Cow’s milk protein allergy (CMPA) affects 2% to 3% of infants and is managed with hypoallergenic formulas. The 2022 recalls of infant formulas due to factors including contamination led to specialty formula shortages, highlighting CMPA management challenges. Understanding health care providers’ (HCPs) decision-making in transitioning to alternative formulas during shortages is crucial. Limited attention has been given to how pediatric physicians make these choices. This study utilized US HCPs’ de-identified survey data to assess driving factors when switching extensively hydrolyzed formulas during shortages. A total of 104 eligible HCPs participated, including general pediatrics, pediatric allergy/immunology, and pediatric gastroenterology specialists. Safety, tolerability, and efficacy were identified as top factors for switching formulas. Formula 1 was considered well-tolerated, patient-accepted, and safe by all HCPs. Most expressed strong belief in Formula 1’s safety and effectiveness. Findings inform CMPA management during shortages, offering guidance to HCPs for suitable formula selection and enhanced infant care.
NocerinoRPezzellaVCosenzaL, et al. The controversial role of food allergy in infantile colic: evidence and clinical management. Nutrients. 2015;7(3):2015-2025. doi:10.3390/nu7032015.
5.
ZeevenhoovenJKoppenIJBenningaMA.The new Rome IV criteria for functional gastrointestinal disorders in infants and toddlers. Pediatr Gastroenterol Hepatol Nutr. 2017;20(1):1-13. doi:10.5223/pghn.2017.20.1.1.
6.
SavinoFMontanariPGallianoI, et al. Lactobacillus rhamnosus GG (ATCC 53103) for the management of infantile colic: a randomized controlled trial. Nutrients. 2020;12(6):1693. doi:10.3390/nu12061693.
7.
LynøeNErikssonA.Is there an association between infantile colic and subdural hemorrhage. Med Hypotheses. 2020;144:110256. doi:10.1016/j.mehy.2020.110256.
8.
DupontC.Diagnosis of cow’s milk allergy in children: determining the gold standard. Expert Rev Clin Immunol. 2014;10(2):257-267. doi:10.1586/1744666X.2014.874946.
9.
MiGLZhaoLQiaoDDKangWQTangMQXuJK.Effectiveness of Lactobacillus reuteri in infantile colic and colicky induced maternal depression: a prospective single blind randomized trial. Antonie Van Leeuwenhoek. 2015;107(6):1547-1553. doi:10.1007/s10482-015-0448-9.
10.
EllwoodJDraper-RodiJCar nesD.Comparison of common interventions for the treatment of infantile colic: a systematic review of reviews and guidelines. BMJ Open. 2020;10(2):e035405. doi:10.1136/bmjopen-2019-035405.
11.
JohnsonJCockerKChangE.Infantile colic: recognition and treatment. Am Fam Physician. 2015;92(7):577-582. Accessed August 23, 2022. https://pubmed.ncbi.nlm.nih.gov/26447441/.
12.
MorrisSJames-RobertsISSleepJGillhamP.Economic evaluation of strategies for managing crying and sleeping problems. Arch Dis Child. 2001;84(1):15-19. doi:10.1136/adc.84.1.15.
13.
KianifarHAhanchianHGroverZ, et al. Synbiotic in the management of infantile colic: a randomised controlled trial. J Paediatr Child Health. 2014;50(10):801-805. doi:10.1111/jpc.12640.
14.
HillDJRoyNHeineRG, et al. Effect of a low-allergen maternal diet on colic among breastfed infants: a randomized, controlled trial. Pediatrics. 2005;116(5):e709-15. doi:10.1542/peds.2005-0147.
15.
KoletzkoSNiggemannBAratoA, et al. 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. doi:10.1097/MPG.0b013e31825c9482.
16.
VandenplasYGutierrez-CastrellonPVelasco-BenitezC, et al. Practical algorithms for managing common gastrointestinal symptoms in infants. Nutrition. 2013;29(1):184-194. doi:10.1016/j.nut.2012.08.008.
17.
BersethCLJohnstonWHStolzSIHarrisCLMitmesserSH.Clinical response to 2 commonly used switch formulas occurs within 1 day. Clin Pediatr (Phila). 2009;48(1):58-65. doi:10.1177/0009922808321897.
18.
WilseyMFlorioJBeackerJ, et al. Extensively hydrolyzed formula improves allergic symptoms in the short term in infants with suspected cow’s milk protein allergy. Nutrients. 2023;15(7):1677. doi:10.3390/nu15071677.
19.
WilseyMJBaranJVLamosL, et al. Short-term symptom improvement in infants with suspected cow’s milk protein allergy using amino acid formula: a prospective cohort analysis. Front Nutr. 2023;10:1208334. doi:10.3389/fnut.2023.1208334.
20.
LeeS.Methods for testing statistical differences between groups in medical research: statistical standard and guideline of Life 537 Cycle Committee. Life Cycle. 2022;2:e1. doi:10.54724/lc.2022.e1.
21.
ChauKLauEGreenbergS, et al. Probiotics for infantile colic: a randomized, double-blind, placebo-controlled trial investigating Lactobacillus reuteri DSM 17938. J Pediatr. 2015;166(1):74-78. doi:10.1016/j.jpeds.2014.09.020.
22.
SungVHiscockHTangM, et al. Treating infant colic with the probiotic Lactobacillus reuteri: double blind, placebo controlled randomised trial. BMJ. 2014;348:g2107. doi:10.1136/bmj.g2107.
23.
SungVD’AmicoFCabanaMD, et al. Lactobacillus reuteri to treat infant colic: a meta-analysis. Pediatrics. 2018;141(1):e20171811. doi:10.1542/peds.2017-1811.
24.
ArikanDAlpHGözümS, et al. Effectiveness of massage, sucrose solution, herbal tea or hydrolysed formula in the treatment of infantile colic. J Clin Nurs. 2008;17(13):1754-1761. doi: 10.1111/j.1365-2702.2007.02093.x.
