Allergic manifestation 15 years after early intervention with hydrolyzed formulas – theGINIStudy

Abstract

BackgroundData on the long‐term impact of hydrolyzed formulas on allergies are scarce.ObjectiveTo assess the association between early intervention with hydrolyzed formulas in high‐risk children and allergic outcomes in adolescence.Methods GINI trial participants (n = 2252) received one of four formulas in the first four months of life as breastmilk substitute if necessary: partial or extensive whey hydrolyzate (pHF‐W, eHF‐W), extensive casein hydrolyzate (eHF‐C) or standard cow′s milk formula (CMF) as reference. Associations between these formulas and the cumulative incidence and prevalence of parent‐reported physician‐diagnosed asthma, allergic rhinitis (AR) and eczema, as well as spirometric indices and sensitization, were examined using generalized linear models.ResultsBetween 11 and 15 years, the prevalence of asthma was reduced in the eHF‐C group compared to CMF (odds ratio (OR) 0.49, 95% confidence interval (CI) 0.26–0.89), which is consistent with the spirometric results. The cumulative incidence of AR was lower in eHF‐C (risk ratio (RR) 0.77, 95% CI 0.59–0.99]) and the AR prevalence in pHF‐W (OR 0.67, 95% CI 0.47–0.95) and eHF‐C (OR 0.59, 95% CI 0.41–0.84). The cumulative incidence of eczema was reduced in pHF‐W (RR 0.75, 95% CI 0.59–0.96) and eHF‐C (RR 0.60, 95% CI 0.46–0.77), as was the eczema prevalence between 11 and 15 years in eHF‐C (OR 0.42, 95% CI 0.23–0.79). No significant effects were found in the eHF‐W group on any manifestation,nor was there an effect on sensitization with any formula.ConclusionIn high‐risk children, early intervention using different hydrolyzed formulas has variable preventative effects on asthma, allergic rhinitis and eczema up to adolescence.

A partially hydrolyzed 100% whey formula and the risk of eczema and any allergy: an updated meta-analysis

“…Later on, industrial support, including that from a pHF manufacturer, was obtained [25, 26]. Five trials were funded by the pHF manufacturer [15, 17, 19–21]; in two trials, the source of funding was not specified [16, 18], and in one trial, the source of funding was unclear [27] (Additional file 2: Table S1).…”

Systematic review about 10 interventions in dermatitis. A document from the Latin American Society of Allergy, Asthma, and Immunology

“…Primary prevention: the increase of IgA levels with breast milk 30 and the use of milk hydrolyzed formulas in high-risk infants reduced the cumulative prevalence of eczema. 31 Although these results are supported by some studies, other research studies do not reproduce these results, so their implementation cannot be widely recommended.…”

Research Progress in Atopic March

“…In most studies, breastfeeding for > 6 months has been recommended because it reduces not only the incidence of AD but also of other allergic diseases ( 104 ). A 15-years follow-up study of the German Infant Nutritional Intervention (GINI) cohort has shown that, if breastfeeding is not possible, compared with standard cow's milk formula (CMF), the interventional use of partial whey hydrolyzate (pHF-W) formula and extensive casein hydrolyzate (eHF-C) formula in the first 4 months of life has significant preventive effects on AD, and the eHF-C formula also reduced the prevalence of AA and AR ( 105 ). However, the mechanisms underlying the preventative effects of hydrolyzed formulas are unknown.…”