Cumulative incidence of atopic disorders in high risk infants fed whey hydrolysate, soy, and conventional cow milk formulas

Abstract

A recent increase in the prevalence of atopic disorders and the enormous costs of management of atopic patients have prompted attempts at prevention. We have examined the effect of exclusive breast feeding and of feeding different infant formulas on incidence of atopic disease in a prospective randomized controlled study. Seventy-two infants were recruited into each of the following groups: cow milk whey hydrolysate formula (NAN/HA) conventional cow milk formula (Similac), soy-based formula (Isomil), and exclusive breast feeding for greater than 4 months. The cumulative incidence of atopic eczema, recurrent wheezing, rhinitis, gastrointestinal symptoms, and colic were noted. Skin prick tests and radioallergosorbent tests for IgE antibodies to milk and soy were performed. At 12 and 18 months of age, the incidence of atopic eczema as also that of all atopic symptoms was significantly lower and similar in the breast-fed and whey hydrolysate groups, compared with the cow milk and soy formula groups. IgE antibodies were detected more often in the cow milk and soy formula groups, especially the former. Among symptomatic infants, fewer skin positive prick tests were seen in the soy group compared with the cow milk group. Our observations show that among infants at high risk of developing atopic disease because of positive family history, exclusive breast feeding or whey hydrolysate formula is associated with a lower incidence and thus a delay in the occurrence of allergic disorders compared with groups fed conventional cow milk or soy formulas.