Wichmann HE, Heinrich J, Schoetzau A, Mosetter M, Schindler J, Hönke A, Franke K, Laubereau B, Sausenthaler S, Thaqi A, Zirngibl A, Zutavern A, Berdel D, von Berg A, Filipiak-Pittroff B, Albrecht B, Baumgart A, Bollrath Ch, Bütner S, Diekamp S, Gross I, Jakob T, Klemke K, Kurpiun S, Mölemann M, Neusüs Varhelyi J, Zorn A, Koletzko S, Reinhard D, Weigand H, Antonie I, Bäumler-Merl B, Tasch C, Göhlert R, Mühlbauer D, Sönnichsen C, Sauerwald T, Kindermann A, Waag M, Koch M, Bauer CP, Grübl A, Bartels P, Brockow I, Fischer A, Hoffmann U, Lötzbeyer F, Mayrl R, Negele K, Schill EM, Wolf B, Krämer U, Link E, Ranft U, Schins R, Sugiri D.
Source
Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany. vonberg@marien-hospital-wesel.de.
Abstract
BACKGROUND:
The long-term effect of nutritional intervention with hydrolyzed infant formulas on allergy development has not been sufficiently evaluated.
OBJECTIVE:
We performed a follow-up of the German Infant Nutritional Intervention study until 6 years of life to investigate the long-term allergy-preventive effect of 3 hydrolyzed infant formulas compared with cow's milk formula (CMF) in a randomized, double-blind trial.
METHODS:
Between 1995 and 1998, 2252 newborns with atopic heredity were randomly assigned at birth to receive one of 4 blinded formulas: partially or extensively hydrolyzed whey formula, extensively hydrolyzed casein formula, or CMF as milk substitute for the first 4 months when breast-feeding was insufficient. The cohort was followed from birth until 6 years of age with yearly questionnaires. Outcomes were physician-diagnosed allergic diseases (atopic dermatitis, food allergy, allergic urticaria, asthma, and hay fever/allergic rhinitis). Log-binomial regression modeled with generalized estimation equations was used for the statistical analysis.
RESULTS:
In the intent-to-treat analysis the relative risk of a physician's diagnosis of allergic manifestation (AM) compared with CMF was 0.82 (95% CI, 0.70-0.96) for partially hydrolyzed whey formula, 0.90 (95% CI, 0.78-1.04) for extensively hydrolyzed whey formula, and 0.80 (95% CI, 0.69-0.93) for extensively hydrolyzed casein formula. The corresponding figures for atopic eczema were 0.79 (95% CI, 0.64-0.97), 0.92 (95% CI, 0.76-1.11), and 0.71 (95% CI, 0.58-0.88), respectively. In the per-protocol analysis all effects were stronger and significant. No significant effect on other AMs was found.
CONCLUSION:
The data confirm a long-term allergy-preventive effect of hydrolyzed infant formulas on AM and atopic eczema until 6 years of age.