Part 2: Cow´s Milk Protein Allergy Management

Abstract

Breastfeeding is an excellent protection factor for babies and it is an incomparable way of providing ideal food for healthy growth and development to a child. It is imperative to recommend its use exclusively during the first 6 months of age, and continue breastfeeding during complement feeding until 2 years of life. Special formulas should be used only when mothers cannot breastfeed. In this case scenario, there are several formulas available, such as hydrolyzed formulas, soy formulas and elemental formulas. Hydrolyzed formulas could be either extensively or partially hydrolyzed and could be serum protein or casein based. The extensively hydrolyzed formulas (eHF), have been proven to eliminate symptoms of Cow Milk Protein Allergy (CMA) in clinical trials. Recent studies have shown that the addition of Lactobacillus rhamnosus (LGG) to an eHFcasein formula, accelerates the acquisition of tolerance in children compared to patients receiving no LGG added eHF. Although soy formula is not hypoallergenic, it could be used to treat CMA. It should not be used before 6 months of age. Partially hydrolyzed formulas or milk from other ruminants, such as sheep or goat, can´t be used as treatment CMA. In patients with high levels of sensitivity or with a history of anaphylactic reaction, administration of elemental formula is recommended. The aim of this review is to inform the management of CMA,to recommend a wise use of hydrolyzed and elementary formulas and to advice the avoidance of the indiscriminate use of these formulas in children with functional disorders.
Keywords
Infant formulas, soymilk, soy protein, Protein Hydrolysates, aminoacids, actobacillus rhamnosus