Hypoallergenic Formula-Feeding for CMPA Infants

In the first six months of an infant’s life, exclusive breastfeeding is recommended. In CMPA infants who are not exclusively breastfed (for whatever reason) then a hypoallergenic formula is necessary to ensure they receive all the nutrients required for growth and development.

These formulas can be based on extensively hydrolyzed proteins such as whey or casein, or can be based on 100% free amino acids. Extensively hydrolyzed formulas (eHFs) with proven efficacy in children with CMPA are usually the first line choice for the majority of infants (Koletzko et al., 2012). 

When an eHF is ineffective at achieving symptom resolution (estimated to be <10%) (Koletzko et al 2012), or when the infant has had an anaphylactic reaction to cow’s milk/dairy, an amino acid-based formula (AAF) should be prescribed.

Hypoallergenic infant formulas are formulas that have been tested and proven to be tolerated by at least 90% of children with documented CMPA with a 95% Confidence Interval (CI), under double-blind, placebo-controlled conditions (AAP, 1990/2000; Businco L et al., 1993 (EAACI); Høst et al., 1999 (ESPGHAN)).