INFLUENCE OF BREAST MILK, SOY OR TWO HYDROLYZED FORMULAS ON THE DEVELOPMENT OF ALLERGIC MANIFESTATIONS IN INFANTS AT RISK

Abstract Background: Infants born to atopic parents are at an increased risk of developing allergy during the first 2 years of life. Objective: To assess the effects of the early introduction of soy, extensively-hydrolyzed casein, or partially-hydrolyzed whey formulas in infants at risk for atopic diseases. Methods: This prospective, double-blind study compared allergic manifestations in 113 formula-fed and 17 breast-fed infants during the first year of life. The children were equally distributed among feeding groups by sex, birth IgE levels, and parental atopy. Study formulas were introduced in the newborn nursery. Gastrointestinal and dermatologic manifestations suggestive of allergy were evaluated at regular intervals during the first year of life. Results: The cumulative incidence of chronic or recurrent vomiting, diarrhea or atopic dermatitis in the first year of life was 18 %. Persistent symptoms led to a formula change in 18 (16 %) of the formula-fed infants (mean age of change: 2.3 months). Formula intolerance was confirmed by an open challenge with the first formula in 15 infants (13%), without significant differences in the number of children with formula changes and positive challenges across all feeding groups. Conclusions: There was no significant difference among the formula groups in the development of symptoms of food intolerance. However, introduction of hydrolyzed cow's milk or soy infant formulas at birth to infants at risk for developing allergy did not completely prevent the development of symptoms commonly attributed to food intolerance. Of the infants who developed intolerance to one of the study formulas 81% improved when changed to a second, randomly-assigned formula, suggesting that intolerance was formula specific.