The efficacy of partially hydrolyzed formulas for allergy prevention in children under five years

ABSTRACT

Background: Recommendations for allergy prevention in children include feeding with partially hydrolyzed formulas if breast-feeding is not possible or insufficient. Objective: The primary objective of this study was to investigate the allergy preventive effect of partially hydrolyzed formulas compared with cow's milk formulas and breast-feeding during the first five years of life in a retrospective randomized trial. Methods: A retrospective, large-scale intervention study of 3,502 unselected children aged between one and five years recruited between April 2005 and March 2006 was performed. Main outcome parameters were allergic manifestations including cow's milk allergy, atopic dermatitis (AD), chronic rhinitis, and recurrent wheeze. Results: About 35.2% developed allergic manifestations mostly during the first year of life. More males developed atopic diseases than females (OR=1.5; 95%CI=1.300-1.719). Compared with the breast-feeding group, the occurrence of atopic diseases significantly increased in the cow's milk formula group (OR=1.66; 95%CI=1.396-1.957) while it decreased in the partially hydrolyzed formula (pHF) group (OR=0.23; 95%CI=0.160-0.314) during the first four years of life. Considering the risk for the development of atopic diseases determined by atopic risk score, there was a positive association between the high risk score children compared to the low risk ones in both the breast-feeding group and the cow's milk formula group. However, there was no significant association in the pHF group. Compared with the breast-feeding group, the risk estimate for the development of atopic diseases was significantly increased in children with high risk score in the cow's milk formula group but was reduced in the pHF group. Conclusion: The risk of atopic diseases can be reduced with partially hydrolyzed formula in high-risk infants when breast-feeding is insufficient.