Preventive effect of hydrolyzed infant formulas persists until age 6 years: long-term results from the German Infant Nutritional Intervention Study (GINI).
BACKGROUND
The long-term effect of nutritional intervention with hydrolyzed infant formulas on allergy development has not been sufficiently evaluated.


OBJECTIVE
We performed a follow-up of the German Infant Nutritional Intervention study until 6 years of life to investigate the long-term allergy-preventive effect of 3 hydrolyzed infant formulas compared with cow's milk formula (CMF) in a randomized, double-blind trial.


METHODS
Between 1995 and 1998, 2252 newborns with atopic heredity were randomly assigned at birth to receive one of 4 blinded formulas: partially or extensively hydrolyzed whey formula, extensively hydrolyzed casein formula, or CMF as milk substitute for the first 4 months when breast-feeding was insufficient. The cohort was followed from birth until 6 years of age with yearly questionnaires. Outcomes were physician-diagnosed allergic diseases (atopic dermatitis, food allergy, allergic urticaria, asthma, and hay fever/allergic rhinitis). Log-binomial regression modeled with generalized estimation equations was used for the statistical analysis.


RESULTS
In the intent-to-treat analysis the relative risk of a physician's diagnosis of allergic manifestation (AM) compared with CMF was 0.82 (95% CI, 0.70-0.96) for partially hydrolyzed whey formula, 0.90 (95% CI, 0.78-1.04) for extensively hydrolyzed whey formula, and 0.80 (95% CI, 0.69-0.93) for extensively hydrolyzed casein formula. The corresponding figures for atopic eczema were 0.79 (95% CI, 0.64-0.97), 0.92 (95% CI, 0.76-1.11), and 0.71 (95% CI, 0.58-0.88), respectively. In the per-protocol analysis all effects were stronger and significant. No significant effect on other AMs was found.


CONCLUSIONS
The data confirm a long-term allergy-preventive effect of hydrolyzed infant formulas on AM and atopic eczema until 6 years of age.
Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany. vonberg@marien-hospital-wesel.de.
Andrea
A
von Berg
Birgit
B
Filipiak-Pittroff
Ursula
U
Krämer
Elke
E
Link
Christina
C
Bollrath
Inken
I
Brockow
Sibylle
S
Koletzko
Armin
A
Grübl
Joachim
J
Heinrich
H-Erich
HE
Wichmann
Carl-P
CP
Bauer
Dietrich
D
Reinhardt
Dietrich
D
Berdel
D002364:Caseins; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000517:prevention & control*; D007223:Infant; D041943:Infant Formula; D007231:Infant, Newborn; D008297:Male; D008894:Milk Proteins; D015995:Prevalence; D011492:Protein Hydrolysates; D011795:Surveys and Questionnaires; D000067816:Whey Proteins
D002364:Caseins; D008894:Milk Proteins; D011492:Protein Hydrolysates; D000067816:Whey Proteins