Potential Allergenic Ingredients in the Formulation of Infant Foods



Carbohydrates, fats, proteins, minerals and vitamins are the main ingredients found in infant foods, and may be responsible for the symptoms of allergic reactions such as anaphylaxis, eczema, hives, mucus in stools, skin rash, etc. Cows’ milk (CM), soy, partially or fully hydrolyzed protein and amino acid-based formulas are the most common infant foods on the market. Sometimes, the protein present in CM generates intolerance in babies. Some of the supplements in soy formulas may also cause infant enterocolitis or proctocolitis. In soy formulas, whey or casein protein is pre-digested to provide nitrogen in the form of a mixture of amino acids and proteins. However, this hydrolysis process may lead to other unidentified allergic reactions, and therefore, does not make the formula non-allergenic. In this chapter, the nutritional composition of different infant foods and the allergic reactions they can provoke are described and discussed.


Allergy Infant formulas Proteins 



We would like to thank the Vellore Institute of Technology, Vellore for their support and assistance in preparing this chapter.

Conflicts of Interest

The authors declare no conflict of interest.


  1. Azad, M. B., Konya, T., Guttman, D. S., Field, C. J., Sears, M. R., HayGlass, K. T., Mandhane, P. J., Turvey, S. E., Subbarao, P., Becker, A. B., Scott, J. A., Kozyrskyj, A. L., & the CHILD Study Investigators. (2015). Infant gut microbiota and food sensitization: Associations in the first year of life. Clinical & Experimental Allergy, 45(3), 632–643. Scholar
  2. Ballard, O., & Morrow, A. L. (2013). Human milk composition: Nutrients and bioactive factors. Pediatric Clinics, 60(1), 49–74. Scholar
  3. Bates, C. J., & Prentice, A. (1994). Breast milk as a source of vitamins, essential minerals and trace elements. Pharmacology & Therapeutics, 62(1–2), 193–220. Scholar
  4. Bhatia, J., Greer, F., & the Committee on Nutrition. (2008). Use of soy protein-based formulas in infant feeding. Pediatrics, 121(5), 1062–1068. Scholar
  5. Brown, E. M., Kenny, D. J., & Xavier, R. J. (2019). Gut microbiota regulation of T cells during inflammation and autoimmunity. Annual Review of Immunology, 37(1), 599–624. Scholar
  6. Chadare, F. J., Madode, Y. E., Fanou-Fogny, N., Kindossi, J. M., Ayosso, J. O., Honfo, S. H., & Hounhouigan, D. J. (2017). Indigenous food ingredients for complementary food formulations to combat infant malnutrition in Benin: A review. Journal of the Science of Food and Agriculture, 98(2), 439–455. Scholar
  7. D’Auria, E., Mandelli, M., Ballista, P., Di Dio, F., & Giovannini, M. (2011). Growth impairment and nutritional deficiencies in a cow’s milk-allergic infant fed by unmodified donkey’s milk. Case Reports in Pediatrics, 2011, 103825. Scholar
  8. de Boissieu, D., Matarazzo, P., & Dupont, C. (1997). Allergy to extensively hydrolyzed cow milk proteins in infants: Identification and treatment with an amino acid-based formula. The Journal of Pediatrics, 131(5), 744–747. Scholar
  9. Dewey, K. G., Heinig, M. J., & Nommsen-Rivers, L. A. (1995). Differences in morbidity between breast-fed and formula-fed infants. The Journal of Pediatrics, 126(5), 696–702. Scholar
  10. Feldman, W., Rosser, W., & McGrath, P. (1988). Controversies on feeding babies: A critical review. Canadian Family Physician, 34, 1199. Scholar
  11. Friel, J., Qasem, W., & Cai, C. (2018). Iron and breastfed milk. Antioxidants (Basel), 7(4), 54. Scholar
  12. Gaucheron, F. (2005). The minerals of milk. Reproduction Nutrition Development, 45(4), 473–483. Scholar
  13. Gibson, R. A., & Kneebone, G. M. (1981). Fatty acid composition of human colostrum and mature breast milk. The American Journal of Clinical Nutrition, 34(2), 252–257. Scholar
  14. Giovannini, M., D’Auria, E., Caffarelli, C., Verduci, E., Barberi, S., Indinnimeo, L., Iacono, I. D., Martelli, A., Riva, E., & Bernardini, R. (2014). Nutritional management and follow up of infants and children with food allergy: Italian Society of Pediatric Nutrition/Italian Society of Pediatric Allergy and Immunology Task Force Position Statement. Italian Journal of Pediatrics, 40(1), 1. Scholar
  15. Gonzales-González, V. A., Díaz, A. M., Fernández, K., & Rivera, M. F. (2018). Prevalence of food allergens sensitization and food allergies in a group of allergic Honduran children. Allergy, Asthma & Clinical Immunology, 14(1), 23. Scholar
  16. Grantham, R. (1974). Amino acid difference formula to help explain protein evolution. Science, 185(4154), 862–864. Scholar
  17. Gregory, N. L. (2012). The case for stock epinephrine in schools. NASN School Nurse, 27(4), 222–225. Scholar
  18. Grifantini, K. (2016). Knowing what you eat: Researchers are looking for ways to help people cope with food allergies. IEEE Pulse, 7(5), 31–34. Scholar
  19. Gupta, R. K., Gupta, K., Sharma, A., Das, M., Ansari, I. A., & Dwivedi, P. D. (2017). Maillard reaction in food allergy: Pros and cons. Critical Reviews in Food Science and Nutrition, 58(2), 208–226. Scholar
  20. Gutiérrez, T. J. (2018). Plantain flours as potential raw materials for the development of gluten-free functional foods. Carbohydrate Polymers, 202, 265–279. Scholar
  21. Hamosh, M. (2001). Bioactive factors in human milk. Pediatric Clinics of North America, 48(1), 69–86. Scholar
  22. Høst, A., & Halken, S. (2004). Hypoallergenic formulas-when, to whom and how long: After more than 15 years we know the right indication! Allergy, 59(s78), 45–52. Scholar
  23. Houghteling, P. D., & Walker, W. A. (2016). Why is initial bacterial colonization of the intestine important to Infantsʼ and Childrenʼs health? Journal of Pediatric Gastroenterology and Nutrition, 60(3), 294–307. Scholar
  24. Kazal, J. L. (2002). Prevention of iron deficiency in infants and toddlers. American Family Physician, 66(7), 1217–1224. Scholar
  25. Khadilkar, A., Khadilkar, V., Chinnappa, J., Rathi, N., Khadgawat, R., Balasubramanian, S., Parekh, B., & Jog, P. (2017). Prevention and treatment of vitamin D and calcium deficiency in children and adolescents: Indian Academy of Pediatrics (IAP) guidelines. Indian Pediatrics, 54(7), 567–573. Scholar
  26. Kilshaw, P. J., & Cant, A. J. (1984). The passage of maternal dietary proteins into human breast milk. International Archives of Allergy and Immunology, 75(1), 8–15. Scholar
  27. Lee, Y., & Sozen, E. (2016). Food allergy knowledge and training among restaurant employees. International Journal of Hospitality Management, 57(52–59), 2016. Scholar
  28. Lee, S., Noh, T. G., Choi, J. H., Han, J., Ha, J. Y., Lee, J. Y., & Park, Y. (2017). NIR spectroscopic sensing for point-of-need freshness assessment of meat, fish, vegetables and fruits. In: Sensing for agriculture and food quality and safety IX (Vol. 10217, p. 1021708). International Society for Optics and Photonics.
  29. Lönnerdal, B. (2013). Bioactive proteins in breast milk. Journal of Paediatrics and Child Health, 49(S1), 1–7. Scholar
  30. Martin, C., Ling, P. R., & Blackburn, G. (2016). Review of infant feeding: Key features of breast milk and infant formula. Nutrients, 8(5), 279. Scholar
  31. Matricardi, P. M., Dramburg, S., Alvarez-Perea, A., Antolín-Amérigo, D., Apfelbacher, C., Atanaskovic-Markovic, M., Berger, U., Blaiss, M. S., Blank, S., Boni, E., Bonini, M., Bousquet, J., Brockow, K., Buters, J., Cardona, V., Caubet, J., Cavkaytar, O., Elliott, T., Esteban-Gorgojo, I., Fonseca, J. A., Gardner, J., Gevaert, P., Ghiordanescu, I., Hellings, P., Hoffmann-Sommergruber, K., Kalpaklioglu, A. F., Marmouz, F., Calderón, A. M., Mösges, R., Nakonechna, A., Ollert, M., Oteros, J., Pajno, G., Panaitescu, C., Perez-Formigo, D., Pfaar, O., Pitsios, C., Rudenko, M., Ryan, D., Sánchez-García, S., Shih, J., Tripodi, S., Poel, L. V., Os-Medendorp, H. V., Varricchi, G., Wittmann, J., Worm, M., & Agache, I. (2019). The role of mobile health technologies in allergy care: An EAACI position paper. Allergy.
  32. Metwally, A. M., Salah El- Din, E. M., Shehata, M. A., Shaalan, A., El Etreby, L. A., Kandeel, W. A., Shaaban, S. Y., & Rabah, T. M. (2016). Early life predictors of socio-emotional development in a sample of Egyptian infants. PLoS One, 11(7), e0158086.
  33. Montagne, D. H., Van Dael, P., Skanderby, M., & Hugelshofer, W. (2009). Infant formulae-powders and liquids. In Y. Tamime (Ed.), Dairy powders and concentrated products (pp. 294–331). Scholar
  34. Newburg, D. S., & Neubauer, S. H. (1995). Chapter 4 – Carbohydrates in milks: Analysis, quantities, and significance. In R. J. Jensen (Ed.), Handbook of milk composition (pp. 273–349). Academic.
  35. O’Connor, D. L., & Brennan, J. (2006). Formulas for preterm and term infants. In P. J. Thureen & W. Hay (Eds.), Neonatal nutrition and metabolism (pp. 409–436). Cambridge University Press.Google Scholar
  36. Palmeira, P., & Carneiro-Sampaio, M. (2016). Immunology of breast milk. Revista da Associação Médica Brasileira, 62(6), 584–593. Scholar
  37. Prado, E. L., & Dewey, K. G. (2014). Nutrition and brain development in early life. Nutrition Reviews, 72(4), 267–284. Scholar
  38. Roncada, P., Piras, C., Soggiu, A., Turk, R., Urbani, A., & Bonizzi, L. (2012). Farm animal milk proteomics. Journal of Proteomics, 75(14), 4259–4274. Scholar
  39. Ross, S. W., Brand, J. C., Thorburn, A. W., & Truswell, A. S. (1987). Glycemic index of processed wheat products. The American Journal of Clinical Nutrition, 46(4), 631–635. Scholar
  40. Shim, J. S., Oh, K., & Kim, H. C. (2014). Dietary assessment methods in epidemiologic studies. Epidemiology and Health, 36, e2014009. Scholar
  41. Sicherer, S. H., & Sampson, H. A. (2014). Food allergy: Epidemiology, pathogenesis, diagnosis, and treatment. Journal of Allergy and Clinical Immunology, 133(2), 291–307. Scholar
  42. Simons, F. E. R. (2006). Anaphylaxis, killer allergy: Long-term management in the community. Journal of Allergy and Clinical Immunology, 117(2), 367–377. Scholar
  43. Tekin, M., Cengiz, M. F., Abbasov, M., Aksoy, A., Canci, H., & Akar, T. (2018). Comparison of some mineral nutrients and vitamins in advanced hulled wheat lines. Cereal Chemistry, 95(3), 436–444. Scholar
  44. Thomas, N., Lähdesmäki, I., & Parviz, B. A. (2012). An electro-enzymatic flexible molecular lactate sensor. In: 2012 7th IEEE International Conference on Nano/Micro Engineered and Molecular Systems (NEMS). (pp. 398–402). IEEE.
  45. Thompson, T., Kane, R. R., & Hager, M. H. (2006). Food allergen labeling and consumer protection act of 2004 in effect. Journal of the Academy of Nutrition and Dietetics, 106(11), 1742–1744. Scholar
  46. U. S. Food and Drug Administration (FDA). (2013). Food Code. Available in:
  47. Venter, C. (2009). Infant atopy and allergic diseases: An introduction to dietary aspects: In the first of a two-part learning file on infant food allergy, Dr Carina Venter reviews the dietary prevention of allergic diseases in infants and the dietary management of atopic infants. Jounal of Family Health Care, 19(3), 92–96. Gale Academic Onefile database. Available in:
  48. Welsh, J. K., & May, J. T. (1979). Anti-infective properties of breast milk. The Journal of Pediatrics, 94(1), 1–9. Scholar
  49. Wen, L. M., Baur, L. A., Rissel, C., Alperstein, G., & Simpson, J. M. (2009). Intention to breastfeed and awareness of health recommendations: Findings from first-time mothers in Southwest Sydney, Australia. International Breastfeeding Journal, 4(1), 9. Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Biotechnology, School of Bioscience & TechnologyVellore Institute of Technology (VIT)VelloreIndia
  2. 2.Instrumental & Food Analysis Laboratory, Industrial Biotechnology Division, School of Bioscience & TechnologyVellore Institute of Technology (VIT)VelloreIndia

Personalised recommendations