Five-year follow up of high-risk infants with family history of allergy exclusively breast-fed or fed partial whey hydrolysate, soy and conventional cow's milk formulas

• Published in: Nutrition research (New York, N.Y.) N.Y.), 1998-08, Vol.18 (8), p.1395-1411
• Main Author: Chandra, Ranjit Kumar
• Format: Article
• Language: English
• Subjects: Asthma; Atopic disease; Biological and medical sciences; Breast-feeding; Eczema; Feeding. Feeding behavior; Food allergy; Fundamental and applied biological sciences. Psychology; Partial whey hydrolysate; Soy formula; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0271-5317; 1879-0739
• DOI: 10.1016/S0271-5317(98)00118-3

The effect of feeding different infant formulas on the incidence of atopic disease and food allergy was assessed in a prospective randomized double-blind study of high-risk infants with a family history of atopy. Two hundred and sixteen high-risk infants whose mothers had elected not to breast-feed were randomized to receive a partial whey hydrolysate formula (Good Start) or a conventional cow's milk formula (Similac) or a soy formula (Isomil). Each formula was used exclusively for 6 months. In addition, a group of 72 consecutively born infants with family history of atopy whose mothers elected to breast-feed and were able to do so for at least the first 4 months were studied. Follow-up until 5 years of age showed a significant lowering in the cumulative incidence of atopic disease in the breast-fed (odds ratio 0.422 [95% confidence intervals 0.200 – 0.891]) and the whey hydrolysate (odds ratio 0.322 [95% confidence intervals 0.159 – 0.653]) groups, compared with the conventional cow's milk group. Feeding with soy formula was not associated with a lower incidence of atopy (odds ratio 0.759 [95% confidence intervals 0.384 – 1.501]). The occurrence of both eczema and asthma was lowest in the breast-fed and whey hydrolysate groups and was comparable in the cow's milk and soy groups. Similar significant differences were noted in the period prevalence of eczema and asthma during 18 – 60 months of age. Eczema severity was less in the whey hydrolysate group compared with the other groups. Double-blind placebo-controlled food challenges showed a lower prevalence of food allergy in the whey hydrolysate group compared with the other formula groups. It is concluded that exclusive breast-feeding or feeding with a partial whey hydrolysate formula is associated with lower incidence of atopic disease and food allergy. This is a useful, cost-effective approach to the prevention of allergic disease in infants and children.