Milk allergy over‐diagnosis

Boyle, Robert; Shamji, Mohamed H.

doi:10.1111/cea.14076

Cited by 4 publications

(2 citation statements)

References 10 publications

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“…This fact further supports the insight that hypoallergenic formulae are indeed over‐purchased compared to medical indication. Our data do not allow us to link purchases to infant diagnoses but does align with other studies that have shown that CMPA in infants is likely over‐diagnosed 41 due to guidelines that label potentially normal infant symptoms as a possible milk allergy 42–45 . In fact, an independent expert consensus recently suggested that narrower criteria are needed to diagnose milk CMPA to avoid unnecessary use of hypoallergenic formula 46 .…”

Section: Discussionsupporting

confidence: 60%

“…Our data do not allow us to link purchases to infant diagnoses but does align with other studies that have shown that CMPA in infants is likely over-diagnosed 41 due to guidelines that label potentially normal infant symptoms as a possible milk allergy. [42][43][44][45] In fact, an independent expert consensus recently suggested that narrower criteria are needed to diagnose milk CMPA to avoid unnecessary use of hypoallergenic formula. 46 Unnecessary use of a hypoallergenic formula in the US is additionally concerning as it also means consumption of lactose-free formula and is more expensive for the consumer.…”

Section: 5% Hypoallergenicmentioning

confidence: 99%

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Protein and carbohydrate content of infant formula purchased in the United States

Järvinen

Schmidt

Young

2022

Clin Experimental Allergy

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Background The protein and carbohydrate composition of formula fed infants' diets in the United States (US) has not been described. The aims of this study were to characterize these dietary exposures in infant formula purchased in the US and to estimate the proportion of formula purchased which is hypoallergenic or lactose‐reduced formula. Methods Powdered infant formula purchase data from all major physical stores in the US prior to the COVID‐19 pandemic, between 2017 and 2019, were obtained from Information Resources, Inc. Protein and carbohydrate composition and scoop sizes for each formula were obtained from manufacturers. Ready to feed liquid products, products for premature infants and products for over 1 year old were not included. Results Total volumes of term formula purchased were 216 million kg of formula powder (equivalent to 1.65 billion litres) over 3 years. Intact protein formula was 67.9% of formula purchased, 26.6% was partially hydrolysed and 5.5% was hypoallergenic (5.2% extensively hydrolysed protein; 0.3% amino acid based). Soy protein formula represented 5.1% of formula purchased. Carbohydrate content overall was 52.7% lactose, 42.3% glucose polymers and 5.0% sucrose. 23.7% of formula purchased included sucrose as a carbohydrate. Of all formula purchased, 59.0% was lactose reduced, containing a non‐lactose carbohydrate. Of ‘standard’ formula, defined as intact protein, non‐thickened, cow's milk formula, 32.3% was lactose reduced. The proportion of hypoallergenic formula purchased significantly exceeded the prevalence of cow's milk protein allergy and increased over the 3‐year study period from 4.9% to 7.6% of all formula sold. Conclusions US infants are exposed to unnecessarily high levels of non‐lactose carbohydrates and hypoallergenic formula, and this may represent a significant nutritional health risk.

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Section: Discussionsupporting

confidence: 60%