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 .
Dietary intervention in infancy and later signs of beta-cell autoimmunity.
BACKGROUND Early exposure to complex dietary proteins may increase the risk of beta-cell autoimmunity and  type 1 diabetes in children with genetic susceptibility . We tested the hypothesis that supplementing breast milk with highly hydrolyzed milk formula would decrease the cumulative incidence of diabetes-associated autoantibodies in such children . METHODS In this double-blind , r and omized trial , we assigned 230 infants with HLA-conferred susceptibility to type 1 diabetes and at least one family member with type 1 diabetes to receive either a casein hydrolysate formula or a conventional , cow's-milk-based formula ( control ) whenever breast milk was not available during the first 6 to 8 months of life . Autoantibodies to insulin , glutamic acid decarboxylase ( GAD ) , the insulinoma-associated 2 molecule ( IA-2 ) , and zinc transporter 8 were analyzed with the use of radiobinding assays , and islet-cell antibodies were analyzed with the use of immunofluorescence , during a median observation period of 10 years ( mean , 7.5 ) . The children were monitored for incident type 1 diabetes until they were 10 years of age . RESULTS The unadjusted hazard ratio for positivity for one or more autoantibodies in the casein hydrolysate group , as compared with the control group , was 0.54 ( 95 % confidence interval [ CI ] , 0.29 to 0.95 ) , and the hazard ratio adjusted for an observed difference in the duration of exposure to the study formula was 0.51 ( 95 % CI , 0.28 to 0.91 ) . The unadjusted hazard ratio for positivity for two or more autoantibodies was 0.52 ( 95 % CI , 0.21 to 1.17 ) , and the adjusted hazard ratio was 0.47 ( 95 % CI , 0.19 to 1.07 ) . The rate of reported adverse events was similar in the two groups . CONCLUSIONS Dietary intervention during infancy appears to have a long-lasting effect on markers of beta-cell autoimmunity -- markers that may reflect an autoimmune process leading to type 1 diabetes . ( 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 .