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 .
Avoidance of Cow's Milk-Based Formula for At-Risk Infants Does Not Reduce Development of Celiac Disease: A Randomized Controlled Trial.
BACKGROUND & AIMS Feeding during the first months of life might affect risk for celiac disease .  Individuals with celiac disease or type 1 diabetes have been reported to have high titers of antibodies against cow 's milk proteins . Avoidance of cow 's milk-based formula for infants with genetic susceptibility for type 1 diabetes reduced the cumulative incidence of diabetes-associated autoantibodies . We performed a r and omized controlled trial in the same population to study whether weaning to an extensively hydrolyzed formula reduced the risk of celiac disease autoimmunity or celiac disease . METHODS We performed a double-blind controlled trial of 230 infants with HLA-defined predisposition to type 1 diabetes and at least 1 family member with type 1 diabetes . The infants were r and omly assigned to groups fed a casein hydrolysate formula ( n = 113 ) or a conventional formula ( control , n = 117 ) whenever breast milk was not available during the first 6 - 8 months of life . Serum sample s were collected over a median time period of 10 years and analyzed for antibodies to tissue transglutaminase ( anti-TG2A ) using a radiobinding assay , to endomysium using an immunofluorescence assay , and antibodies to a deami date d gliadine peptide using an immunofluorometry assay . Duodenal biopsies were collected if levels of anti-TG2A exceeded 20 relative units . Cow 's milk antibodies were measured during the first 2 years of life . RESULTS Of the 189 participants analyzed for anti-TG2A , 25 ( 13.2 % ) tested positive . Of the 230 study participants observed , 10 ( 4.3 % ) were diagnosed with celiac disease . We did not find any significant differences at the cumulative incidence of anti-TG2A positivity ( hazard ratio , 1.14 ; 95 % confidence interval , 0.51 - 2.54 ) or celiac disease ( hazard ratio , 4.13 ; 95 % confidence interval , 0.81 - 21.02 ) between the casein hydrolysate and cow 's milk groups . Children who developed celiac disease had increased titers of cow 's milk antibodies before the appearance of anti-TG2A or celiac disease . CONCLUSIONS In a r and omized controlled trial of 230 infants with genetic risk factors for celiac disease , we did not find evidence that weaning to a diet of extensively hydrolyzed formula compared with  cow 's milk-based formula would decrease the risk for celiac disease later in life . Increased titers of cow 's milk antibody before anti-TG2A and celiac disease indicates that subjects with celiac disease might have increased intestinal permeability in early life . Clinical Trials.gov Number : NCT00570102
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 .