Short- and long-term effects of feeding hydrolyzed protein infant formulas on growth at < or = 6 y of age: results from the German Infant Nutritional Intervention Study.
BACKGROUND
The short- and long-term effects of feeding with hydrolyzed formulas on growth are uncertain.


OBJECTIVE
Our aim was to investigate the potential differences in body mass index (BMI) over the first 6 y of life between infants fed with partially hydrolyzed whey (pHF-W), extensively hydrolyzed whey (eHF-W), extensively hydrolyzed casein (eHF-C), or cow-milk formula (CMF) and infants exclusively breastfed for the first 16 wk of life.


METHODS
We established a prospective, randomized, double-blind trial of full-term neonates with atopic heredity in the German birth cohort followed by the German Infant Nutritional Intervention Study through the first 6 y of life. Intention-to-treat and per-protocol analyses of absolute and World Health Organization-standardized BMI trajectories for 1840 infants (pHF-W: n = 253; eHF-W: n = 265; eHF-C: n = 250, CMF: n = 276; breastfed: n = 796) were performed.


RESULTS
No significant differences in absolute or World Health Organization-standardized BMI trajectories were found among the pHF-W, eHF-W, CMF, and breastfed groups during the 6-y follow-up. However, in the eHF-C group, both intention-to-treat and per-protocol analyses showed a significantly slower sex-adjusted BMI gain through the 8th to 48th week of life (-0.1 to -0.2 lower BMI z score) but not beyond. Analyses of weight and length revealed that this difference is due to a slightly diminished weight gain in the first year of life because growth in length did not differ among study groups for the entire follow-up.


CONCLUSIONS
To our knowledge, this is the first randomized trial investigating both short- and long-term effects of partially and extensively hydrolyzed formula (pHF-W, eHF-W, eHF-C), CMF, and breastfeeding on growth in one trial. Feeding with eHF-C led to a transient lower weight gain in the first year of life. No long-term consequences of different formulas on BMI were observed.
Rzehak
Peter
P
Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany. peter.rzehak@helmholtz-muenchen.de
Sausenthaler
Stefanie
S
Koletzko
Sibylle
S
Reinhardt
Dietrich
D
von Berg
Andrea
A
Krämer
Ursula
U
Berdel
Dietrich
D
Bollrath
Christina
C
Grübl
Armin
A
Bauer
Carl Peter
CP
Wichmann
H-Erich
HE
Heinrich
Joachim
J
D000818:Animals; D015992:Body Mass Index; D001942:Breast Feeding; D002648:Child; D002675:Child, Preschool; D004044:Dietary Proteins / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006128:Growth / Q000187:drug effects*; D006801:Humans; D006868:Hydrolysis; D007223:Infant; D041943:Infant Formula / Q000737:chemistry*; D007231:Infant, Newborn; D008297:Male; D008892:Milk; D008894:Milk Proteins / Q000494:pharmacology*; D008895:Milk, Human
D004044:Dietary Proteins; D008894:Milk Proteins