The effect of a partially hydrolysed formula based on rice protein in the treatment of infants with cow’s milk protein allergy

Abstract

Reche M, Pascual C, Fiandor A, Polanco I, Rivero-Urgell M, Chifre R, Johnston S, Martín-Esteban M. The effect of a partially hydrolysed formula based on rice protein in the treatment of infants with cow’s milk protein allergy. Pediatr Allergy Immunol 2010: 21: 577–585. © 2010 John Wiley & Sons A/SInfants diagnosed with allergy to cow’s milk protein (CMP) are fed extensively hydrolysed cow’s milk formulas, modified soy formulas or even amino acid-based formulas. Hydrolysed rice protein infant formulas have become available and have been shown to be well tolerated by these infants. A prospective open, randomized clinical study to compare the clinical tolerance of a new hydrolysed rice protein formula (HRPF) with an extensively hydrolysed CMP formula (EHF) in the feeding of infants with IgE-mediated cow’s milk allergy. Ninety-two infants (46 boys and 46 girls, mean age 4.3 months, range 1.1–10.1 months) diagnosed with IgE-mediated cow’s milk allergy were enrolled in the study. Clinical tolerance to the formula products was tested. Clinical evaluation included skin prick tests with whole cow’s milk, soya and rice as well as antigens of CMP (beta-lactoglobulin, alpha-lactalbumin, casein and bovine seroalbumin), HRPF and EHF and specific IgE determinations to CMP using CAP technology. Patients were randomized to receive either an EHF based on CMP or a new HRPF. Follow-up was at 3, 6, 12, 18 and 24 months. Growth parameters were measured at each visit. One infant showed immediate allergic reaction to EHF, but no reaction was shown by any infant in the HRPF group. The number of infants who did not become tolerant to CMP during the study was not statistically different between the two groups. Measurement of IgE levels of infants allergic to CMP during the study showed no significant differences between the two formula groups. Growth parameters were in the normal range and similar between groups. In this study, the HRPF was well tolerated by infants with moderate to severe symptoms of IgE-mediated CMP allergy. Children receiving this formula showed similar growth and development of clinical tolerance to those receiving an EHF. In accordance with current guidelines, this HRPF was tolerated by more than 90% of children with CMP allergy and therefore could provide an adequate and safe alternative to CMP-hydrolysed formulas for these infants.

Profile of a milk-allergic patient who tolerated partially hydrolyzed whey formula

“…5 Other studies have addressed the potential effects of formula selection on the natural history of CM allergy, but pHWFs were not specifically examined. 2, 6, 7 pHWF may carry unique immunoregulatory characteristics. 8,9 …”

Diagnosis and management of food allergies: new and emerging options: a systematic review

“…The first study, published in 2010 by Reche et al, compared the clinical tolerance of a hydrolyzed rice protein formula with an extensively hydrolyzed cow’s milk formula (EHCF) in infants with IgE-mediated cow’s milk allergy. The authors found no significant differences regarding tolerance achievement, adverse reactions, sIgE level, growth, or clinical tolerance 101. In a 2013 trial comparing five feeding regimens in milk-allergic children (EHCF, EHCF + Lactobacillus rhamnosus GG, hydrolyzed rice formula, soy formula, and amino acid formula), milk-allergic children who received EHCF alone or in combination with L. rhamnosus GG achieved tolerance at 12 months.…”

İnek sütü protein alerjisi

“…Anne sütü almayan bebeklerde inek sütü proteini içermeyen mamaların kullanı-mı önerilmektedir. Bu amaçla AAF, yarı hidrolize mamalar, tam hidrolize mamalar (eHF), soya bazlı mamalar ve pirinç bazlı mamalar kullanılmaktadır [22]. Sadece AAF non-alerjiktir.…”