Table 4.

Hydrolysed formulas: pros and cons.

Type of Formula	Results	Pros	Cons
CM-based pHF	May improve symptoms of FGIDs Conflicting efficacy in prevention of allergy and eczema Improved gastric emptying vs. standard formulas	Often combined with pro/prebiotic components, reduced lactose and modified fat Better palatability compared to eHF and AAF	Not suitable to treat CMA Absence of long-term follow-up data Limited controlled trials Higher cost vs. standard formulas
CM based eHF	Efficacy in 90% of patients with CMA Accelerates gastric emptying vs. pHF and vs. standard formulas	first choice for CMA treatment, except for anaphylaxis, EoE, and severe CMA May improve symptoms of FGIDs Better absorption of peptides vs. amino-acids	Much higher cost vs. standard formulas Absence of lactose in most eHF Poor palatability and possible effect on taste development
Amino-acid formula	Efficacy in 100% of infants with CMA Efficacy in 75–90% of patients with EoE	First choice treatment for severe CMA, anaphylaxis, and EoE in infants	Much higher cost vs. eHF and vs. standard formulas Absence of lactose Poor palatability and possible effect on taste development
Rice-based eHF	Reported efficacy in the treatment of CMA in selected subjects	Second choice treatment for CMA, except for anaphylaxis, EoE, and severe CMA	Arsenic content should be limited and labelled Different amino-acid profile compared to CM based formulas Limited number of studies (mostly on IgE-mediated CMA)
Soy-based infant formulas	Possible efficacy in selected subjects with CMA	Low cost	Not recommended in the first 6 months of life and in infants with gastrointestinal symptoms Possible allergy to soy Concerns related to phytoestrogens and transgenic modified soybean