Document Detail


Cow's milk protein avoidance and development of childhood wheeze in children with a family history of atopy.
MedLine Citation:
PMID:  12137717     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In infants with a family history of atopy, food allergen avoidance has been advocated as means of preventing the development of atopic disease when breast-feeding is not possible or supplemental feeding is needed. Most infant formulas are based on cow's milk protein. Alternative choices include soya based and hydrolysed cows milk formulas. OBJECTIVES: To estimate the effect of dietary avoidance of cow's milk protein on the development of asthma or wheeze in children. SEARCH STRATEGY: The Cochrane database was searched for eligible trials until February 2002. The full text papers of all abstracts identified as RCTs were obtained and reviewed independently by two reviewers. SELECTION CRITERIA: Randomised controlled trials involving children with a family history of atopy in at least one first degree relative were considered if feeding with cow's milk based standard formula was compared to dietary avoidance of cow's milk protein using soya or other hypoallergenic formula during the initial four months of life or longer. DATA COLLECTION AND ANALYSIS: Two reviewers extracted data independently. A priori defined subgroups were the types of hypoallergenic artificial feed and dietary restrictions on mother and/or child's diet. MAIN RESULTS: Six trials used hydrolysed formula for at least 4 months in addition to dietary restrictions and in some cases dust-mite reduction measures. The risk of infants experiencing asthma or wheeze during the first year of life was reduced compared to standard cow's milk based formula (Relative Risk =0.40, 95% Confidence Intervals 0.19, 0.85). Feeding soya-based formula as opposed to standard cow's milk formula did not reduce the risk of having asthma or wheeze at any age. REVIEWER'S CONCLUSIONS: Breast-milk should remain the feed of choice for all babies. In infants with at least one first degree relative with atopy, hydrolysed formula for a minimum of 4 months combined with dietary restrictions and environment measures may reduce the risk of developing asthma or wheeze in the first year of life. There is insufficient evidence to suggest that soya-based milk formula has any benefit.
Authors:
F S Ram; F M Ducharme; J Scarlett
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cochrane database of systematic reviews (Online)     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2002  
Date Detail:
Created Date:  2002-07-24     Completed Date:  2002-09-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD003795     Citation Subset:  IM    
Affiliation:
Department of Physiological Medicine, St George's Hospital Medical School, Level 0, Jenner Wing, Cranmer Terrace, London, UK, SW17 0RE. fram@sghms.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Asthma / etiology,  prevention & control*
Family
Humans
Infant
Infant Food
Infant, Newborn
Milk Hypersensitivity / immunology*
Milk Proteins / administration & dosage*,  adverse effects
Randomized Controlled Trials as Topic
Respiratory Sounds / etiology*
Chemical
Reg. No./Substance:
0/Milk Proteins
Comments/Corrections
Comment In:
Evid Based Nurs. 2003 Apr;6(2):43   [PMID:  12710418 ]
Update In:
Cochrane Database Syst Rev. 2007;(2):CD003795   [PMID:  17636737 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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