Evaluation of an Extensively Hydrolyzed Casein-Whey Protein Formula in Immediate Cow's Milk Protein Hypersensitivity

Martín-Esteban, Manuel; García-Ara, Maria Carmen; Banqué-Molas, Montserrat; Boyano-Martínez, Maria Teresa; Martín-Muñoz, Flor; Díaz-Pena, José María

doi:10.1097/00005176-199804000-00007

Cited by 22 publications

(12 citation statements)

References 15 publications

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“…Furthermore, as also mentioned by Martin‐Esteban et al. (20) the results of this kind of study are strongly dependent on the type of study population. The guidelines are drawn up to be generalized for the overall population, but the studies are usually performed in specialized hospitals, in which the population of children is often more seriously affected by CMA.…”

Section: Discussionmentioning

confidence: 56%

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Hypoallergenicity of an extensively hydrolyzed whey formula

Giampietro

Kjellman

Oldæus

et al. 2001

Pediatric Allergy Immunology

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Several different protein hydrolysate-based infant formulas have been promoted as hypoallergenic and considered suitable for the dietary management of cow's milk allergy (CMA). Accepting that none of the hydrolysate-based products is completely safe, the American Academy of Pediatrics (AAP) recommends that these formulas should be tested in a double-blind placebo-controlled setting and tolerated by at least 90% of children with proven CMA. In principle, this recommendation is also endorsed by the European Society of Paediatric Gastroenterology and Nutrition (ESPGAN) and the European Society of Paediatric Allergy and Clinical Immunology (ESPACI). In this two-center study, 32 children with proven CMA were tested with the extensive hydrolysate whey formula Nutrilon Pepti, for comparison with Profylac (extensive) and Nan HA (partial) whey hydrolysate products. Skin-prick tests (SPTs) were, respectively, positive to the three hydrolysate formulas in 19%, 15%, and 32% of children. After oral challenge it was concluded that 97% (95% CI: 85-100%) of the children tolerated Nutrilon Pepti, 94% (95% CI: 75-100%) tolerated Profylac, and 64% (95% CI: 37-81%) tolerated Nan HA. This study demonstrates that the extensive hydrolysates Nutrilon Pepti and Profylac are well tolerated in a population of children with proven CMA and that both products can be considered safe for their intended use. This study confirms that a very small number of children react even to extensively hydrolyzed formulas. SPT prior to oral exposure to the hydrolysate-based formulas can indicate whether a child is at risk of showing reactions to the product. Introduction of new products to these children should be carried out under a doctor's supervision. However, the majority of the SPT-positive children did tolerate the two extensively hydrolyzed whey-based formulas tested.

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Section: Discussionmentioning

confidence: 56%

“…A recent study conducted by Martin‐Esteban et al. (20) with a casein‐whey protein hydrolysate formula, was also performed according to the current guidelines. However, 50% of the children were fed the tested formula before the challenge.…”

Section: Discussionmentioning

confidence: 99%

Hypoallergenicity of an extensively hydrolyzed whey formula

Giampietro

Kjellman

Oldæus

et al. 2001

Pediatric Allergy Immunology

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“…The figure of 10% appears to be derived from the statement that for a formula to be considered hypoallergenic at least 90% of cows milk allergic children must tolerate the product and the actual proportion of children intolerant to EHF may be less than this 5 . Thus the combined results of three studies of EHF in children with IgE‐mediated or non‐IgE‐mediated cows milk protein allergy found that 97% (126/130) tolerated EHF 5–7 . There is a small group of children with multiple food protein hypersensitivity some of whom do not tolerate EHF; however, it is unclear what proportion of the total cows milk allergic patients this comprises.…”

Section: Discussionmentioning

confidence: 99%

“…5 Thus the combined results of three studies of EHF in children with IgE-mediated or non-IgE-mediated cows milk protein allergy found that 97% (126/130) tolerated EHF. [5][6][7] There is a small group of children with multiple food protein hypersensitivity some of whom do not tolerate EHF; however, it is unclear what proportion of the total cows milk allergic patients this comprises. A hospital-based specialist paediatric allergy unit identified approximately 60 such patients over 10 years with suspected late adverse reactions to formulae including cows milk, soy and protein hydrolyzate.…”

Section: Discussionmentioning

confidence: 99%

Hypoallergenic formula prescribing practices in Australia

Kemp

2006

J Paediatrics Child Health

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There are significant regional differences which do not appear to be related to the prevalence of allergic disease. In some States and Territories AAF may be frequently prescribed as a first line treatment for cows milk allergy and for prevention of allergic disease in contradistinction to current recommendations of the Pharmaceutical Benefits Scheme and authoritative statements and position papers. Re-examination of both the Pharmaceutical Benefit Scheme guidelines and the knowledge and perceptions of the prescribing community is indicated.

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“…It has been recommended that a formula should be called ‘hypoallergic’ if it is tolerated by at least 90% (with 95% confidence) of the infants with CMA [18]. These criteria have been met by some extensive hydrolysates [9,19] and amino acid mixtures [10].…”

Section: Introductionmentioning

confidence: 99%

Determination of allergenicity to three cow's milk hydrolysates and an amino acid‐derived formula in children with cow's milk allergy

Caffarelli

Plebani

Poiesi

et al. 2002

Clin Experimental Allergy

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In this study, none of the cow's milk substitutes has been found to be non-allergenic. Our results suggest that in children with IgE-mediated cow's milk allergy, the first ingestions of extensively hydrolysed cow's milk protein formulas require strict medical supervision because of immediate reactions. This is not the case for amino acid-derived formula. Moreover, our data suggest that treatment of children allergic to cow's milk with cow's milk substitutes should be monitored for several days to document tolerance.

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Evaluation of an Extensively Hydrolyzed Casein-Whey Protein Formula in Immediate Cow's Milk Protein Hypersensitivity

Cited by 22 publications

References 15 publications

Hypoallergenicity of an extensively hydrolyzed whey formula

Hypoallergenicity of an extensively hydrolyzed whey formula

Hypoallergenic formula prescribing practices in Australia

Determination of allergenicity to three cow's milk hydrolysates and an amino acid‐derived formula in children with cow's milk allergy

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