| Popis: |
This is a literature review, “Hypoallergenic formulas: what, when and to whom”. The aim of this study: to explore what different types of infant hypoallergenic formulas exists, when to give them and to whom. The objectives of this research are: 1. What infant formulas are used for cow’s milk protein allergy prophylaxis? 2. What infant formulas are used for cow’s milk protein allergy treatment? 3. Are there other hypoallergenic non-dairy infant formulas and what are they used for? The method of this study: This is a literature review. Studies and articles were recollected in the data base of The National Center for Biotechnology Information (NCBI). The articles related to infant hypoallergenic formulas were identified and collected using search phrases: “Infant milk allergy”, “Milk allergy”, “Milk allergy prevention”, “Milk allergy treatment”, “Infant formula”, “Hydrolyzed formula”, “Amino acid infant formula”, “Partially hydrolyzed formula”, “and Infant rice formulas ”,“ Infant soy formulas”. The articles and studies were selected for inclusion in this thesis based on their relevance on the topic and the age and language of the article. The results of this study: Sixteen studies regarding infant formulas of different kinds have been included in the results of this literature review. Some studies show different results but the overall conception regarding infant formula feeding in children with cow’s milk protein allergy are as follows: pHF are superior to standard IF when it comes to prophylaxis in children at high risk of CMPA, however eHF can also be used as prophylaxis. The first choice treatment of CMPA is the use of eHF, but AAF are a good choice as well, especially in highly sensitive infants that continue to exhibit symptoms of CMPA despite being fed with an eHF. SBIF can also be used as treatment in CMPA, but is not recommended to the same extent due to the reason that children with CMPA may also be allergic to soy. Rice based IF is well tolerated in children with CMPA and could be an interesting option as first line treatment in the future if more studies will be done in that area. However rice based IF are very low in protein content, and therefore put the CMPA child at risk for malnutrition. One study where the rice based IF was supplemented with protein, it showed good results in all of the participants in regards to tolerance and nutritional value. No other PBB meet nutritional standards and are not an option for infant feeding. Conclusions: IFs used for prophylaxis includes pHF, and in some cases eHF are also used as prophylaxis. The pHF cannot be used as treatment in CMPA. The first choice treatment option for CMPA today is extensively hydrolyzed IF. AAF can also be used as treatment of CMPA, especially in highly sensitive children that still exhibit symptoms of allergy despite being fed with eHF. SBIF is the most accepted one of the plant based formulas, and can be used as a treatment option in children with CMPA, however, one should keep in mind that children with CMA can also be allergic to soy, and it cannot be given to children less than 6 months of age. Therefore AAF is the better choice, and it is also more nutritionally suitable compared to SBIF. An upcoming option for the treatment of CMA is the rice based formulas, they are tolerated of > 90 % of infants with CMA, however they need to be supplemented with proteins if they are to meet adequate nutritional values, and the rice based formulas are not yet fully accepted as treatment option. Other PBB are being studied, but so far, none has found to be adequate to meet nutritional criteria, further investigations and studies needs to be performed in that area. |
