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Extensive protein hydrolysate formula effectively reduces regurgitation in infants with positive and negative challenge tests for cow's milk allergy
Author(s) -
Vandenplas Y.,
De Greef E.
Publication year - 2014
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12615
Subject(s) - medicine , hydrolysate , regurgitation (circulation) , milk allergy , allergy , cow milk , pediatrics , food science , immunology , food allergy , biochemistry , chemistry , hydrolysis
Aim Cow's milk protein allergy ( CMPA ) is treated using an elimination diet with an extensive protein hydrolysate. We explored whether a thickened or nonthickened version was best for infants with suspected CMPA , which commonly causes regurgitation/vomiting. Methods Diagnosis of CMPA was based on a positive challenge test. We compared the efficacy of two casein extensive hydrolysates ( eCH ), a nonthickened version ( NT ‐ eCH ) and a thickened version ( T ‐ eCH ), using a symptom‐based score covering regurgitation, crying, stool consistency, eczema, urticarial and respiratory symptoms. Results A challenge was performed in 52/72 infants with suspected CMPA and was positive in 65.4%. All confirmed CMPA cases tolerated eCH . The symptom‐based score decreased significantly in all infants within a month, and the highest reduction was in those with confirmed CMPA . Regurgitation was reduced in all infants (6.4 ± 3.2–2.8 ± 2.9, p < 0.001), but fell more with the T‐ eCH (−4.2 ± 3.2 regurgitations/day vs. −3.0 ± 4.5, ns), especially in infants with a negative challenge (−3.9 ± 4.0 vs. −1.9 ± 3.4, ns). Conclusion eCH fulfilled the criteria for a hypoallergenic formula, and the NT ‐ eCH and T ‐ eCH formulas both reduced CMPA symptoms. The symptom‐based score is useful for evaluating how effective dietary treatments are for CMPA .