Abstract
Cow’s milk allergy (CMA) is the most common food allergy in early childhood, and its prevalence continues to rise. Exclusive breastfeeding is recommended for infants in the first 6 months of life, but this recommendation is poorly adhered to in many parts of the world, including the Middle East, North Africa, and Pakistan (MENAP) region. If the infant is affected by CMA, current guidelines recommend extensively hydrolyzed formulas (eHFs) or amino acid-based formulas (AAFs) in the case of severe symptoms, and hydrolyzed rice formulas (HRFs) where available. In recent years, HRFs have been proposed as a plant-based alternative to cow’s milk protein-based eHFs, and updates to current guidelines have been recommended. In 2014, a consensus statement and guidelines were published for the Middle East region on the prevention, diagnosis, and management of CMA. As new advances have been made in the extensively hydrolyzed hypoallergenic infant formula space, along with updated scientific evidence, a workshop of experts from the MENAP region focused on HRF was convened in 2021. This publication summarizes the insights from this meeting. During the consensus part of the meeting, a new approach was discussed and approved by all participants, and agreement was reached that HRF can be recommended as a first-line alternative to cow’s milk-based eHF in the dietary management of CMA.
Highlights
Allergy risk has become a significant public health issue with rising prevalence, and despite past, current, and ongoing research, the reasons are not fully understood [1,2,3]
healthcare professionals (HCPs) Survey Findings from the MENAP Region A brief survey of six questions was distributed to 50 HCPs with an interest in infant nutrition and cow’s milk allergy in Kuwait, Saudi Arabia, and the United Arab Emirates in advance of the roundtable, to assess current first- and second-line approaches to the dietary management of Cow’s milk allergy (CMA)
Most (97%) respondents indicated that patients at least sometimes switch from a first-line formula; 68% of HCPs indicated that patients “sometimes” make the switch, 24% indicated this happens “often”, and 5% indicated “very often”
Summary
Allergy risk has become a significant public health issue with rising prevalence, and despite past, current, and ongoing research, the reasons are not fully understood [1,2,3]. Cow’s milk allergy (CMA) is the most common food allergy in early childhood, and approximately 80% of children will outgrow it by 3–5 years of age [4,5]; its prevalence ranges from 1.9% to 4.9% [6] It manifests through a variety of symptoms that place a significant burden on the infant and caregiver alike [7]. In recent years, hydrolyzed rice formulas (HRFs) have been proposed as a suitable plant-based alternative to cow’s milk protein-based eHFs, and updates to current guidelines have been recommended by DRACMA and the Committee on Nutrition of the French Society of Pediatrics [9,10]. During the consensus section of the meeting, a potential new approach to the therapeutic management of CMA using HRF was discussed and approved by all participants
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