.1 % ) at 1 year ( active compared vs control , P < .007 ) . Der p 1 levels in crib mattress and nursery floor in the active group were extremely low ( crib mattresses geometric mean [ 95 % CI ] 2.3 ng [ 1.6 - 3.4 ] at birth , 6.8 ng [ 4.5 - 10 ] at age 6 months , and 15.6 ng [ 9.8 - 24.8 ] at age 1 year [ active vs control , P = .001 ] ; nursery 1 ng [ 0.9 - 1.1 ] at birth , 1.7 ng [ 1.2 - 2.5 ] at age 6 months , and 2 ng [ 1.3 - 3.5 ] at age 1 year [ active vs control , P < .00001 ] ) . The total amount of allergen recovered at age 1 year was 29-fold ( 95 % CI 15.1- to 56.7-fold ) higher in the control group than in the active group . CONCLUSIONS The avoidance measures used in this study achieved and maintained a low mite allergen environment during pregnancy and in the first year of life in homes of infants at risk of atopy
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 .