Five‐Year Follow‐Up of High‐Risk Infants with Family History of Allergy Who Were Exclusively Breast‐Fed or Fed Partial Whey Hydrolysate, Soy, and Conventional Cow's Milk Formulas

Abstract

Background:Allergy is a common cause of illness. The effect of feeding different infant formulas on the incidence of atopic disease and food allergy was assessed in a prospective randomized double‐blind study of high‐risk infants with a family history of atopy.Methods:216 high‐risk infants whose mothers had elected not to breast‐feed were randomized to receive exclusively a partial whey hydrolysate formula or a conventional cow's milk formula or a soy formula until 6 months of age. Seventy‐two high risk infants breast‐fed for ≥ 4 months were also studied.Results:Follow‐up until 5 years of age showed a significant lowering in the cumulative incidence of atopic disease in the breast‐fed (odds ratio 0.422 [0.200‐0.891]) and the whey hydrolysate (odds ratio 0.322 [0.159‐0.653) groups, compared with the conventional cow's milk group. Soy formula was not effective (odds ratio 0.759 [0.384‐1.501]). The occurrence of both eczema and asthma was lowest in the breast‐fed and whey hydrolysate groups and was comparable in the cow's milk and soy groups. Similar significant differences were noted in the 18‐60 month period prevalence of eczema and asthma. Eczema was less severe in the whey hydrolysate group compared with the other groups. Double‐blind placebo‐controlled food challenges showed a lower prevalence of food allergy in the whey hydrolysate group compared with the other formula groups.Conclusions:Exclusive breast‐feeding or feeding with a partial whey hydrolysate formula is associated with lower incidence of atopic disease and food allergy. This is a cost‐effective approach to the prevention of allergic disease in children.