An extensively hydrolysed rice protein-based formula in the management of infants with cow's milk protein allergy: preliminary results after 1 month

Yvan Vandenplas, Elisabeth De Greef, Bruno Hauser, Paradice Study Group, Paradice Study Group, C Halut, Mn Robberecht, N Balduck, A l'Homme, Mp Mohring, T Carvelli, B Hauser, E Defontaine, Jf Questiau, J Christens, F Henckens, R Lemmens, L Vercammen, E De Greef, Yvan Vandenplas, Elisabeth De Greef, Bruno Hauser, Paradice Study Group, Paradice Study Group, C Halut, Mn Robberecht, N Balduck, A l'Homme, Mp Mohring, T Carvelli, B Hauser, E Defontaine, Jf Questiau, J Christens, F Henckens, R Lemmens, L Vercammen, E De Greef

Abstract

Background: Guidelines recommend extensively hydrolysed cow's milk protein formulas (eHF) in the treatment of infants diagnosed with cow's milk protein allergy (CMPA). Extensively hydrolysed rice protein infant formulas (eRHFs) have recently become available, and could offer a valid alternative.

Methods: A prospective trial was performed to evaluate the clinical tolerance of a new eRHF in infants with a confirmed CMPA. Patients were followed for 1 month. Clinical tolerance of the eRHF was evaluated with a symptom-based score (SBS) and growth (weight and length) was monitored.

Results: Thirty-nine infants (mean age 3.4 months, range 0.5-6 months) diagnosed with CMPA were enrolled. All infants tolerated the eRHF and experienced a normal growth.

Conclusions: In accordance with current guidelines, this eRHF is tolerated by more than 90% of children with proven CMPA with a 95% CI, and is an adequate alternative to cow's milk-based eHF.

Trial registration number: ClinicalTrials.gov NCT01998074.

Keywords: Allergy; Gastroenterology; General Paediatrics; Nutrition.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

References

    1. Vandenplas Y, Koletzko S, Isolauri E, et al. Guidelines for the diagnosis and management of cow's milk protein allergy in infants. Arch Dis Child 2007;92:902–8
    1. Koletzko S, Niggemann B, Arato A, et al. ; European Society of Pediatric Gastroenterology, Hepatology, and Nutrition. Diagnostic approach and management of cow's-milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J Pediatr Gastroenterol Nutr 2012;55:221–9
    1. Bhatia J, Greer F; American Academy of Pediatrics Committee on Nutrition. Use of soy protein-based formulas in infant feeding. Pediatrics 2008;121:1062–8
    1. No authors listed]. American Academy of Pediatrics. Committee on Nutrition. Hypoallergenic infant formula. Pediatrics 2000;106:346–9
    1. Zeiger RS, Sampson HA, Bock SA, et al. Soy allergy in infants and children with IgE-associated cow's milk allergy. J Pediatr 1999;134:614–22
    1. Agostoni C, Axelsson I, Goulet O, et al. ; ESPGHAN Committee on Nutrition. Soy protein infant formulae and follow on formulae a commentary by the ESPGHAN. J Pediatr Gastroenterol Nutr 2006;42:352–61
    1. Høst A, Koletzko B, Dreborg S, et al. Dietary products used in infants for treatment and prevention of food allergy. Joint Statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI) Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition. Arch Dis Child 1999;81:80–4
    1. Klemola T, Vanto T, Juntunen-Backman K, et al. Allergy to soy formula and to extensively hydrolyzed whey formula in infants with cow's milk allergy: a randomised study with a follow-up to the age of 2 years. J Pediatr 2002;140:219–24
    1. Koletzko B, Baker S, Cleghorn G, et al. ; ESPGHAN Committee on Nutrition. Global Standard for the composition of infants formula: recommendations of an ESPGHAN coordinated international expert group. J Pediatr Gastroenterol Nutr 2005;41:584–99
    1. Commission Directive 2006/141/CE of 22 December 2006 on infant formulae and follow-on formulae and amending Directive 1999/21/EC. OJ L 401, 30.12.2006, p.1.
    1. Vandenplas Y, Steenhout P, Planoudis Y, et al. ; Althera Study Group. A double-blind randomized trial comparing two extensively hydrolyzed formulas with probiotics for the treatment of cow's milk protein allergy. Acta Paediatr 2013;102:990–8
    1. Vandenplas Y, Steenhout P, Grathwohl D; Althera Study Group. A pilot study on the application of a symptom-based score for the diagnosis of cow's milk protein allergy. SAGE Open Med 2014;2
    1. Vandenplas Y, De Greef E; ALLAR Study Group. Extensive protein hydrolysate formula effectively reduces regurgitation in infants with positive and negative challenge tests for cow's milk allergy. Acta Paediatr 2014;103:e243–50
    1. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development. Geneva: World Health Organization, 2006.
    1. Dreborg S, Frew A. EAACI position paper: allergen standardization and skin tests. Allergy 1993;48(Suppl 14):48–82
    1. Fiocchi A, Travaini M, D'Auria E, et al. Tolerance to a rice hydrolysate formula in children allergic to cow's milk and soy. Clin Exp Allergy 2003;33:1576–80
    1. Fiocchi A, Restani P, Bernardini R, et al. A hydrolyzed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study. Clin Exp Allergy 2006;36:311–16
    1. Reche M, Pascual C, Findaor A, et al. The effect of a partially hydrolyzed formula based on rice protein in the treatment of infants with cow's milk protein allergy. Pediatr Allergy Immunol 2010;21:577–85
    1. Comité de Nutrition de la Société Française de Pédiatrie. Utilisation des formules à charge antigénique réduite. Arch Pediatr 2000;7:302–61
    1. Savino F, Castagno E, Monti G, et al. Z-score of weight for age of infants with atopic dermatitis and cow's milk allergy fed with a rice-hydrolysate formula during the first two years of life. Acta Paediatr 2005;94:115–19
    1. D'Auria E, Sala M, Lodi F, et al. Nutritional value of a rice-hydrolysate formula in infants with cows’ milk protein allergy: a randomized pilot study. J Int Med Res 2003;31:215–22
    1. Agostoni C, Fiocchi A, Rive E, et al. Growth of infants with IgE-mediated cow's milk allergy fed different formulas in the complementary feeding period. Pediatr Allergy Immunol 2007;18:599–606
    1. Lasekan JB, Koo WK, Walters J, et al. Growth, tolerance and biochemical measures in healthy infants fed a partially hydrolyzed rice protein-based formula: a randomised, blinded prospective trial. J Am Coll Nutr 2006;25:12–19
    1. Council Directive 98/83/EC of 3 November 1998 on the quality of water intended for human consumption. OJ L 330, 5.12.1998, p.32.
    1. United Kingdom Food Standards Agency. Food Survey Information Sheet 02/09. Survey of total and inorganic arsenic in rice drinks.
    1. Pedrosa M, Pascual CY, Larco JI, et al. Palatability of hydrolysates and other substitution formulas for cow's milk-allergic children: a comparative study of taste, smell, and texture evaluated by healthy volunteers. J Investig Allergol Clin Immunol 2006;16:351–6
    1. Vandenplas Y, Hachimi-Idrissi S, Casteels A, et al. A clinical trial with an anti-regurgitation formula. Eur J Pediatr 1994;153:419–23
    1. Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997;32:920–4

Source: PubMed

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