RECOMMENDATIONS FOR SOY INFANT FORMULA - A REVIEW OF THE LITERATURE AND A SURVEY OF PEDIATRIC ALLERGISTS

Statements in the pediatric and gastroenterology literature to the eff ect that use of soybean formula should be avoided because of its high ''allergenicity'' seem to be unfounded. A review of the literature as well as personal experience in practice and with two dietary prophylac tic studies spanning 15 years suggest that the availability of soybean formula constitutes a useful contribution to our knowledge of the han dling of many nutritional problems of infants and children. The availa bility of soybean formula provides parents of infants with cow's milk allergy a nutritional food that can be used in the preparation of many kinds of food dishes and desserts to provide variety for children on restrictive diets. Over the past four decades, the use of soybean form ula as a part of a dietary prophylaxis against the development of atop y in children of allergic families has been well accepted by the vast majority of infants who have received it. A survey of pediatric allerg ists showed the limits of what can be obtained by even the least deman ding questionnaire. Given the rarity of reactions and the difficulty i n identifying a clear causal agent, the average allergist is ''overask ed'' by even a simple one-page set of questions. If anything, the wide range of answers indicates widespread confusion. A definitive answer about the existence of soybean allergies cannot be obtained without a detailed protocol for reporting and cross-validating such observations in a collaborative study. The use of soybean in infant feeding goes b ack many centuries in Chinese and Japanese cultures. In modern Japan, soy formula is commonly used either as a substitute for human breast m ilk or as a postweaning protein source in the first year of life. The first reported use of a soybean preparation for feeding infants with m ilk allergy was reported by Hill and Stuart in 1929.(1) Yet recommenda tions for soybean formula have remained controversial. We review the e vidence for and against soybean formula and present data from a survey of pediatric allergists.