Probiotic Formula May Protect Infants With Milk Allergy

TOPLINE:

Children with cow’s milk protein allergy (CMPA) who received an extensively hydrolyzed casein formula enriched with Lactobacillus rhamnosus GG (EHCF+LGG) had a lower incidence of allergic manifestations such as eczema, urticaria, asthma, and oculorhinitis and were more likely to acquire immune tolerance to the allergen than those who received other formulas.

METHODOLOGY:

• Researchers studied 313 non-breastfed children (median age at baseline, 5 months; 64.5% boys) with suspected immunoglobulin E–mediated CMPA between December 2src14 and June 2src22.
• Children were on a strict cow’s milk protein elimination diet and received one of five formulas: the probiotic casein formula, a rice hydrolyzed formula, a soy formula, an extensively hydrolyzed whey formula, or an amino acid–based formula.
• Researchers assessed the participants’ allergic symptoms, dietary compliance, and the acquisition of immune tolerance through oral food challenges during six follow-up visits.
• The primary objective was to estimate the occurrence of at least one allergic manifestation — oculorhinitis, atopic eczema, asthma, or urticaria — during the 72-month study.

TAKEAWAY:

• The incidence of allergic manifestations was the lowest in the EHCF+LGG cohort, at src.3src (Bonferroni-corrected 95% CI, src.15-src.44), whereas the incidence rates for the other formulas ranged from src.68 to src.83.
• Risk ratios showed that the risk for allergic manifestations was more than doubled with the other formulas compared with the probiotic formula (P <.srcsrc1 for all).
• The incidence of immune tolerance acquisition was highest in the EHCF+LGG cohort, at src.95, whereas rates with the other formulas ranged from src.6src to src.84.
• Two children developed celiac disease during the study period (one who received soy formula and one who received rice formula), and no other autoimmune disorders were reported.

IN PRACTICE:

“The use of EHCF supplemented with LGG in fact not only appears to mitigate the progression of the allergic march but also promotes the earlier acquisition of immune tolerance,” the authors wrote. “These findings suggest that such formulas should be considered a preferred strategy in managing CMPA.”

SOURCE:

Rita Nocerino, with the University of Naples Federico II in Naples, Italy, was the corresponding author of the study, which was published online on April 5 in Clinical Nutrition.

LIMITATIONS:

This study was limited by its observational design, the exclusion of children with severe CMPA or significant comorbidities, and a lack of data on gut microbiota and Th1/Th2 cytokines. Randomized trials are needed to establish that LGG supplementation reduces allergic manifestations in children with CMPA, the researchers noted.

DISCLOSURES:

This study was supported by an unrestricted grant from Mead Johnson Nutrition. One author, Roberto Berni Canani, MD, PhD, reported speaking for or receiving research grants from several companies that manufacture infant formula.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.