title: Treating cow's milk protein allergy: a double-blind randomized trial comparing two extensively hydrolysed formulas with probiotics.
abstract: OBJECTIVE
  The treatment for cow's milk protein allergy (CMPA) is a diet with an extensive hydrolysate. This study aimed to determine whether a whey (eWH) or casein hydrolysate (eCH) is the best option.
  
  
  METHODS
  Infants with suspected CMPA were treated with an eWH or eCH, and efficacy was assessed with a symptom-based score developed by the authors. Diagnosis of CMPA was based on a positive challenge. If positive, the same eHF/eCH was continued. If negative, a standard starter and follow-up formula were given up to the age of 12 months.
  
  
  RESULTS
  An open challenge was performed on 85/116 (73%) infants suspected of CMPA on clinical grounds and was positive in 59/85 (69%). After 1 month, the symptom-based scores in both groups showed significant statistical and clinical reductions, and total and specific IgE and skin prick test results were similar. Both hydrolysates were enriched with probiotics, which were recovered in the gastrointestinal flora. The eWH-Standard Formula sequence led to better growth at the age of 1 year than the other three feeding regimens tested.
  
  
  CONCLUSIONS
  The eWH and eCH are equally effective. The symptom-based score is a useful tool to evaluate the efficacy of dietary treatment in infants with CMPA.
authors.affiliation: Universitair KinderZiekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. yvan.vandenplas@uzbrussel.be
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
authors.forename: Philippe
authors.initials: P
authors.lastname: Steenhout
authors.forename: Yannis
authors.initials: Y
authors.lastname: Planoudis
authors.forename: Dominik
authors.initials: D
authors.lastname: Grathwohl
mesh_terms: D002364:Caseins; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D041943:Infant Formula; D016015:Logistic Models; D008297:Male; D016269:Milk Hypersensitivity / Q000175:diagnosis / Q000178:diet therapy*; D008894:Milk Proteins / Q000009:adverse effects; D019936:Probiotics / Q000627:therapeutic use*; D011492:Protein Hydrolysates / Q000627:therapeutic use*; D016896:Treatment Outcome; D000067816:Whey Proteins
chemical_list: D002364:Caseins; D008894:Milk Proteins; D011492:Protein Hydrolysates; D000067816:Whey Proteins
keywords: (extensive) Hydrolysate; Cow's milk protein allergy; Infant nutrition; Probiotic