A perspective on partially hydrolyzed protein infant formula in nonexclusively breastfed infants

Abstract

The World Health Organization recommends that infants should be exclusively breastfed for the first 6 months of life to provide optimal nutrition in this critical period of life. After this, infants should receive nutritionally adequate and safe complementary foods while breastfeeding continues for up to 2 years of age or beyond. For nonbreastfed infants, infant formula is an available option to provide the nutrition needed. Infant formula is usually prepared from industrially modified cow’s milk and processed to adjust for the nutritional needs of infants. However, cow’s milk is one of the most common causes of food allergy, affecting 2%–5% of all formula-fed infants during their first year of life. One strategy to prevent cow’s milk allergy in nonbreastfed infants is the use of partially hydrolyzed formula (pHF) in high-risk infants, which are infants born in families with atopic disease. However, based on an epidemiological study, approximately half of the infants who develop allergy are not part of the at-risk group. This is because the non-at-risk group is significantly larger than the at-risk group and the non-at-risk infants have approximately 15% risk of developing allergies. This study aimed to evaluate the effects of partially hydrolyzed whey formula (pHF-W) in nonbreastfed infants and determine whether pHF-W can prevent atopic disease in high-risk infants and can be used as routine starter formula regardless of the allergy risk status.

Comparison of the acute metabolic effect of different infant formulas and human milk in healthy adults: a randomized trial

“…However, half of the infants with allergy or atopic dermatitis in the first year of life had no prior family history of allergy; the use of PHw formulas in the general infant population has also proven to be efficacious in reducing the risk of developing atopic dermatitis 27 . In recent years, the metabolic response to partially hydrolyzed infant formula has been questioned based on the assumption that PHw formulas would result in a higher postprandial aminoacidemia and thus, greater insulin secretion by the pancreatic β-cells 28 , due to the fact that PHw protein induces more rapid gastric emptying and a higher release of plasma amino acids compared with intact protein 29,30 . Moreover, a 2016 consensus statement concluded that there was a lack of data related to the metabolic effects of PHw formulas 6 .…”

Immune development of children born from Caesarean section

“…Moreover, some studies have shown that the role of nutrition intervention could also play in gut microbiota production for unbreastfed babies. 41,42 Some clinical and preclinical studies demonstrate that synbiotics can prevent certain allergic diseases. This contributed to the use of synbiotic to compensate for early microbial bowel disruptions.…”

Variation in Infant Formula Macronutrient Ingredients Is Associated with Infant Anthropometrics

“…Historical research regarding protein source in formula has primarily focused on soy vs. dairy-based formula [ 2 , 3 , 4 ], and an extensive focus on the degree of protein hydrolysis as it relates to immune-related conditions, such as eczema and type 1 diabetes [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. Limited work has focused on growth and shown that both partially and fully hydrolyzed protein sources do result in reduced growth rates (compared to intact protein formula), more similar to breastfed infants [ 12 , 13 , 14 ].…”