Use of an amino acid-based formula in the management of cow's milk allergy and multiple food protein intolerance in children☆

Abstract 

Rationale

Cow's milk allergy (CMA) and multiple food protein intolerance (MFPI), both IgE and non-IgE-mediated, may persist beyond infancy necessitating the continued use of a hypoallergenic formula. The aim of this study was to assess the hypoallegenicity and nutritional benefit of feeding an amino acid-based formula (AAF) to children with CMA or MFPI.

Methods

Physician-supervised negative challenges to a nutritionally complete AAF (Neocate One+, SHS International Ltd, UK) preceded 6-months open feeding of the formula to 31 cow's milk (CM) allergic children (age range: 14 months to 8 years at entry) from 2 centres (Mount Sinai Hospital, USA and Tampere University Hospital, Finland).

Results

The AAF provided additional energy and protein, resulting in an improvement over the study period in relative weight for height (mean scores of −3.1 (SD 6.9) at entry and −1.2 (SD 7.9) at 6-months follow-up, p=0.03, two-sided Wilcoxon signed rank test). All subjects tolerated the challenges and open feeding, confirming the formula's hypoallergenicity.

Conclusions

CM is nutritionally important in the diets of children, and dietary therapy that involves the complete avoidance of CM warrants specialist intervention and monitoring. Feeding a nutritionally appropriate substitute for CM to children with CMA and MFPI may alleviate the poor growth often associated with this group.

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