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 .
Effect of environmental manipulation in pregnancy and early life on respiratory symptoms and atopy during first year of life: a randomised trial
BACKGROUND Asthma places huge dem and s on health-care services , and its prevalence is increasing . Reduction of exposure to environmental allergens could offer a realistic chance for primary prevention . Our aim was to ascertain whether or not living in a low-allergen environment reduces the risk of  asthma and atopic diseases in infants . METHODS We assigned infants to four risk groups according to parental atopic status . We enrolled 291 high-risk couples ( both parents atopic , no pets ) into a prospect i ve , prenatally r and omised , cohort study , and allocated them to environmental manipulation , in which measures to reduce prenatal and postnatal allergen exposure were undertaken ( active HRA ) ( n=145 ) or no intervention ( control HRC ) ( n=146 ) . Two further prospect i ve groups were studied : 161 high-risk infants with pets in the home ( HRP group ) and 168 low-risk infants , whose parents were both non-atopic ( LR group ) . The main outcome measures were signs and symptoms of atopic disease at 1 year of age . FINDINGS 103 families dropped out or were lost to follow up . At age 1 year we followed-up 133 HRA , 118 HRC , 140 HRP , and 126 LR infants . Children in the HRA group were less likely to have respiratory symptoms during the first year of life than those in the HRC group . The most pronounced differences were in the relative risks for severe wheeze with shortness of breath ( relative risk 0.44 [ 95 % CI 0.20 - 1.00 ] ) , prescribed medication for the treatment of wheezy attacks ( 0.58 [ 0.36 - 0.95 ] ) , and wheezing after vigorous playing , crying , or exertion ( 0.18 [ 0.04 - 0.79 ] ) . Probability of respiratory symptoms in HRC and HRP infants was similar , whereas it was much lower in the LR than in the HRC group . Cat ownership was significantly associated with sensitisation to cats ( 24.6 [ 3.04 - 199.05 ] ; p=0.003 ) . INTERPRETATION Environmental manipulation reduces some respiratory symptoms in the first year of life in high-risk infants . Further follow up is needed , however , to ascertain whether living in a low-allergen environment reduces allergy and asthma in later life
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 .