Hydrolyzed Infant Formulas

Study Finds Long-Term Allergy-Preventive Effect of Hydrolyzed Infant Formulas on Allergy and Atopic Eczema

A study in the June 2008 edition of the Journal of Allergy Clinical Immunology found that at six years of age, nutritional intervention with hydrolyzed infant formula had long-lasting allergy-preventive effects.  The study was a randomized prospective trial from the German Infant Nutritional Intervention (GINI) study, where newborns with atopic heredity were randomly assigned at birth to receive one of 4 blinded formulas: partially hydrolyzed whey formula, extensively hydrolyzed whey formula, extensively hydrolyzed casein formula, or cow’s milk formula (CMF) as milk substitute for the first 4 months when breast-feeding was insufficient.  The study followed the infants from birth until six years of age through the administration of a yearly questionnaire; development of allergic disease was assessed by asking if the child had been diagnosed with an atopic disease by a physician since the last follow up.  

At six years of age, children who were fed partially hydrolyzed whey formula, extensively hydrolyzed whey formula, or extensively hydrolyzed casein formula showed reduced allergic manifestation compared to those children fed cow’s milk formula as an infant.  However, the authors note that “there is no preventive effect of any of the formulas on the cumulative incidence of asthma at 6 years.”

This study is “the first and largest randomized trial ever conducted that followed high-risk children who were supplemented with different hydrolyzed infant formulas in the first 4 months of life to the age of 6 years,” according to the authors.  The large sample size, the randomization of the formula intervention, and the long-term follow up are strengths of the study.  One limitation of the study, however, is that the follow-up was not complete; less than 80% of study participants answered the 6 year questionnaire.  The authors assessed the possible impact of this limitation by analyzing if participation in the 6 year questionnaire was selective (thereby biasing the results), but found that the relative risks were nearly unchanged.  The authors note that they will continue to monitor allergy manifestation in this cohort until at least 10 years of age.

von Berg, A., et al., Preventive effect of hydrolyzed infant formulas persists until age 6 years: long-term results from the German Infant Nutritional Intervention Study (GINI). J Allergy Clin Immunol, 2008. 121 (6): p. 1442-7.