Extensively hydrolyzed casein formula with probiotic prevents atopic manifestations

The use of extensively hydrolyzed casein formula containing the probiotic Lactobacillus rhamnosus GG (EHCF + LGG) for the treatment of cow’s milk allergy (CMA) in children also seems to suppress other atopic manifestations, a recent study has found.

The researchers conducted a prospective analysis of 365 children with suspected immunoglobulin E-mediated CMA. Participants had been placed on a substitutive formula: EHCF + LGG, rice hydrolyzed, soy, amino acid-based, and extensively hydrolyzed whey (EWHF) formula. Each formula was taken by 73 participants. The main outcome was at least one atopic manifestation at 36 months.

Incidence of atopic manifestations was lowest in the EHCF + LGG group, and highest among those taking amino acid-based formula (0.22 vs 0.77). Binomial regression model found that the latter formula increased the risk of the main outcome by more than three times relative to the former (risk ratio [RR], 3.50, 95 percent confidence interval [CI], 2.23–5.49; p<0.001).

Notably, all other substitutions yielded significantly higher risk estimates of atopic manifestations compared with EHCF + LGG.

For instance, rice hydrolyzed (RR, 2.37, 95 percent CI, 1.46–3.86; p<0.001) and soy (RR, 2.62, 95 percent CI, 1.63–4.22; p<0.001) formulas, along with EWHF (RR, 2.31, 95 percent CI, 1.42–3.77; p<0.001) all increased the likelihood of atopic manifestations by more than twice, as compared with EHCF + LGG.

“[T]his cohort study performed in a well-characterized population of children with CMA shows that EHCF + LGG could be effective in preventing the allergic march and in accelerating the time of immune tolerance acquisition,” the researchers said.