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. 2023 Jan 30:4:1073430.
doi: 10.3389/falgy.2023.1073430. eCollection 2023.

Symptom's resolution and growth outcome of children with cow's milk protein allergy consuming two hydrolyzed formulas: A retrospective study in Mexico

Elizabeth Estrada Reyes  1 , Benjamín Zepeda Ortega  2 , Dominique Ten Haaf  3 , Urszula Kudla  3 , Leilani Muhardi  3 , Denise L Hofman  3 , Jeske H J Hageman  3 , Rosa E Huerta Hernández  4
Affiliations

Symptom's resolution and growth outcome of children with cow's milk protein allergy consuming two hydrolyzed formulas: A retrospective study in Mexico

Elizabeth Estrada Reyes et al. Front Allergy. .

Abstract

Background: Cow's milk protein allergy (CMPA) is the leading cause of food allergy in infants and young children. An extensively hydrolyzed formula (eHF) is the first choice of dietary management, however, not all of them have similar peptide profiles and degree of hydrolysis. The aim of this retrospective study was to investigate the use of two commercially available infant formulas in the clinical management of CMPA in Mexico in terms of symptoms' resolution and growth trajectories.

Methods: Medical records of 79 subjects from four sites in Mexico were included to retrospectively evaluate the trajectory of atopic dermatitis, other symptoms of cow's milk protein allergy and growth outcomes. The study formulas were based on hydrolyzed whey protein (eHF-W) and hydrolyzed casein protein (eHF-C).

Results: Medical records of 79 patients were enrolled, 3 were excluded from analysis based on previous formula consumption. Seventy-six children with confirmed CMPA based on skin prick test and/or serum specific IgE levels were included in the analysis. 82% of patients (n = 65) consumed the eHF-C, reflecting the doctors' preference for formulas with a higher grade of hydrolysis and the high incidence of positive reactions to beta-lactoglobulin amongst subjects. During their first visit to the doctors, 55% of the subjects consuming the casein-based formula and 45% of subjects consuming the whey-based formula presented with mild or moderate dermatological symptoms. Other frequently reported symptoms included respiratory issues, enteropathies and colitis which improved during the consumption of both formulas. All CMPA-related symptoms showed improvement during formula consumption. During the period of retrospective observation, growth significantly improved for both groups.

Conclusion: Consumption of eHF-C and eHF-W effectively improved symptoms' resolution and growth outcomes among children with CMPA in Mexico. More preference was reported towards eHF-C due to its hydrolysate profile and lack of b-lactoglobulin.

Trial registration: The study was registered at ClinicalTrials.gov: NCT04596059.

Keywords: Mexico; SCORAD; cow's milk protein allergy; growth; hydrolysates; infant formula.

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Conflict of interest statement

DLH, UK, LM, DH, and JH are employees of FrieslandCampina at the time of trial execution and manuscript submission.

Figures

Figure 1
Figure 1
Growth outcomes of the study subjects consuming eHF-C, presented as Z-scores (mean ± SD); (A) weight-for-age, (B) height-for-age, (C) weight-for-height, and (D) BMI-for-age Z-scores. Weight-for-age (WAZ) and height-for-age (HAZ) significantly improved during formula consumption (p = 0.02 and p = 0.04 respectively).
Figure 2
Figure 2
Growth outcomes of the study subjects consuming eHF-W, presented as Z-scores (mean ± SD, with individual scores); (A) weight-for-age, (B) height-for-age, (C) weight-for-height, and (D) BMI-for-age Z-scores. Weight-for-age (WAZ) significantly improved during formula consumption (p = 0.04).
Figure 3
Figure 3
Average age-range of reported onset (*) and resolution (^) of symptoms in both groups.
See this image and copyright information in PMC

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