title: Efficacy and safety of hydrolyzed cow milk and amino acid-derived formulas in infants with cow milk allergy.
abstract: OBJECTIVE
  To determine the antigenicity, nutritional adequacy, and growth-promoting efficacy of protein hydrolysate or amino acid-derived formulas in infants with cow milk allergy.
  
  
  METHODS
  Several protein hydrolysate or amino acid-derived formulas were graded for beta-lactoglobulin content and skin reactivity in 74 atopic children with cow milk allergy proved by a double-blind, placebo-controlled challenge. A randomized, prospective follow-up study of 9 months included 22 infants with a mean age of 6 months (95% confidence interval, 4 to 7), who were fed an extensively hydrolyzed whey formula (group We), and 23 infants with a mean age of 17 (95% confidence interval, 4 to 7) months, who were given an amino acid-derived formula (group AA).
  
  
  RESULTS
  Both formulas were clinically and biochemically tolerated. The mean concentration of essential amino acids in plasma was lower in group We but higher in group AA compared with values for breast-fed control infants (p = 0.001). There was a different trend between the groups in weight (p = 0.09) and length (p = 0.006). Growth was promoted in group AA during the follow-up; it was constant during the first months, followed by a gradual decline in rate in group We. In both groups, atopic eczema improved significantly and progressively, and a downward trend was found in serum total and milk-specific IgE concentrations, proving the efficacy of both formulas.
  
  
  CONCLUSIONS
  Extensively hydrolyzed formulas are safe and effective for most infants; an amino acid-derived formula may be preferable for infants with multiple food allergies, especially for the maintenance of normal growth.
authors.affiliation: Department of Pediatrics, University of Tampere Medical School, Finland.
authors.forename: E
authors.initials: E
authors.lastname: Isolauri
authors.forename: Y
authors.initials: Y
authors.lastname: Sütas
authors.forename: S
authors.initials: S
authors.lastname: Mäkinen-Kiljunen
authors.forename: S S
authors.initials: SS
authors.lastname: Oja
authors.forename: R
authors.initials: R
authors.lastname: Isosomppi
authors.forename: K
authors.initials: K
authors.lastname: Turjanmaa
mesh_terms: D000596:Amino Acids; D000818:Animals; D003876:Dermatitis, Atopic / Q000175:diagnosis; D004311:Double-Blind Method; D005500:Follow-Up Studies; D005526:Food, Formulated; D006801:Humans; D007223:Infant; D007225:Infant Food; D007782:Lactoglobulins / Q000032:analysis; D008892:Milk; D010919:Placebos; D012720:Severity of Illness Index
chemical_list: D000596:Amino Acids; D007782:Lactoglobulins; D010919:Placebos