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No evidence that hydrolysed cow’s milk infant formula prevents allergic disease

International guidelines currently recommend the use of hydrolysed cow’s milk formula as opposed to standard formula for the prevention of cow’s milk allergy and eczema in infants at risk of allergic disease. 1This recent study found no consistent evidence that hydrolysed cow’s milk formula prevents allergic diseases, despite current guideline recommendations supporting its use. 1

In a systematic literature review and meta-analysis commissioned by the UK Food Standards Agency, Boyle and colleagues analysed the results of 37 intervention trials involving over 19,000 participants, investigating hydrolysed formula for the prevention of allergic and autoimmune disease. 1Outcomes assessed included the risk of eczema, wheeze, allergic rhinitis, food allergy, allergic sensitisation and autoimmune outcomes (autoimmune thyroid disease, coeliac disease, inflammatory bowel disease, juvenile rheumatoid arthritis, psoriasis, type 1 diabetes mellitus and vitiligo). 1

The study found no consistent evidence that partially or extensively hydrolysed cow’s milk formulas reduce the risk of allergic or autoimmune disease in infants with high risk for these disorders. 1

Furthermore, analysis of study quality revealed evidence of publication bias in studies of eczema and wheeze, whilst most studies of allergic outcomes had a high or unclear risk of bias and evidence of conflict of interest. 1

Given these findings, the authors concluded that current guidelines advocating hydrolysed formula for infants at high risk should be revised. 1

Reference list

  1. Boyle RJ, Ierodiakonou D, Khan T, Chivinge J, Robinson Z, Geoghegan N, et al. Hydrolysed formula and risk of allergic or autoimmune disease: systematic review and meta-analysis. To be published in BMJ. [Preprint] 2016; doi:http://dx.doi.org/10.1136/bmj.i974.