Infant formulae: how well are they tested?

Vandenplas, Yvan; Alliet, Philippe; Winckel, Myriam Van; Robberecht, Eddy

doi:10.1007/s004310100753

Cited by 2 publications

(2 citation statements)

References 2 publications

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“…With longer follow-up, the effect size of protection appears to decrease, suggesting that allergic manifestations are delayed rather than truly prevented [9]. The risks of prolonged use of hypoallergenic formula have been poorly studied [62]. A recent large observational ‘real life’ study from the Netherlands showed that the delayed introduction of cow’s milk in the diet of high-risk infants was associated with increased atopy risk at the age of 2 years [55].…”

Section: Other Preventive Measuresmentioning

confidence: 99%

Clinical practice

Kneepkens

Brand

2010

Eur J Pediatr

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The increase in allergic disease prevalence has led to heightened interest in the factors determining allergy risk, fuelled by the hope that by influencing these factors one could reduce the prevalence of allergic conditions. The most important modifiable risk factors for allergy are maternal smoking behaviour and the type of feeding. A smoke-free environment for the child (to be), exclusive breastfeeding for 4–6 months and the postponement of supplementary feeding (solids) until 4 months of age are the main measures considered effective. There is no place for restricted diets during pregnancy or lactation. Although meta-analyses suggest that hypoallergenic formula after weaning from breastfeeding grants protection against the development of allergic disease, the evidence is limited and weak. Moreover, all current feeding measures aiming at allergy prevention fail to show effects on allergic manifestations later in life, such as asthma. In conclusion, the allergy preventive effect of dietary interventions in infancy is limited. Counselling of future parents on allergy prevention should pay attention to these limitations.

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Section: Other Preventive Measuresmentioning

confidence: 99%

Clinical practice

Kneepkens

Brand

2010

Eur J Pediatr

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“…Given the fact that the distribution of severity of AE in the population is highly skewed, with most cases of AE at the mildest end of the spectrum (25), it can be assumed that any intervention aimed at preventing the development of AE will involve the mildest cases of eczema. The usefulness of preventing such very mild cases of AE, which can be easily managed with skin care advice and intermittent use of steroid ointments (26, 27), and which carry a favourable long‐term outcome (28), has never been weighed against the effort involved and against the possible side effects of such an intervention (29). More specifically, it can be argued that treating six infants at risk for prolonged periods of time with a hypoallergenic formula to delay the skin manifestations of one case of mild AE are not worth the effort.…”

Section: Only the Mildest Cases Are Preventedmentioning

confidence: 99%

Dietary prevention of allergic disease in children: Are current recommendations really based on good evidence?

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Vlieg‐Boerstra

Dubois

2007

Pediatric Allergy Immunology

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We provide a critical appraisal of the literature on the effects of dietary prevention of atopic disease in children. In our view, currently available studies suffer from lack of blinding which is a major problem if the primary end point is subjective (such as the diagnosis of eczema). In addition, long-term follow-up suggests that atopic symptoms are delayed rather than truly prevented, and that only the mildest cases are prevented (or delayed). Although it has been reported that cow's milk allergy is truly prevented by dietary interventions in early life, this has never been demonstrated by double-blind placebo-controlled food challenges. No studies to date have shown effects of hypoallergenic formulae on objective markers of atopic sensitization, such as specific IgE levels. Finally, there is no universally accepted pathophysiological mechanism which could explain the usefulness of hypoallergenic formulae in allergy prevention. In conclusion, we feel that the currently available evidence on the allergy preventive effects of hypoallergenic formulae is insufficient to justify blanket advice being given to 'high risk' families. Such advice gives parents the hope that they can actually prevent allergy in their children which may not be justified. A cautious approach in advising interventions with hypoallergenic formulae to prevent allergy in high-risk infants is warranted.

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Infant formulae: how well are they tested?

Cited by 2 publications

References 2 publications

Clinical practice

Clinical practice

Dietary prevention of allergic disease in children: Are current recommendations really based on good evidence?

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