Guidance on reducing the risk of cows’ milk protein allergy

EACCI Food allergy and anaphylaxis Guidelines (2014)1

“If breastfeeding is insufficient or not possible for the first 4 months, infants at high risk can be recommended a hypoallergenic formula with documented preventive effect for the first 4 months of life.”

American Academy of Pediatrics Clinical Report (2008)2

“Atopic dermatitis may be delayed or prevented by the use of extensively or partially hydrolyzed formulas, compared with cows’ milk formula, in early childhood.”

ESPGHAN (1999)3

“If exclusive breastfeeding is not possible, it is recommended that a hypoallergenic formula (with a confirmed reduced allergenicity in adequate clinical studies) should be used.”

British Dietetic Association consensus statement (2010)4

“Recommended alternatives to breast milk are partially or extensively hydrolysed formula milks, with infants at highest risk being given extensively hydrolysed casein milk. These hydrolysed formulae should be used for 4–6 months or until the time that cow’s milk in any form has been introduced into the infants diet.”

  1. Muraro A et al. Allergy 2014; 69(5): 590–601.
  2. Greer FR et al. Pediatrics 2008; 121(1): 183–191.
  3. Høst A et al. Arch Dis Child 1999; 81: 80–84.
  4. BDA, April 2014. Update Note: Practical Dietary Prevention Strategies for Infants at Risk of Developing Allergic Disease. Available here.

EACCI, European Academy of Allergy and Clinical Immunology

IMPORTANT NOTICE: Breast milk is best for babies and breastfeeding should continue for as long as possible. Good maternal nutrition is important for the preparation and maintenance of breastfeeding. Introducing partial bottle-feeding may have a negative effect on breastfeeding and reversing a decision not to breastfeed is difficult. Caregivers should always seek the advice of a doctor, midwife, health visitor, public health nurse, dietitian or pharmacist on the need for and proper method of use of infant milks and on all matters of infant feeding. Social and financial implications should be considered when selecting a method of infant feeding. Infant milk should always be prepared and used as directed. Inappropriate foods or feeding methods, or improper use of infant formula, may present a health hazard.