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Cow’s Milk Allergy: Protein Hydrolysates or Amino Acid Formula?

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Pharma-Nutrition

Part of the book series: AAPS Advances in the Pharmaceutical Sciences Series ((AAPS,volume 12))

Abstract

A child with cow’s milk protein allergy needs a replacement feeding. The elimination diet should be strictly followed, at least until 9–12 months of age. If the child is not breastfed or the mother cannot or no longer wishes to breastfeed, the first choice is an extensive cows’ milk hydrolysate (extensively hydrolysed formula, eHF) of efficacy proven by scientifically sound studies. If it is not tolerated, an amino acid formula is warranted. Rice protein eHF can be an alternative to cows’ milk protein-based eHF. Soy protein infant formulae are also a suitable alternative in infants >6 months, after establishing tolerance to soy protein by clinical challenge. Children with cows’ milk protein allergy (CMPA) and symptoms resisting to eHF feeding are said allergic to eHF and need to be fed using an amino acid-based formula (AAF), in which almost all allergenic residues have been eliminated. An AAF may be used on first intention in a child who does not accept the eHF or in some clinical presentations of CMPA such as proctocolitis, eosinophilic esophagitis, severe symptoms and failure to thrive.

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  1. Service d’Explorations Fonctionnelles Digestives Pédiatriques, Université Paris Descartes, Hôpital Necker-Enfants Malades, 149, rue de Sèvres, 75015, Paris, France

    Christophe Dupont

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  1. Pharmacology, Utrecht University, The Netherlands

    Gert Folkerts

  2. Immunopharmacology, Utrecht University, The Netherlands

    Johan Garssen

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Dupont, C. (2014). Cow’s Milk Allergy: Protein Hydrolysates or Amino Acid Formula?. In: Folkerts, G., Garssen, J. (eds) Pharma-Nutrition. AAPS Advances in the Pharmaceutical Sciences Series, vol 12. Springer, Cham. https://doi.org/10.1007/978-3-319-06151-1_18

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