Formulas for infants with Cow's Milk Protein Allergy
With over 150 years of expertise in infant formula and 45 years of expertise in food allergy, Nestlé Health Science has a strong commitment to pioneering HMO research and nutritional innovations. Nestlé Health Science brings hypoallergenic specialty formulas with state of the art quality, safety and nutrition that are inspired by breastmilk. Breastmilk will always remain the best source of nutrition for all infants.
What is a hypoallergenic speciality formula?
Hypoallergenic speciality formulas are recommended for infants and young children diagnosed with cow's milk/dairy protein allergy (CMPA), that are not exclusively breastfed. These products are based on proteins that have been heat-treated and enzymatically hydrolyzed to different degrees to disrupt the majority of allergenic epitopes (Nutten et al., 2020).
For an infant formula to be labelled “hypoallergenic” it needs to have been clinically tested and proven to be effective in at least 90% of children with proven CMPA (with a 95% CI), according to the American Academy of Pediatrics (AAP) (AAP, 2000).
Only hypoallergenic formulas, either extensively hydrolyzed (eHF) or amino acid-based formulas (AAF) are considered suitable milk replacements for children with CMPA. Partially hydrolyzed formulas (pHF) are not a suitable replacement formula in infants and children with CMPA.
Figure 1: Processes and technologies in the development of hypoallergenic extensively hydrolyzed formulas and an amino acid-based formula, for infants diagnosed with cow’s milk protein allergy or MFPA.
CLINICAL INDICATION
The first choice for infants and young children with cow’s milk allergy.
Alfaré® HMO has been specially developed to treat BMA in infants and young children with gastrointestinal disorders. It is also suitable for infants with diarrhea and lactose intolerance, but not for galactosemia.
Alfamino® HMO is the next step for infants who live with severe CMPA, multiple food allergies and/or conditions affecting absorption.
First choice in infants and young children for severe cases of BMA. It contains a lipid blend of DHA/ARA, structured lipids and medium chain triglycerides to promote tolerance and absorption.
The next step for young children over 1 year of age who live with severe CMPA, multiple food allergies and/or conditions affecting absorption.
First choice for small children from 1 year with severe cow’s milk allergy and/or food intolerance.
EHF or AAF
Althéra® with HMO is an extensively hydrolyzed, hypoallergenic special food.
Alfare® with HMO is an extensively hydrolyzed, lactose-free, hypoallergenic special food.
SMALL PEPTIDES
Extensively hydrolyzed formulas (eHFs) are formulas in which the cow’s milk proteins have been rigorously broken down into small peptides, to make them hypoallergenic. Althéra® HMO and Alfaré® HMO are tolerated by > 98% of infants with CMPA.
Alfamino® with HMO is an amino acid-based, non-allergenic special food.
Alfamino® Junior with HMO is an amino acid-based, non-allergenic special food.
AMINO ACIDS
Amino acid-based formulas (AAFs) contain free amino acids. As they contain no cow’s milk protein, AAFs such as Alfamino® HMO are recommended in infants with severe symptoms of CMPA and/or multiple food allergies.
Human Milk oligosaccharides
Breast milk contains an intriguing component known as human milk oligosaccharides, or HMO. HMOs are a large component of breast milk and science has recently succeeded in replicating them for use in specialty formula for cow’s milk allergies.
Human milk oligosaccharides (HMO) are the third most abundant solid component in breast milk, with 2’fucosyllactose (2’Fl) and lacto-N-neotetraose (LNnT) being two of the most significant.
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