Abstract
Background: Allergic diseases are a major public health burden worldwide. Evidence suggests that early nutrition might play a key role in the future development of allergies and the use of hydrolyzed protein formulas have been proposed to prevent allergic disease, mainly in term infants with risk factors.Aim: To evaluate the preventive effect of a hydrolyzed protein formula vs. an intact protein formula on allergy development in preterm infants with or without risk factors.Methods: We performed a 3-year follow-up study of a previous triple-blind, placebo-controlled randomized trial. Evidence of atopic dermatitis, asthma and IgE-mediated food allergies were evaluated according to a validated parental questionnaire (Comprehensive Early Childhood Allergy Questionnaire). Food sensitization was also investigated by skin prick test at 3 years of chronological age.Results: Of the 30 subjects in the intact protein formula group and 30 in the extensively hydrolyzed formula group, respectively 18 and 16 completed the 3-year follow-up and entered the final analysis. No group differences in the incidence of atopic dermatitis, asthma, IgE-mediated food allergies, and food sensitization were found.Conclusion: Despite the small number of cases, extensively hydrolyzed protein formula seems to be ineffective in allergic diseases prevention in preterm neonates. Further adequately powered, randomized controlled trials evaluating hydrolyzed protein formula administration to prevent allergic diseases in preterm neonates are needed.
Highlights
Allergic rhinitis (AR), asthma, eczema, and food allergy are some of the most common pediatric chronic conditions worldwide and have a major impact on children health and quality of life [1].Allergic diseases are genetically determined and influenced by several factors such as environmental pollution, smoke, aeroallergens, and early feeding pattern [2]
This paper describes the followup results of a previous published triple-blind, controlled, clinical trial, in preterm neonates fed with either intact protein formula or extensively hydrolyzed formula [14, 15]
The results of our study indicated that extensively hydrolyzed formulas (eHF) did not provide any preventive effects of allergy in preterm infants
Summary
Allergic rhinitis (AR), asthma, eczema, and food allergy are some of the most common pediatric chronic conditions worldwide and have a major impact on children health and quality of life [1].Allergic diseases are genetically determined and influenced by several factors such as environmental pollution, smoke, aeroallergens, and early feeding pattern [2]. A tailored approach seems to be the best strategy to hamper the so-called “atopic march” [3]. In this perspective, standard operative procedures to prevent allergy have become a priority in managing public health and infant feeding is considered the most important modifiable factor that can be targeted [4]. Evidence suggests that early nutrition might play a key role in the future development of allergies and the use of hydrolyzed protein formulas have been proposed to prevent allergic disease, mainly in term infants with risk factors
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