Alternatives to Cow’s Milk-Based Infant Formulas in the Prevention and Management of Cow’s Milk Allergy

Abstract

Cow’s milk-based infant formulas are the most common substitute to mother’s milk in infancy when breastfeeding is impossible or insufficient, as cow’s milk is a globally available source of mammalian proteins with high nutritional value. However, cow’s milk allergy (CMA) is the most prevalent type of food allergy among infants, affecting up to 3.8% of small children. Hypoallergenic infant formulas based on hydrolysed cow’s milk proteins are commercially available for the management of CMA. Yet, there is a growing demand for more options for infant feeding, both in general but especially for the prevention and management of CMA. Milk from other mammalian sources than the cow, such as goat, sheep, camel, donkey, and horse, has received some attention in the last decade due to the different protein composition profile and protein amino acid sequences, resulting in a potentially low cross-reactivity with cow’s milk proteins. Recently, proteins from plant sources, such as potato, lentil, chickpeas, quinoa, in addition to soy and rice, have gained increased interest due to their climate friendly and vegan status as well as potential lower allergenicity. In this review, we provide an overview of current and potential future infant formulas and their relevance in CMA prevention and management.

Factors associated with parental burden among parents of children with food allergies in China: a cross-sectional study

“…This may be related to the fact that parents were worried about the lack of pure nutrient intake when amino acid milk powder was an alternative to breast milk and cow's milk. 48 There is a great need for comprehensive and systematic FA-based health education programmes. [49][50][51] On the one hand, it will help parents manage their children's food allergies (FA) correctly and find alternative nutrients to ensure normal growth and development.…”

“…In one of the noteworthy findings of this study, the parental burden of parents whose children took in amino acid milk powder was high. This may be related to the fact that parents were worried about the lack of pure nutrient intake when amino acid milk powder was an alternative to breast milk and cow’s milk 48. There is a great need for comprehensive and systematic FA-based health education programmes 49–51.…”

Camel Milk Cannot Prevent the Development of Cow's Milk Allergy—A Study in Brown Norway Rats

“…Collectively, this stresses that camel milk would not be a suitable protein source for infant formulas for CMA prevention. We hypothesize that donkey and horse milk proteins due to even lower protein homologies with cow's milk proteins, with protein sequence identities of 46–74% [ 5 ] would likewise not provide suitable sources for CMA prevention, whereas goat and sheep milk proteins, with protein sequence identifies to cow's milk proteins of 85–95% [ 5 ] would probably be better options. It has been suggested that a high degree of homology is needed between proteins in order to obtain a bystander effect and drive tolerance towards counterpart proteins.…”

Yield and Composition Variations of the Milk from Different Camel Breeds in Saudi Arabia

“…Additionally, camel whey or casein fortifications considerably increased the high radical scavenging activity of the camel milk-based infant formula as compared to those of the commercial infant formula [75]. Infant formula made from digested camel milk had anti-inflammatory properties that were superior to those of the commercial infant formula and bovine milk, indicating that it would be a feasible option for the creation of a hypoallergenic formula for infants who are allergic to bovine milk [75,76]. Additionally, peptic camel whey hydrolysates were examined as potential sources of peptides with antihypertensive properties capable of inhibiting the angiotensin-converting enzyme and renin [77].…”