Introducing formula to infants at risk for allergic disease
- David M Fleischer, MD
David M Fleischer, MD
- Associate Professor of Pediatrics
- Children's Hospital Colorado
- University of Colorado Denver School of Medicine
The term "allergy" refers to a hypersensitivity reaction initiated by immunologic mechanisms. Three factors are needed to develop allergic disease: the appropriate genetic background, contact with the allergen(s), and environmental factors, such as timing, amount, and frequency of exposure.
The most prevalent allergic or atopic disorders include atopic dermatitis (AD), asthma, allergic rhinitis (AR), and food allergies. These conditions afflict 20 percent of the population of the United States, and their prevalence is rising in developed nations. The increase in atopic diseases has been recognized as a pandemic, thus emphasizing the need for effective allergy prevention .
Convincing studies support the existence of a critical time early in infancy during which the genetically predisposed atopic infant is at higher risk for becoming sensitized . Thus, dietary interventions in the first year of life have been analyzed for their effects on the prevalence of allergic disease .
Studies examining the associations between the use of various infant formulas and the development of allergic diseases in infants at high risk for atopic conditions are discussed in this topic review. Associations between early or delayed introduction of complementary foods and the development of atopy are reviewed separately, as are other aspects of the primary prevention of allergic disease. (See "Primary prevention of allergic disease: Maternal diet in pregnancy and lactation" and "The impact of breastfeeding on the development of allergic disease" and "Introducing highly allergenic foods to infants and children".)
The definition of an infant at high risk for developing allergic disease is reviewed here, as are the different formulas available for infants.
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- Infants at high risk for developing allergy
- Types of formulas
- FORMULA SELECTION FOR THE HIGH-RISK INFANT
- Breastfeeding versus hydrolyzed formulas
- Studies comparing different formulas
- - Cow's milk formula versus partially hydrolyzed formula
- - Cow's milk formula versus extensively hydrolyzed formula
- - Partially hydrolyzed formula versus extensively hydrolyzed formula
- - Soy formula versus others
- SUMMARY AND RECOMMENDATIONS