Special formulas in infant nutrition: a review

Special formulas should only be used by medical prescription and for those lactating infants with diagnosed nutritional problems. Lactose-free formula s or those based on soy are the logical choice when the exclusion of lactos e from the diet is considered necessary. At present, there is no concensus on the appropriateness of soy formulas for the treatment and prevention of nutritional allergies and current opinion seems to favour hydrolyzed protei n formulas. High-degree protein hydrolysate formulas are used to treat lactating infant s with an allergy to cow milk proteins or with serious nutritional problems . These formulas are not without risk, as they may contain residual epitope s capable of provoking a severe allergic reaction. Before using these formu las, allergenicity tests should be performed, particularly for highly sensi tive infants. The unpleasant taste and high cost of these formulas, in addi tion to possible nutritional problems, limit their use in the prevention of atopic disease, although their efficacy is well established. Partially pro tein hydrolysate formulas are only used for preventive purposes and are not suitable for lactating infants with a proven allergy to cow milk. Although these formulas can reduce the incidence or delay the appearance of certain atopic symptoms, they have not been shown to prevent IgE-mediated allergic reactions to cow's milk and so their effectiveness is open to question. (C ) 1998 Elsevier Science Ireland Ltd. All rights reserved.