Sage Journals: Discover world-class research

Abstract

Background:

Some studies have explored the effects of amino acid-based formulas (AAF), extensively hydrolyzed formulas (EHF), and soy-based formulas (SF) on growth indices, weight-for-age z-scores, length-for-age z-scores, and weight in children with cow’s milk allergy (CMA).

Aims:

This review aimed to evaluate and differentiate the effectiveness of AAF, EHF, and SF on growth parameters in children with CMA.

Methods:

A systematic review was conducted in three databases—PubMed, Web of Science, and Scopus—up to March 2023 to identify eligible studies. Eight articles were analyzed in this study. Effect sizes were reported as weighted mean difference with 95% confidence intervals (CI). Statistical heterogeneity between studies was assessed using Cochran’s Q-test. The risk of bias was evaluated using the ROBINS-I tool.

Results:

A total of eight studies, encompassing 469 participants, met the inclusion criteria. The meta-analysis demonstrated a significant positive effect of the AAF and EHF on weight and weight-for-age z-scores, while no significant changes were observed for length-for-age z-scores. Furthermore, pooled effect sizes indicated that AAF had a more pronounced impact in weight-for-age z-scores (+0.30) compared with EHF (+0.25). Soy-based formulas had negligible effects on growth parameters.

Conclusion:

The findings suggest that AAF and EHF are more effective in improving growth parameters, particularly weight-for-age z-scores, in children with CMA compared with SF. Among the formulas studied, AAF showed the greatest positive impact on weight-for-age z-scores. These results highlight the importance of formula selection for optimizing growth outcomes in children with CMA.

Get full access to this article

View all access options for this article.

References

De Greef

, Hauser

, Devreker

, et al. Diagnosis and management of cow’s milk protein allergy in infants. World J Pediatr, 2012; 8(1):19–24.

Prescott

, Pawankar

, Allen

, et al. A global survey of changing patterns of food allergy burden in children. World Allergy Organ J, 2013; 6(1):21.

Yang

, Tan

, Wu

, et al. Prevalence, characteristics, and outcome of cow’s milk protein allergy in Chinese infants: A population-based survey. J Parenter Enteral Nutr, 2019; 43(6):803–808.

Munblit

, Perkin

, Palmer

, et al. Assessment of evidence about common infant symptoms and cow’s milk allergy. JAMA Pediatr, 2020; 174(6):599–608.

Bruijnzeel‐Koomen

, Ortolani

, Aas

, et al. Adverse reactions to food. Allergy, 1995; 50(8):623–635.

Lasekan

, Baggs

. Efficacy of soy-based formulas in alleviating gastrointestinal symptoms in infants with milk-based formula intolerance: A randomized clinical trial. Clin Pediatr (Phila), 2021; 60(3):184–192.

Meek

, Noble

. Breastfeeding and the use of human milk. Pediatrics, 2022; 150(6):e2022057988.

Muraro

, Werfel

, Hoffmann-Sommergruber

, et al.; EAACI Food Allergy and Anaphylaxis Guidelines Group. EAACI food allergy and anaphylaxis guidelines: Diagnosis and management of food allergy. Allergy, 2014; 69(8):1008–1025.

Aggett

, Haschke

, Heine

, et al. Comment on antigen-reduced infant formulae. ESPGAN Committee on Nutrition. Acta Paediatr, 1993; 82(3):314–319.

10.

Koletzko

, Niggemann

, Arato

, et al.; European Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Diagnostic approach and management of cow’s-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J Pediatr Gastroenterol Nutr, 2012; 55(2):221–229.

11.

Niggemann

, von Berg

, Bollrath

, et al. Safety and efficacy of a new extensively hydrolyzed formula for infants with cow’s milk protein allergy. Pediatr Allergy Immunol, 2008; 19(4):348–354.

12.

Fiocchi

, Dahda

, Dupont

, et al. Cow’s milk allergy: Towards an update of DRACMA guidelines. World Allergy Organ J, 2016; 9(1):35.

13.

Klemola

, Vanto

, Juntunen-Backman

, et al. Allergy to soy formula and to extensively hydrolyzed whey formula in infants with cow’s milk allergy: A prospective, randomized study with a follow-up to the age of 2 years. J Pediatr, 2002; 140(2):219–224.

14.

D’Auria

, Sala

, Lodi

, et al. Nutritional value of a rice-hydrolysate formula in infants with cows’ milk protein allergy: A randomized pilot study. J Int Med Res, 2003; 31(3):215–222.

15.

Agostoni

, Fiocchi

, Riva

, et al. Growth of infants with IgE-mediated cow’s milk allergy fed different formulas in the complementary feeding period. Pediatr Allergy Immunol, 2007; 18(7):599–606.

16.

Hozo

, Djulbegovic

, Hozo

. Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol, 2005; 5:13.

17.

Iyengar

, Greenhouse

. Sensitivity analysis and diagnostics. Handbook of research synthesis and meta-analysis, 2009:417–433.

18.

Carroccio

, Cavataio

, Montalto

, et al. Evaluation of pancreatic function development after hydrolyzed protein-based and soy-based formulas in unweaned infants. Scand J Gastroenterol, 1997; 32(3):273–277.

19.

Yeom

K-B-R

, Kim

K-H

. Efficacy and safety of soy protein based formula in atopic dermatitis. JFN, 2011; 16(3):248–252.

20.

Yan

, Chen

, Li

, et al. [Evaluation of therapeutic effects of three hypoallergenic formulae in infants with cow’s milk protein allergy]. Zhonghua er ke za zhi = Chinese journal of pediatrics, 2011; 49(7):501–505.

21.

Canani

, Nocerino

, Frediani

, et al. Amino acid-based formula in cow’s milk allergy: Long-term effects on body growth and protein metabolism. J Pediatr Gastroenterol Nutr, 2017; 64(4):632–638.

22.

McLeish

, MacDonald

, Booth

. Comparison of an elemental with a hydrolysed whey formula in intolerance to cows’ milk. Arch Dis Child, 1995; 73(3):211–215.

23.

Anania

, Martinelli

, Brindisi

, et al. Hydrolyzed rice formula: An appropriate choice for the treatment of cow’s milk allergy. J Clin Med, 2022; 11(16).

24.

Dupont

, Bradatan

, Soulaines

, et al. Tolerance and growth in children with cow’s milk allergy fed a thickened extensively hydrolyzed casein-based formula. BMC Pediatr, 2016; 16:96.

25.

Verduci

, Di Profio

, Cerrato

, et al. Use of soy-based formulas and cow’s milk allergy: Lights and shadows. Front Pediatr, 2020; 8:591988.

26.

Westmark

. Soy-Based therapeutic baby formulas: Testable hypotheses regarding the pros and cons. Front Nutr, 2016; 3:59.

27.

Hill

, Murch

, Rafferty

, et al. The efficacy of amino acid-based formulas in relieving the symptoms of cow’s milk allergy: A systematic review. Clin Exp Allergy, 2007; 37(6):808–822.

28.

Majamaa

, Miettinen

, Laine

, et al. Intestinal inflammation in children with atopic eczema: Faecal eosinophil cationic protein and tumour necrosis factor-alpha as non-invasive indicators of food allergy. Clin Exp Allergy, 1996; 26(2):181–187.

29.

Meyer

, Venter

, Fox

, et al. Practical dietary management of protein energy malnutrition in young children with cow’s milk protein allergy. Pediatr Allergy Immunol, 2012; 23(4):307–314.

30.

Hon

K-LE

, Lam

M-CA

, Leung

T-F

, et al. Nocturnal wrist movements are correlated with objective clinical scores and plasma chemokine levels in children with atopic dermatitis. Br J Dermatol, 2006; 154(4):629–635.

31.

Martin

, Ling

, Blackburn

. Review of infant feeding: Key features of breast milk and infant formula. Nutrients, 2016; 8(5).

32.

Fleischer

, Venter

, Vandenplas

. Hydrolyzed formula for every infant? Nestle Nutr Inst Workshop Ser, 2016; 86:51–65.

33.

Vanderhoof

, Murray

, Kaufman

, et al. Intolerance to protein hydrolysate infant formulas: An underrecognized cause of gastrointestinal symptoms in infants. J Pediatr, 1997; 131(5):741–744.

34.

Miraglia Del Giudice

, D’Auria

, Peroni

, et al. Flavor, relative palatability and components of cow’s milk hydrolysed formulas and amino acid-based formula. Ital J Pediatr, 2015; 41(1):42–48.

35.

Vanderhoof

, Moore

, de Boissieu

. Evaluation of an amino acid− Based formula in infants not responding to extensively hydrolyzed protein formula. J Pediatr Gastroenterol Nutr, 2016; 63(5):531–533.

36.

Ribes-Koninckx

, Amil-Dias

, Espin

, et al. The use of amino acid formulas in pediatric patients with allergy to cow’s milk proteins: Recommendations from a group of experts. Front Pediatr, 2023; 11:1110380.

37.

Secretariat. Infant and Young Child Nutrition: WHO; 2002. Available from: https://apps.who.int/gb/archive/pdf_files/WHA55/ea5515.pdf

38.

Medicine. USNLo. Infant Formulas. Available from: https://www.nlm.nih.gov/medlineplus/ency/article/002447.htm

39.

Bawa

, Anilakumar

. Genetically modified foods: Safety, risks and public concerns-a review. J Food Sci Technol, 2013; 50(6):1035–1046.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.06 MB

0.02 MB