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. 1995 Sep;73(3):211–215. doi: 10.1136/adc.73.3.211

Comparison of an elemental with a hydrolysed whey formula in intolerance to cows' milk.

C M McLeish 1, A MacDonald 1, I W Booth 1
PMCID: PMC1511300  PMID: 7492157

Abstract

In a double blind study, 40 infants with cows' milk intolerance of various causes were randomised to receive a nutritionally complete formula in which nitrogen was supplied either as whey hydrolysate or amino acids. The median age of infants was 10 weeks (range 36 weeks' gestation to 108 weeks' postnatal age). After a median follow up period of 25 weeks there was no significant difference in dietary intake between the formulas. Twenty four weeks after entry, weight and weight for length improved equally on both formulas. Plasma albumin improved significantly on the hydrolysed whey formula but not in the amino acid group. Both milks were palatable and normal intakes of formula were maintained. Biochemical and haematological indices remained within normal limits. There was no difference in stool frequency and vomiting between the two formulas. Two infants developed a probable allergic colitis while receiving hydrolysed whey. Amino acid formula may have a role in the management of atopic infants with severe cows' milk intolerance who have already reacted to whey or casein hydrolysate formula.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Boner A. L., Benedetti M., Spezia E., Piacentini G. L., Bellanti J. A. Evaluation of the allergenicity of infant formulas in a guinea pig model. Ann Allergy. 1992 May;68(5):404–406. [PubMed] [Google Scholar]
  2. Businco L., Cantani A. Hypersensitivity reaction in an infant fed hydrolyzed lactalbumin. J Pediatr Gastroenterol Nutr. 1991 Nov;13(4):429–429. doi: 10.1097/00005176-199111000-00015. [DOI] [PubMed] [Google Scholar]
  3. Businco L., Cantani A., Longhi M. A., Giampietro P. G. Anaphylactic reactions to a cow's milk whey protein hydrolysate (Alfa-Ré, Nestlé) in infants with cow's milk allergy. Ann Allergy. 1989 Apr;62(4):333–335. [PubMed] [Google Scholar]
  4. Crampton R. F., Gangolli S. D., Simson P., Matthews D. M. Rates of absorption by rat intestine of pancreatic hydrolysates of proteins and their corresponding amino acid mixtures. Clin Sci. 1971 Nov;41(5):409–417. doi: 10.1042/cs0410409. [DOI] [PubMed] [Google Scholar]
  5. Dean T. P., Adler B. R., Ruge F., Warner J. O. In vitro allergenicity of cows' milk substitutes. Clin Exp Allergy. 1993 Mar;23(3):205–210. doi: 10.1111/j.1365-2222.1993.tb00883.x. [DOI] [PubMed] [Google Scholar]
  6. Ellis M. H., Short J. A., Heiner D. C. Anaphylaxis after ingestion of a recently introduced hydrolyzed whey protein formula. J Pediatr. 1991 Jan;118(1):74–77. doi: 10.1016/s0022-3476(05)81849-9. [DOI] [PubMed] [Google Scholar]
  7. GOLDMAN A. S., ANDERSON D. W., Jr, SELLERS W. A., SAPERSTEIN S., KNIKER W. T., HALPERN S. R. MILK ALLERGY. I. ORAL CHALLENGE WITH MILK AND ISOLATED MILK PROTEINS IN ALLERGIC CHILDREN. Pediatrics. 1963 Sep;32:425–443. [PubMed] [Google Scholar]
  8. Hamill P. V., Drizd T. A., Johnson C. L., Reed R. B., Roche A. F., Moore W. M. Physical growth: National Center for Health Statistics percentiles. Am J Clin Nutr. 1979 Mar;32(3):607–629. doi: 10.1093/ajcn/32.3.607. [DOI] [PubMed] [Google Scholar]
  9. Heyman M. B., Stoker T. W., Rudolph C. D., Frick O. L. Hypersensitivity reaction in an infant fed hydrolyzed lactalbumin contained in a semielemental formula. J Pediatr Gastroenterol Nutr. 1990 Feb;10(2):253–256. doi: 10.1097/00005176-199002000-00020. [DOI] [PubMed] [Google Scholar]
  10. Keohane P. P., Grimble G. K., Brown B., Spiller R. C., Silk D. B. Influence of protein composition and hydrolysis method on intestinal absorption of protein in man. Gut. 1985 Sep;26(9):907–913. doi: 10.1136/gut.26.9.907. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Lifschitz C. H., Hawkins H. K., Guerra C., Byrd N. Anaphylactic shock due to cow's milk protein hypersensitivity in a breast-fed infant. J Pediatr Gastroenterol Nutr. 1988 Jan-Feb;7(1):141–144. doi: 10.1097/00005176-198801000-00026. [DOI] [PubMed] [Google Scholar]
  12. McLaughlan P., Anderson K. J., Widdowson E. M., Coombs R. R. Effect of heat on the anaphylactic-sensitising capacity of cows' milk, gots' milk, and various infant formulae fed to guinea-pigs. Arch Dis Child. 1981 Mar;56(3):165–171. doi: 10.1136/adc.56.3.165. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Rugo E., Wahl R., Wahn U. How allergenic are hypoallergenic infant formulae? Clin Exp Allergy. 1992 Jun;22(6):635–639. doi: 10.1111/j.1365-2222.1992.tb00180.x. [DOI] [PubMed] [Google Scholar]
  14. Sampson H. A., James J. M., Bernhisel-Broadbent J. Safety of an amino acid-derived infant formula in children allergic to cow milk. Pediatrics. 1992 Sep;90(3):463–465. [PubMed] [Google Scholar]
  15. Silk D. B., Fairclough P. D., Clark M. L., Hegarty J. E., Marrs T. C., Addison J. M., Burston D., Clegg K. M., Matthews D. M. Use of a peptide rather than free amino acid nitrogen source in chemically defined "elemental" diets. JPEN J Parenter Enteral Nutr. 1980 Nov-Dec;4(6):548–553. doi: 10.1177/0148607180004006548. [DOI] [PubMed] [Google Scholar]
  16. Vandenplas Y., Hauser B., Blecker U., Suys B., Peeters S., Keymolen K., Loeb H. The nutritional value of a whey hydrolysate formula compared with a whey-predominant formula in healthy infants. J Pediatr Gastroenterol Nutr. 1993 Jul;17(1):92–96. doi: 10.1097/00005176-199307000-00014. [DOI] [PubMed] [Google Scholar]
  17. Walker-Smith J. A., Digeon B., Phillips A. D. Evaluation of a casein and a whey hydrolysate for treatment of cow's-milk-sensitive enteropathy. Eur J Pediatr. 1989 Oct;149(1):68–71. doi: 10.1007/BF02024340. [DOI] [PubMed] [Google Scholar]

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