Breast milk alternative may prevent food allergies

Posted on: Tue, 09/13/2005 - 8:15am
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Tue Sep 13, 2005 10:39 AM ET

By Charnicia E. Huggins
NEW YORK (Reuters Health) - Using hydrolyzed casein or whey formulas when breast milk is inadequately produced may help prevent at-risk infants from developing allergies, according to a review of studies on the topic.

"Both partially hydrolyzed whey formulas and extensively hydrolyzed casein formulas have been shown to reduce the incidence of allergy in high risk infants," study author Tiffani Hays told Reuters Health.

Hays, a senior pediatric nutritionist at Johns Hopkins Children's Center in Baltimore, Maryland, recommends that these two types of formula be used by mothers who are "unable to breast feed," or those who need "to supplement breast feeding and ... are interested in reducing their child's risk of developing allergies."

Infants with at least one parent with allergies are at high risk of developing the condition and those with either both parents or a parent and a sibling who are affected are up to 70 percent more likely to develop an allergy than other infants.

According to published reports, food allergy, currently experienced by up to 6 percent of young children and infants, seems to be on the rise among this population, especially in developed countries. Hays' own child had food allergies as a youngster, as did other students in the school, she told Reuters Health. Most children outgrow food allergies, as her son did, Hays said, but the ones who do not outgrow the condition tend to have severe reactions, which, in some cases, can be life threatening.

Hydrolysate formulas, which have a lower-molecular weight than cow's milk formulas, were developed as an alternative to formulas with intact milk or soy proteins, for infants at risk of food allergy. Such formulas have traditionally been used to treat food allergies and intolerance, but are now also used to prevent allergic disease in high-risk infants.

Hays, and co-author Dr. Robert A. Wood, reviewed nine studies on the use of extensively hydrolyzed formulas, 12 studies on the use of partially hydrolyzed formulas in infants at high-risk of food allergy and one study that examined the use of partially hydrolyzed formulas among a general sample of infants. The studies compared hydrolyzed formulas to breastfeeding, cow's milk, soy-based formulas or some combination of these products.

In most cases, high-risk infants who consumed extensively hydrolyzed casein formulas or partially hydrolyzed whey formulas had a lower rate of food allergy for up to 5 years after birth than did those fed cow's milk-based formulas, Hays and Wood report in this month's issue of Archives of Pediatrics and Adolescent Medicine.

And, they report, none of the studies found an increased risk of allergy among infants fed any type of hydrolyzed formula.

"We should be able to decrease the incidence of allergy by choosing these formulas when breast feeding is insufficient or not chosen," Hays told Reuters Health.

Various types of extensively hydrolyzed casein formulas, recommended for allergy prevention by the American Academy of Pediatrics, the European Society for Paediatric Allergology and Clinical Immunology and the Europeans Society for Paediatric Gastroenterology, Hepatology and Nutrition, are available in the United States.
These formulas have been shown to relieve symptoms in more than 9 out of 10 infants with allergies to cow's milk, yet, Hays explained, they are typically more expensive and have an "altered taste," in comparison to cow milk preparations.

Partially hydrolyzed whey formulas, on the other hand, are also accessible and "are available in the United States as starter infant formulas with comparable taste and cost to intact cow milk formulas," according to Hays, "so a parent can choose this formula to supplement breast milk without any additional risks."

Yet, partially hydrolyzed formulas may not be an option for parents who suspect their infant may already have a food allergy. Children with allergies "could potentially still react" to such formulas, Hays said, emphasizing that partially hydrolyzed formulas are "not for treatment, they were designed for prevention, but (extensively hydrolyzed formulas) can be used for both."

Overall, Hays advises that families with a history of allergy should, first and foremost, consider breastfeeding infants for the first 12 months after birth.

If, however, mothers decide against breast feeding, or do not produce sufficient breast milk, and want to reduce their infant's risk of food allergy, she recommends that families choose "the partially hydrolyzed whey formula with delayed introduction of solid foods until after 6 months of age, and delayed introduction of the major allergens such as milk, egg, soy, peanut, nuts and shellfish until after 1 year of age."

SOURCE: Archives of Pediatrics and Adolescent Medicine, September 2005.

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