1. Introduction
CMPA, AD, allergy, atopic dermatitis, CoMiSS, early-onset cow’s milk, ’s Milk Protein Allergy, allergic diseases
ALLERGY, ATOPIC DERMATITIS, PROTEIN ALLERGY
The development of early-onset cow’s milk protein allergy and atopic dermatitis during the first months of life is multifactorial, including both genetic and nutritional aspects. This study aims to assess the impact of different feeding patterns on the incidence of cow’s milk protein allergy, atopic dermatitis, and growth among infants with a family history of allergy. A total of 551 high-risk infants were randomly recruited from 3 European countries in three feeding regimens: exclusive breastfeeding, partially hydrolyzed formula, or standard formula with intact protein either exclusively or supplementary to breastfeeding. During the first 6 months of intervention, amongst infants with a family history of atopic dermatitis, 6.5% of partially hydrolyzed formula-fed infants and 22.7% of exclusively breastfed infants (The prevalence of Cow’s Milk Protein Allergy (CMPA) has increased in developed countries in the last four decades [The diagnostic approach for CMPA includes, depending on the type of reaction, a detailed medical history, allergy work-up, including skin prick tests (SPT) and/or determination of specific IgE(s) to milk proteins, while oral food challenge (OFC) remains the gold standard for CMPA diagnosis. CoMiSS has lately been used as an additional awareness tool in the assessment of subjects with CMPA-suggestive symptoms [Given the prevalence, comorbidities, and cost of allergic diseases for the healthcare system, primary prevention strategies have been developed with respect to feeding practices for infants at high risk [According to the U.S. Food and Drug Administration and European Food Safety Authority (EFSA) requirements, growth monitoring studies (GMS) is necessary to show the safety of formulas with new protein fractions, during the period when formula is the sole source of nutrition. However, the different results in growth velocity among the formula feeding patterns could potentially reflect crucial differences in protein concentrations when weight, length, or head circumference are assessed. With regards to effects on growth in mixed-fed (either pHF or SF with breastmilk) infants, no differences (noninferiority) have been reported, while mixed feeding with pHF closely tracked EBF [In the present study, the effect of the feeding regimen on the development of CMPA, AD, and growth parameters within the first 6 months of life was compared between high-risk infants who were exclusively breastfed and those who were formula-fed (exclusively or partially with pHF or SF).