New Guidelines Developed for Infants Allergic to Cow's Milk

A new set of guidelines for kids allergic to cow milk will be presented in the next issue of the Journal Archives of Disease in Childhood. The new guidelines call to restrict the type of formula that allergic infants may receive.

The new "Guidelines for the diagnosis and management of cow's milk protein allergy in infants" emphasizes that allergic infants should be given only extensively hydrolyzed formula or an amino-acid based formula rather than a soy-based product as a first line substitute for cow's milk.

The new recommendations were developed in Europe under the lead of Dr. Vandenplas, based on existing national recommendations in Germany, the Netherlands, and Finland, as well as on the researchers' personal experience.

The new guidelines were developed under "Act Against Allergy Taskforce," which is industry supported. Caution should be taken since the Act Against Allergy Taskforce guidelines were developed with support from companies that makes extensively hydrolyzed formula.

The American Academy of Pediatrics (AAP) guidelines, published in 2000, are currently followed, (at least in the US), to manage allergies in kids intolerant to regular cow milk. According to these guidelines soy milk is the alternative offered for kids allergic to cow's milk.

Soy milk is cheaper than the new choices set in the new European guidelines being presented. However, it causes allergic reactions in 10% to 35% of infants according to Dr. Vandenplast´s study.

Partially hydrolyzed formulas (the ones currently recommended by the AAP) are often not tolerated because they contain higher concentrations of intact cow's milk protein than extensively hydrolyzed formulas. On the other hand, extensively hydrolyzed formulas (the one recommended by the new guidelines) can be as much as three times costly as soy milk.

Infant formulas based on milk from other mammals, such as sheep, buffalo, horse, camel, or goat, are not recommended by the new guidelines due to the high risk of cross-reactivity.

More specifically the new guidelines call for: