THE LONG-TERM EFFECT OF A PARTIAL WHEY HYDROLYSATE FORMULA ON THE PROPHYLAXIS OF ATOPIC DISEASE

At the age of 5 years, the prevalence of atopic manifestations was ana lysed in 58 formula-fed ''at risk'' infants because of a history of at opic disease in at least two first degree relatives. Infants were rand omly assigned to receive either a partial whey-hydrolysate formula (n: 28) or a regular cow's milli formula (n: 30) during the first 6 month s of life; thereafter, feeding was unrestricted. Only non-breastfed in fants were included. The groups did not differ in risk factors or in k nown confounding factors possibly influencing the incidence of manifes tations suggestive of atopic disease. At 6 months, the prevalence of c ow's milk protein (CMP) sensitivity was significantly decreased in the hydrolysate group (7% versus 43%; P: 0.002). At the age of 12 (21% ve rsus 53%; P: 0.029), 36 (25% versus 57%; P: 0.018) and 60 months (29% versus 60%; P: 0.016) there was still a significant difference in the number of atopic manifestations, if calculated cumulatively. There was no difference between the groups if only the new cases after the age of 6 months were considered. Eczema was less frequent in the whey-hydr olysate group, but only during the Ist year of life, suggesting a decr eased prevalence of CMP sensitivity. During the first 6 months, diarrh oea of non-infectious origin occurred in 8/30 infants (27%) of the ada pted formula group, and in no infant in the hydrolysate group. ''Colic as single manifestation'' was considered of ''allergic'' origin in 1/ 28 infants in the hydrolysate group, and in 4/30 infants in the adapte d formula group. If gastro-intestinal symptoms such as ''diarrhoea and colic as single manifestation'' are not considered, the number of inf ants with CMP sensitivity remains only significant for the first 6 mon ths (P: 0.004). At 12, 36 and 60 months, differences are not significa nt (0.106, 0.116 and 0.07, respectively). The results of this study su pport the hypothesis that allergy prevention is antigen specific. Conc lusion If mother's milk is not available and other studies confirm the se results, there might be an indication for partial hydrolysates in i nfants with a family history of atopy, since these formulae reduce the incidence of CMP sensitivity.