EFFICACY AND SAFETY OF HYDROLYZED COW MILK AND AMINO ACID-DERIVED FORMULAS IN INFANTS WITH COW MILK ALLERGY

Objective: To determine the antigenicity, nutritional adequacy, and gr owth-promoting efficacy of protein hydrolysate or amino acid-derived f ormulas in infants with cow milk allergy. Study design: Several protei n hydrolysate or amino acid-derived formulas were graded for beta-lact oglobulin content and skin reactivity in 74 atopic children with cow m ilk allergy proved by a double-blind, placebo-controlled challenge, A randomized, prospective follow-up study of 9 months included 22 infant s with a mean age of 6 months (95% confidence interval, 4 to 7), who w ere fed an extensively hydrolyzed whey formula (group W-e), and 23 inf ants with a mean age of 7 (95% confidence interval, 4 to 7) months, wh o were given an amino acid-derived formula (group AA), Results: Both f ormulas were clinically and biochemically tolerated, The mean concentr ation of essential amino acids in plasma was lower in group W-e but hi gher in group AA compared with values for breast-fed control infants ( a = 0.001), There was a different trend between the groups in weight ( p = 0.09) and length (p = 0.006), Growth was promoted in group AA duri ng the follow-up; it was constant during the first months, followed by a gradual decline in rate in group W-e, In both groups, atopic eczema improved significantly and progressively, and a downward trend was fo und in serum total and milk-specific IgE concentrations, proving the e fficacy of both formulas, Conclusions: Extensively hydrolyzed formulas are safe and effective for most infants; an amino acid-derived formul a may be preferable for infants with multiple food allergies, especial ly for the maintenance of normal growth.