Specialty Infant Formulas for Milk Allergy: Current Choices and Unmet Needs
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Purpose of Review
Literature on the different options for the management of cow’s milk allergy (CMA) was reviewed. Literature was searched using databases to find original papers and reviews on this topic.
Amino acid based infant formula (AAF) is the most effective dietary treatment of CMA. However, because of the high cost, guidelines recommend extensively hydrolyzed formula (eHF) with a clinical proof of efficacy as the first choice option. In many parts of the world, rice hydrolysates are an alternative option. Soy infant formula can sometimes still be considered, in the absence of more suitable products. Yet, about 10 to 15% of infants allergic to cow milk will also react to soy. Thickened eHF and AAF may be helpful in infants presenting also with troublesome regurgitation. Partially hydrolyzed formula or infant formula with intact protein from other animals is no option. Finally, oral immune therapy is indicated in some children with persistent CMA.
eHF remains the first option for the treatment of most patients with CMA. Recent data on induction of oral tolerance in CMA infants are interesting and deserve further research.
KeywordsCow milk (protein) allergy Extensively hydrolyzed formula Amino acid formula
Compliance with Ethical Standards
Conflict of Interest
Y Vandenplas has participated as a clinical investigator, and/or advisory board member, and/or consultant, and/or speaker for Abbott Nutrition, Biocodex, CHR Hansen, Danone, Nestle Health Science, Nestle Nutrition Institute, Nutricia, Mead Johnson Nutrition, Schär, United Pharmaceuticals, Wyeth. S Nutten is a Nestec Ltd. employee.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
References and Recommended Reading
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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