title: Evaluation of pancreatic function development after hydrolyzed protein-based and soy-based formulas in unweaned infants. Immune Status of Infants Fed Soy-Based Formulas With or Without Added Nucleotides for 1 Year: Part 1: Vaccine Responses, and Morbidity Association between breast feeding and asthma in 6 year old children: findings of a prospective birth cohort study Soy allergy in infants and children with IgE-associated cow's milk allergy. Cumulative incidence of atopic disorders in high risk infants fed whey hydrolysate, soy, and conventional cow milk formulas. Five-year follow-up of high-risk infants with family history of allergy who were exclusively breast-fed or fed partial whey hydrolysate, soy, and conventional cow's milk formulas. Infant feeding, wheezing, and allergy: a prospective study. Soy versus cow's milk in infants with a biparental history of atopic disease: development of atopic disease and immunoglobulins from birth to 4 years of age Effect of allergen avoidance in infancy on allergic manifestations at age two years. Dietary prophylaxis of allergic disease in children. Dietary treatment of infant colic: a double-blind study. Immune Status of Infants Fed Soy-Based Formulas With or Without Added Nucleotides for 1 Year: Part 2: Immune Cell Populations A PROSPECTIVE STUDY OF COW'S MILK PROTEIN INTOLERANCE IN SWEDISH INFANTS Effect of allergen avoidance on development of allergic disorders in infancy Factors influencing the relation of infant feeding to asthma and recurrent wheeze in childhood Intolerance of cow's milk and chronic constipation in children Infant feeding and allergy. Allergenicity of goat's milk in children with cow's milk allergy. Dietary modifications versus dicyclomine hydrochloride in the treatment of severe infantile colics Reduced bone mineralization in infants fed palm olein-containing formula: a randomized, double-blinded, prospective trial. Evidence of very delayed clinical reactions to cow's milk in cow's milk‐intolerant patients Nutritional evaluation of various protein hydrolysate formulae in term infants during the first month of life Lower Calcium Absorption in Infants Fed Casein Hydrolysate- and Soy Protein-Based Infant Formulas Containing Palm Olein Versus Formulas without Palm Olein Effects of maternal diet during late pregnancy and lactation on the development of atopic diseases in infants up to 18 months of age—in‐vivo results Nutritional evaluation of protein hydrolysate formulas. Prospective oral food challenge study of two soybean protein isolates in patients with possible milk or soy protein enterocolitis. Comparison of Breast, Cow, and Soy Feedings in the Prevention of Onset of Allergic Disease Randomized clinical trial of soy formula with and without added fiber in antibiotic-induced diarrhea. Effect of feeding whey hydrolysate, soy and conventional cow milk formulas on incidence of atopic disease in high risk infants. Growth and protein status of term infants fed soy protein formulas differing in protein content. Parental counseling compared with elimination of cow's milk or soy milk protein for the treatment of infant colic syndrome: a randomized trial. The natural history of intolerance to soy and extensively hydrolyzed formula in infants with multiple food protein intolerance. Prevention of atopic disease in "at-risk newborns" by prolonged breast-feeding. Patterns of food hypersensitivity during sixteen years of double-blind, placebo-controlled food challenges. Tolerance of a soy formula by infants and children. Allergen avoidance in infancy and allergy at 4 years of age Cow's milk formula as a cause of infantile colic: a double-blind study. Environmental factors and symptoms in infants at high risk of allergy. Allergy to soy formula and to extensively hydrolyzed whey formula in infants with cow's milk allergy: a prospective, randomized study with a follow-up to the age of 2 years. Are all wheezing disorders in very young (preschool) children increasing in prevalence? Influence of maternal diet during lactation and use of formula feeds on development of atopic eczema in high risk infants.
abstract: AIMS Different protein sources could determine differences in the maturation of the exocrine pancreas in humans during the first months after birth ; however , no studies have been carried out in man to evaluate the effect of a hydrolyzed protein diet on exopancreatic function . Our aim was therefore to determine the effect of two different milk formulas on pancreatic secretion in patients with cow 's milk protein allergy ( CMPA ) . METHODS We selected 12 infants ( median age , 3.0 months ) , fed for 6 weeks with a hydrolyzed casein-based formula , and 14 infants ( median age , 3.0 months ) who received a soy-protein based formula over the same period . As controls , two groups of age-matched infants with no gastrointestinal disease and receiving a free diet  were studied . In the patients with CMPA a secretin-cerulein test was performed at the commencement of the diet and after 6 weeks ; in the controls the same test was performed only once . Enzyme concentrations and outputs of trypsin , chymotrypsin , lipase , and phospholipase were assayed . RESULTS No significant difference was observed between the two groups of patients with CMPA for any of the enzymes studied , either at base line or after 6 weeks of diet . No difference was recorded between CMPA patients and age-matched controls on a free diet either . In both CMPA groups there was a significant increase over basal values in trypsin , chymotrypsin , and lipase concentrations after 6 weeks . Furthermore , there was a significant positive correlation between the age of the patients and enzyme concentrations . Mean daily weight gain was 27.4 + /- 3.9 g with hydrolyzed casein and 27.2 + /- 3.5 g in soyfed patients . CONCLUSIONS It is suggested that the diets with different protein content used in subjects with CMPA did not determine any difference in the stimulation of proteolytic and lipolytic pancreatic enzymes Background Immunologic development of soy-fed infants has not been extensively studied . Early studies of soy flour – based formulas showed decreased immunoglobulin production when soy protein intake was limited . However , there were no significant differences in rotavirus vaccine responses between breast-fed and soy protein isolate – based formula-fed infants .  Nucleotides added to milk-based formula benefit infant immune status , but reports of the immunologic effects of adding nucleotides to soy-based formula are not available . This study evaluated immune status and morbidity of infants fed soy protein isolate formulas with and without added nucleotides for 1 year . Methods Newborn , term infants enrolled in a masked 12-month feeding trial were assigned r and omly to groups fed soy formula with or without added nucleotides ( n = 94 , n = 92 ) . A nonr and omized human milk/formula cohort ( n = 81 ) was concurrently enrolled . Recommended immunizations were administered at 2 , 4 , and 6 months . Immune status was determined from antibody responses to Haemophilus influenzae type b , tetanus , diphtheria , and poliovirus vaccines at 6 , 7 , and 12 months . Parents and physicians reported morbidity data . Results All vaccine responses were within normal ranges . No response differences were observed between infants fed soy formula and those fed nucleotide-supplemented soy . However , antibody to H. influenzae type b at 7 and 12 months was higher in infants fed nucleotide-supplemented soy than in infants fed human milk/formula ( P = 0.007 , P = 0.008 , respectively ) . Human milk/formula-fed infants had higher poliovirus neutralizing antibody at 12 months than did soy-fed infants ( P = 0.016 ) . Morbidity analyses showed that only physician-reported diarrhea was different among groups ( groups fed human milk/formula had less diarrhea than did soy groups , P = 0.011 ) . Conclusions Term infants fed soy protein isolate – based formulas  have normal immune development as measured by antibody responses to childhood immunizations Abstract Objectives : To investigate the association between the duration of exclusive breast feeding and the development of  asthma related outcomes in children at age 6 years . Design : Prospect i ve cohort study . Setting : Western Australia . Subjects : 2187 children ascertained through antenatal clinics at the major tertiary obstetric hospital in Perth and followed to age 6 years . Main outcome measures : Unconditional logistic regression to model the association between duration of exclusive breast feeding and outcomes related to asthma or atopy at 6 years of age , allowing for several important confounders : sex , gestational age , smoking in the household , and early childcare . Results : After adjustment for confounders , the introduction of milk other than breast milk before 4 months of age was a significant risk factor for all asthma and atopy related outcomes in children aged 6 years : asthma diagnosed by a doctor ( odds ratio 1.25 , 95 % confidence interval 1.02 to 1.52 ) ; wheeze three or more times since 1 year of age ( 1.41 , 1.14 to 1.76 ) ; wheeze in the past year ( 1.31 , 1.05 to 1.64 ) ; sleep disturbance due to wheeze within the past year ( 1.42 , 1.07 to 1.89 ) ; age when doctor diagnosed asthma ( hazard ratio 1.22 , 1.03 to 1.43 ) ; age at first wheeze ( 1.36 , 1.17 to 1.59 ) ; and positive skin prick test reaction to at least one common aeroallergen ( 1.30 , 1.04 to 1.61 ) . Conclusion : A significant reduction in the risk of childhood asthma at age 6 years occurs if exclusive breast feeding is continued for at least the 4 months after birth . These findings are important for our underst and ing of the cause of childhood asthma and suggest that public health interventions to optimise breast feeding may help to reduce the community burden of childhood asthma and its associated traits . Key messages Asthma is the leading cause of admission to hospital in Australian children and its prevalence is increasing Whether breast feeding protects against asthma or atopy , or both , is controversial Asthma is a complex disease , and the relative risks between breast feeding and asthma or atopy are unlikely to be large ; this suggests the need for investigation in a large prospect i ve birth cohort with timely assessment of atopic outcomes and all relevant exposures Exclusive breast feeding for at least 4 months is associated with a significant reduction in the risk of asthma and atopy at age 6 years and with a significant delay in the age at onset of wheezing and asthma being diagnosed by a doctor Public health interventions to promote an increased duration of exclusive breast feeding may help to reduce the morbidity and prevalence of childhood asthma  and OBJECTIVES To determine the prevalence of soy allergy in IgE-associated cow 's milk allergy ( CMA ) . STUDY DESIGN Children < 3.5 years with documented IgE-associated CMA ( n = 93 ) were evaluated for soy allergy by double-blind , placebo-controlled food challenge , open challenge , or convincing previous history of an anaphylactic reaction to soy .  Children tolerant to soy at entry received soy formula and were followed up for 1 year . RESULTS Of this IgE-associated CMA cohort ( ages 3 to 41 months ) , 14 % ( 95 % CI = 7 . 7%-22.7 % ) were determined to have soy allergy , 12 definitely at entry and 1 possibly after 1 year of soy ingestion . The latter child experienced severe failure to thrive at enrollment and exhibited improved growth while receiving soy during follow-up but was diagnosed with eosinophilic esophagitis at study completion . Improved growth ( P < .05 ) occurred in the non-soy-allergic cohort ingesting soy formula ( 579 31 mL/d ) during the year of follow-up . CONCLUSIONS Soy allergy occurs in only a small minority of young children with IgE-associated CMA . As such , soy formula may provide a safe and growth-promoting alternative for the majority of children with IgE-associated CMA shown to be soy tolerant at the time of introduction of soy formula A recent increase in the prevalence of atopic disorders and the enormous costs of management of atopic patients have prompted attempts at prevention . We have examined the effect of exclusive breast feeding and of feeding different infant formulas on incidence of atopic disease in a prospect i ve r and omized controlled study . Seventy-two infants were recruited into each of the following groups : cow milk whey hydrolysate formula ( NAN/HA ) conventional cow milk formula ( Similac ) , soy-based formula ( Isomil ) , and exclusive breast feeding for greater than 4 months .  The cumulative incidence of atopic eczema , recurrent wheezing , rhinitis , gastrointestinal symptoms , and colic were noted . Skin prick tests and radioallergosorbent tests for IgE antibodies to milk and soy were performed . At 12 and 18 months of age , the incidence of atopic eczema as also that of all atopic symptoms was significantly lower and similar in the breast-fed and whey hydrolysate groups , compared with the cow milk and soy formula groups . IgE antibodies were detected more often in the cow milk and soy formula groups , especially the former . Among symptomatic infants , fewer skin positive prick tests were seen in the soy group compared with the cow milk group . Our observations show that among infants at high risk of developing atopic disease because of positive family history , exclusive breast feeding or whey hydrolysate formula is associated with a lower incidence and thus a delay in the occurrence of allergic disorders compared with groups fed conventional cow milk or soy formulas BACKGROUND Allergy is a common cause of illness . The effect of feeding different infant formulas on the incidence of atopic disease and food allergy was assessed in a prospect i ve r and omized double-blind study of high-risk infants with a family history of atopy . METHODS 216 high-risk infants whose mothers had elected not to breast-feed were r and omized to receive exclusively a partial whey hydrolysate formula or a conventional cow 's milk formula or a soy formula until 6 months of age . Seventy-two high risk infants breast-fed for > or = 4 months were also studied . RESULTS Follow-up until 5 years of age showed a significant lowering in the cumulative incidence of atopic disease in the breast-fed ( odds ratio 0.422 [ 0.200 - 0.891 ] ) and the whey hydrolysate ( odds ratio 0.322 [ 0.159 - 0.653 ) groups , compared with the conventional cow 's milk group . Soy formula was not effective ( odds ratio 0.759 [ 0.384 - 1.501 ] ) . The occurrence of both eczema and asthma was lowest in the breast-fed and whey hydrolysate groups and was comparable in the cow 's milk and soy groups . Similar significant differences were noted in the 18 - 60 month period prevalence of eczema and asthma . Eczema was less severe in the whey hydrolysate group compared with the other groups . Double-blind placebo-controlled food challenges showed a lower prevalence of food allergy in the whey hydrolysate group compared with the other formula groups . CONCLUSIONS Exclusive breast-feeding or feeding with a partial whey hydrolysate formula is associated with lower incidence of atopic disease and food allergy . This is a cost-effective approach to the prevention of allergic disease in children The determinants of wheezing and allergy were investigated in 453 children with a family history of allergic disease . A r and omised controlled trial examined the effects of withholding cows ' milk protein during the first three months of life and replacing cows ' milk with soya milk . The children were followed up to the age of 7 years . Withholding cows ' milk did not reduce the incidence of allergy or wheezing . Children who had ever been breast fed had a lower incidence of wheeze than those who had not ( 59 % and 74 % respectively ) . The effect persisted to age 7 years in the non-atopics only , the risk of wheeze being halved in the breast fed children after allowing for employment status , sex passive smoking , and overcrowding . Allergic disease was not associated with exposure to tobacco smoke , house dust mite antigen , or cats . Breast feeding may confer long term protection against respiratory infection Forty‐eight children with a biparental history of atopic disease were followed from birth to 4 years of age . One group was fed soy and the other cow 's milk from weaning to 9 months of age . Two‐thirds of the children developed symptoms of atopic disease with no significant difference between the groups . No difference was found in the serum immunoglobulins ( IgE antibodies , IgA , IgG and IgM ) during the observation period . The soy fed children showed transiently lower levels of IgG antibodies to cow 's milk but higher levels of IgG antibodies to soy protein . Six children showed cow 's milk intolerance and a further five had symptoms possibly related to the use of cow 's milk . Withholding cow 's milk during the first 9 months did not reduce the incidence of symptoms of cow 's milk intolerance from birth to 4 years of age . Thus , no benefit was found from replacing cows ' milk with soy . A prolonged breast feeding seems most rational for infants at risk of developing atopic disease , even if the present study did not show evidence of a prophylactic effect of breast milk against the development of atopic disease BACKGROUND One hundred twenty children , identified before birth as being at high risk for atopy , were prenatally assigned to prophylactic or control groups . METHODS The infants in the prophylactic group either received breast milk from mothers on an exclusion diet or an extensively hydrolyzed formula . Their bedrooms and living rooms were treated repeatedly with an acaricide , and they used polyvinyl-covered mattresses with vented head areas . The infants in the control group were fed conventionally , and no environmental control was recommended . RESULTS A significant advantage , first demonstrated at 1 year of age , persists for children in the prophylactic group . They have less of any allergy or eczema , but the reduced prevalence of asthma is no longer significant . Only three children in the prophylactic group had positive skin prick test results compared with 16 in the control group , suggesting a significant reduction in sensitization . CONCLUSION A dual approach to allergen avoidance , focusing on foods and aeroallergens , appears to be beneficial in selected high-risk infants . Avoidance of potent allergens in early life increases the threshold for sensitization in these high-risk infants . Whether sensitization has been avoided or merely deferred has yet to be proved IN 1953 Glaser and Johnstone1 reported on the use of soybean milk as an aid in the prophylaxis of  allergic disease in children . They concluded that if one withheld cow 's milk , beef , egg and wheat from the diets of potentially allergic children from the time of birth until the age of six to nine months , only one quarter as many of these children acquired major respiratory allergies compared to their siblings and another nonrelated control group . They also reported that the incidence of atopic eczema in infants on the restricted diet was only one fourth as great as in the . . The possible role of cows milk intolerance in the aetiology of infant colic was evaluated in 19 babies presenting to their health visitor or general practitioner in one town . Over a three week period a st and ard modified cows milk formula was compared with a soya milk formula on a double blind basis . The duration of colic symptoms was significantly reduced during the week on soya milk ( P less than 0.01 ) , with 11 out of 19 babies fulfilling the diagnostic criteria for cows milk intolerance . Four babies whose symptoms failed to improve either spontaneously or with soya milk were given a hydrolysed protein milk with a positive response in two , confirmed by challenge testing . Thus in 13 out of 19 babies ( 68 % ) the symptoms of infant colic resolved almost completely with dietary change Background Infants fed a soy protein isolate – based formula  have immunization responses similar to breast-fed infants . However , cellular aspects of the immunologic development of soy-fed infants have not been studied extensively . Nucleotides added to milk-based formula benefit infant immune status , but reports of the immunologic effects of adding nucleotides to soy-based formula are not available . This study examines immune cell population s of infants fed soy protein isolate formulas with and without added nucleotides for 1 year . Methods Newborn , term infants studied in a masked 12-month feeding trial were assigned  r and omly to soy formula groups with and without added nucleotides  ( n = 94 , n = 92 ) . A nonr and omized human milk/formula-fed cohort ( n = 81 )  , was concurrently enrolled . Blood sample s were collected at 6 , 7 , and 12 months . Thirty-two immune cell population s were characterized using three-color flow cytometry . Cellular markers were chosen to assess general pediatric immune status , emphasizing maturation and activation of B , T , and NK lymphocytes . Results All cell population s , number and percentages , were within age-related normal ranges . The only significant difference found between  soy formula and human milk/formula-fed infants was the percentage of CD57 + NK T cells at 12 months ( human milk/formula > soy formula , P = 0.034 ) . There were significant differences at some time points between human milk/formula-fed and nucleotide-supplemented soy formula – fed infants in population s of lymphocytes , eosinophils , total T , helper T , naive helper , memory/effector helper , CD57−T , and CD11b+CD8+NK cells . None of the cell population s differed between infants fed  soy formula  versus soy plus nucleotides  . Conclusions Infants fed this commercial soy formula  demonstrated immune cell status similar to human milk/formula-fed infants , consistent with normal immune system development . The addition of nucleotides to soy formula did not significantly change specific individual immune cell population s but tended to increase numbers and percentages of T cells and decreased numbers and percentages of NK cells Abstract . 1079 of 1548 newborn infants were followed during their first year . 328 were prospect ively contacted once a month . 751 were followed up at child welfare clinics . Altogether 20 were diagnosed as being cow 's milk protein intolerant ( 1.9 % ) . Symptoms from the gastrointestinal tract and the skin predominated . Only 2 had respiratory symptoms . Ten had their symtpoms within one week after the introduction of cow 's milk , 3 of them at their first cow 's milk‐containing meal . A further 4 already had symptoms when fed only human milk . The others ( 6 infants ) showed symptoms after more than one week on a cow 's milk containing diet . Before 2 years of age , 13 had recovered . Twelve of the cow 's milk protein intolerant infants also showed adverse reactions to other foods , soy‐protein intolerance being the most common ( 7 infants ) . A family history of allergy was found in 35 % ( 116 ) of the 328 infants and in 70 % ( 14 ) of those with cow 's milk protein intolerance There is much evidence that the development of allergic disorders may be related to early exposure of allergens , including those in breastmilk . We have tried to find out whether avoidance of food and inhaled allergens in infancy protects against the development of  allergic disorders in high-risk infants . In a prenatally r and omised , controlled study 120 infants with family history of atopy and high ( greater than 0.5 kU/l ) cord-blood concentrations of total IgE were allocated r and omly to prophylactic and control groups . In the prophylactic group ( n = 58 ) , lactating mothers  avoided allergenic foods ( milk , egg , fish , and nuts ) and avoided feeding their infants these foods and soya , wheat , and orange  up to the age of 12 months ; the infants ' bedrooms and living rooms were treated with an acaricidal powder and foam every 3 months , and concentrations of Dermatophagoides pteronyssinus antigen(Der p l ) in dust sample s were measured by enzyme-linked immunosorbent assay . In the control group ( n = 62 ) , the diet of mothers and infants was unrestricted ; no acaricidal treatment was done and Der p l concentrations were measured at birth and at 9 months . A paediatric allergy specialist unaware of group assignment examined the infants for allergic disorders at 10 - 12 months . Odds ratios were calculated by logistic regression analysis for various factors with control for other confounding variables . At 12 months , allergic disorders had developed in 25 ( 40 % ) control infants and in 8 ( 13 % ) of the prophylactic group ( odds ratio 6.34 , 95 % confidence intervals 2.0 - 20.1 ) . The prevalences at 12 months of asthma ( 4.13 , 1.1 - 15.5 ) and eczema ( 3.6 , 1.0 - 12.5 ) were also significantly greater in the control group .  Parental smoking was a significant risk factor for total allergy at 12 months whether only one parent smoked ( 3.97 , 1.2 - 13.6 ) or both parents smoked ( 4.72 , 1.2 - 18.2 ) BACKGROUND The relationship between infant feeding and childhood asthma is controversial . This study tested the hypothesis that the relation between breast feeding and childhood asthma is altered by the presence of maternal asthma . METHODS Healthy non-selected newborn infants ( n=1246 ) were enrolled at birth . Asthma was defined as a physician diagnosis of asthma plus asthma symptoms reported on ⩾2 question naires at 6 , 9 , 11 or 13 years . Recurrent wheeze ( ⩾4 episodes in the past year ) was reported by question naire at seven ages in the first 13 years of life . Duration of exclusive breast feeding was based on prospect i ve physician reports or parental question naires completed at 18 months . Atopy was assessed by skin test responses at the age of 6 years . RESULTS The relationship between  breast feeding , asthma , and wheeze differed with the presence or absence of maternal asthma and atopy in the child . After adjusting for confounders , children with asthmatic mothers were significantly more likely to have asthma if they had been exclusively breast fed ( OR 8.7 , 95 % CI 3.4 to 22.2 ) . This relationship was only evident for atopic children and persisted after adjusting for confounders . In contrast , the relation between recurrent wheeze and breast feeding was age dependent . In the first 2 years of life exclusive breast feeding was associated with significantly lower rates of recurrent wheeze ( OR 0.45 , 95 % CI 0.2 to 0.9 ) , regardless of the presence or absence of maternal asthma or atopy in the child . Beginning at the age of 6 years , exclusive breast feeding was unrelated to prevalence of recurrent wheeze , except for children with asthmatic mothers in whom it was associated with a higher odds ratio for wheeze ( OR 5.7 , 95 % CI 2.3 to 14.1 ) , especially if the child was atopic . CONCLUSION The relationship between breast feeding and asthma or recurrent wheeze varies with the age of the child and the presence or absence of maternal asthma and atopy in the child . While associated with protection against recurrent wheeze early in life , breast feeding is associated with an increased risk of asthma and recurrent wheeze beginning at the age of 6 years , but only for atopic children with asthmatic mothers Background : Chronic diarrhea is the most common gastrointestinal symptom of intolerance of cow 's milk among children . On the basis of a prior open study , we hypothesized that intolerance of cow 's milk can also cause severe perianal lesions with pain on defecation and consequent constipation in young children . Methods : We performed a double-blind , crossover study comparing cow 's milk with soy milk in 65 children ( age range , 11 to 72 months ) with chronic constipation ( defined as having one bowel movement every 3 to 15 days ) . All had been referred to a pediatric gastroenterology clinic and had previously been treated with laxatives without success ; 49 had anal fissures and perianal erythoma or edema . After 15 days of observation , the patients received cow 's milk or soy milk for 2 weeks . After a one week washout period , the feedings were reversed . A response was defined as eight or more bowel movements during a treatment period . Results : Forty-four of the 65 children ( 68 percent ) had a response while receiving soy milk .  Anal fissures and pain with defecation resolved . None of the children who received cow 's milk had a response . In all 44 children with a response , the response was confirmed with a double blind challenge with cow 's milk . Children with a response had a higher frequency of coexistent rhinitis , dermatitis , or bronchospasm than those with no response ( 11 of 44 children vs. 1 of 21 , P = 0.05 ) ; they were also more likely to have anal fissures and erythema or edema at base line ( 40 of 44 vs. 9 of 21 , P < 0.001 ) , evidence of inflammation of the rectal mucosa on biopsy ( 26 of 44 vs. 5 of 21 , P = 0.008 ) , and signs of hypersensitivity , such as specific IgE antibodies to cow's-milk antigens ( 31 of 44 vs. 4 of 21 , p < 0.001 ) . Conclusions : In young children , chronic constipation can be a manifestation of intolerance of cow 's milk The effect of withholding cows ' milk was examined in 487 infants at high risk of allergic disease . Before birth they were r and omly allocated either to a control group , most of whom received cows ' milk preparations , or to an intervention group , who were offered a soya based substitute .  Eczema and wheezing occurred to a similar extent in the two groups during the first year of life , although napkin rash , diarrhoea , and oral thrush were commoner in the intervention group , especially during the first three months . Breast feeding for any length of time was associated with a reduced incidence of wheezing and diarrhoea BACKGROUND Cow 's milk allergy ( CMA ) is a common disease of infancy and childhood . An appropriate cow 's milk ( CM ) substitute is necessary for feeding babies with CMA .  CM substitutes are soy formulas and casein- or whey-based extensively hydrolyzed formulas . In several countries , including Italy , goat 's milk ( GM ) formulas are available , and some physicians recommend them for feeding babies with CMA . OBJECTIVE We sought to investigate , in vitro and in vivo , the allergenicity of GM in 26 children with proven IgE-mediated CMA . METHODS All the children underwent skin tests with CM and GM ; detection of specific serum IgE to CM and GM ; and double-blind , placebo-controlled , oral food challenges ( DBPCOFCs ) with fresh CM , GM , and , as placebo , a soy formula ( Isomil , Abbott , Italy ) . CAP inhibition and immunoblotting inhibition assays were also carried out in 1 of 26 and 4 of 26 children with positive RAST results to both CM and GM , respectively . RESULTS All the children had positive skin test responses and CAP results to both CM and GM , all had positive DBPCOFC results to CM , and 24 of 26 had positive DBPCOFCs to GM . In CAP inhibition tests , preincubation of serum with CM or GM strongly inhibited IgE either to CM or to GM . In immunoblotting inhibition assays , preincubation with CM completely extinguished reactivity to GM , whereas GM partially inhibited reactivity to CM . CONCLUSIONS These data strongly indicate that GM is not an appropriate CM substitute for children with IgE-mediated CMA . A warning on the lack of safety of GM for children with CMA should be on the label of GM formulas to prevent severe allergic reactions in babies with CMA This study examined 120 infants , aged 3–12 weeks , with severe colics and compared the results of a specific hypoallergenic diet ( group A ) with those of pharmacological treatment ( group B ) . Non‐breastfed group A infants  received soy milk and if unresponsive , hydrolyzed milk formulas ;  mothers of breast‐fed infants  received a diet without cow 's milk , eggs or fish .  Breast‐fed and non‐breast‐fed group B infants received dicyclomine hydrochloride 3 mg/kg/day . Results , based on quantitative measurements of crying . indicated that in breast‐fed infants there was no significant improvement between group A ( 62.5 % ) and group B ( 66.6 % ) infants . Among formula‐fed infants , comparison of positive results using soy milk ( 65.9 % ) with positive results using dicyclomine ( 53.3 % ) was not significant ; positive results using soy milk and hydrolyzed milk formulas in non‐responders to soy milk , provided an improvement in 95.4 % of cases . Pharmacological treatment provided an improvement in 53.3 % ) of cases . The diffcrence was significant ( p<0.01 ) OBJECTIVE Palm and palm olein ( PO ) oils are used in some infant formula fat blends to match the fatty acid profile of human milk , but their presence has been shown to lower calcium and fat absorption . We aim ed to determine if the reported differences in calcium absorption could affect skeletal development by comparing bone mineral accretion in healthy term infants fed a milk-based formula with ( PMF ) or without PO . METHODS Whole body bone mineralization was evaluated in healthy term infants fed 1 of 2 coded , commercially available , ready-to-feed infant formulas in a r and omized , double-blind , parallel study . Subjects were fed either 1 ) . PMF formula ( Enfamil with iron ; Mead Johnson Division of Bristol Myers , Evansville , IN ; N = 63 ) containing PO/coconut/soy/high-oleic sunflower oils ( 45/20/20/15 % oil ) ; or 2 ) . milk-based formula without PO ( Similac with iron ; Ross Products Division Abbott Laboratories , Columbus , OH ; N = 65 ) , containing high-oleic safflower/coconut/soy oils ( 40/30/30 % oil ) from enrollment by 2 weeks after birth until 6 months . Anthropometrics and formula intake were determined monthly ; total body bone mineral content ( BMC ) and bone mineral density ( BMD ) were measured at baseline , 3 , and 6 months of age using dual energy x-ray absorptiometry . RESULTS Intent-to-treat analyses indicated no significant differences between feeding groups in weight , length , head circumference , or formula intake throughout the study . BMC and BMD were not different at baseline but repeated measures analyses show that infants fed PMF had significantly lower BMC and BMD at 3 and 6 months . CONCLUSIONS Healthy term infants fed a formula containing PO as the predominant oil in the fat blend had significantly lower BMC and BMD than those fed a formula without PO . The inclusion of PO in infant formula at levels needed to provide a fatty acid profile similar to that of human milk leads to lower bone mineralization Background : In patients with cow 's milk protein intolerance ( CMPI ) , delayed clinical reactions to cow 's milk ( CM ) ingestion may be misdiagnosed if the clinical symptoms are not “ classical ” and there is a long time lapse between ingestion of CM and the clinical reaction . The aim was to evaluate the clinical outcome of CMPI in a cohort of CM‐intolerant children , with particular attention to the occurrence of clinical manifestations beyond 72 h after CM challenge The aim of the study was to compare , during the first month of life , growth parameters , biochemical indices of protein metabolism and plasma amino acid concentrations in newborn infants fed either human milk ( n = 23 ) , three different whey hydrolysate formulae ( WHF 1 , n = 13 ; WHF 2 , n = 10 ; WHF 3 , n = 13 ) , a soy-collagen hydrolysate formula ( SCHF n = 18 ) or a whey-casein hydrolysate formula ( WCHF , n = 20 ) .  Growth parameters and the various protein concentrations determined in the infants fed WHF 1 and WHF 2 were similar to the values observed with human milk . With WHF 3 , growth in weight , length and head circumference and serum total protein concentrations were reduced significantly whereas blood urea nitrogen was increased . With SCHF , growth in weight and length as well as serum total protein and transferrin concentration were decreased significantly , whereas serum IgG concentration was increased . With WCHF growth in length and serum transferrin concentration were decreased compared to the human milk group . In the various groups , the plasma amino acid pattern reflected the amino acid content of the formula . Whey hydrolysate formula induced mainly an increase in threonine and a decrease in tyrosine concentrations .  Soy-collagen hydrolysate formula led to an increase of non-essential amino acids , such as glycine and hydroxyproline , and a decrease in plasma lysine and cystine .  Whey-casein hydrolysate formula induced a plasma amino acid pattern close to the profile observed with human milk . Nevertheless , the plasma concentrations of most of the various amino acids were higher . ( ABSTRACT TRUNCATED AT 250 WORDS Objective : Quantitative balance studies were performed to compare fat and calcium absorption in healthy , full term infants fed casein hydrolysate-based ( CHF ) and soy protein-based ( SPF ) infant formulas with or without palm olein ( PO ) .  Previous studies have reported that PO significantly reduced absorption of both fat and calcium in cow ’s milk-based formulas in which most of the calcium is inherent in the milk protein . In both SPF and CHF virtually all calcium is added as calcium salts . Methods : Two r and omized , blinded , crossover balance studies were conducted in normal term infants using a three-day home balance method . One study evaluated 10 infants fed commercially available CHF with or without PO , and the other study evaluated 12 infants fed commercially available SPF with or without PO .  Fat and calcium absorption were determined based on the weight of formula intake , weight of stools , and measured calcium and fat in formula and stools . Results : Fat and calcium intake did not differ between the groups fed CHF . However , infant ’s calcium and fat absorption was less , 41 ± 6 % ( Mean ± SEM ) and 92.0 ± 0.8 % , respectively , when fed CHF with PO compared to 66 ± 5 % and 96.6 ± 1.1 % , respectively , when fed CHF without PO , ( p < 0.01 ) . For infants fed SPF , fat and calcium intake did not differ between the feeding groups . Mean calcium absorption was also significantly less when infants were fed SPF with PO , 22 ± 3 % , than when fed SPF with no PO , 37 ± 4 % ( p < 0.05 ) . Fat absorption did not differ between the two SPFs . Conclusion : This study demonstrates that PO , as the predominant fat , is associated with significantly lower absorption of calcium from infant formulas in which calcium salts are the source of calcium . These findings corroborate previous reports of this negative effect of PO in cow milk-based infant formulas in which most of the calcium is a component of the cow milk protein source One hundred and sixty‐two women with respiratory allergy to animal d and ers and /or pollens were r and omly allocated to a diet consisting of either a very low ingestion of hens ' egg and cows ' milk or a daily ingestion of one hens ' egg and about 11 of cows ' milk during the last 3 months of pregnancy .  One hundred and sixty‐three infants were followed prospect ively up to 18 months of age when the cumulated incidence of atopic disease in each child was evaluated blindly . No significant differences in the distribution of atopic disease were found among the infants in relation to the maternal diet during late pregnancy . The numbers of skin‐prick tests positive to ovalbumin , ovomucoid , β‐lactoglobulin and cows ' milk were likewise not influenced by differences in the maternal diet during late pregnancy . Genetic factors rather than maternal diet during the perinatal period probably have a greater effect on the incidence of atopic diseases during early infancy Growth parameters , biochemical indice of protein metabolism and plasma Amino acid ( AA ) concentrations were investigated during the first month of life in term infants ( n = 61 ) fed various protein hydrolysate formulas ( whey ( WHF , n = 3 ) , soy collagen ( SCHF , n = 1 ) and whey-casein hydrolysate formulas ( WCHF , n = 1 ) ) . In addition , metabolic balance studies were performed in 10 infants fed WHF and in 5 fed WCHF . Comparatively to breast fed infants , growth reduction and decrease in plasma protein concentrations were observed with the use of one of the WHF and in a lesser extent with the SCHF and the WCHF . Plasma amino acid pattern reflected the AA content of the formulas . Whey hydrolysate formulas induced mainly an increase in threonine and a decrease in tyrosine concentrations .  Soy-collagen hydrolysate formula led to an increase of non-essential amino acids , such as glycine and hydroxyproline and a decrease in plasma lysine and cystine .  Whey-casein hydrolysate formula induced a plasma amino acid pattern close to the profile observed in breast fed infant . Metabolic balance studies showed a relative reduction in nitrogen absorption and utilisation in the infants fed the WHF and the WCHF . In addition a drastic reduction in fat , calcium and phosphorus absorption was also observed with the use of the WCHF . In preterm infants ( n = 19 ) fed whey predominant hydrolysed preterm formulas ( n = 3 ) , metabolic balance studies an plasma AA concentration were evaluated at the end of the first month of life at 34 weeks of gestation age . Comparatively to similar preterm infants fed conventional preterm formulas , a relative reduction in nitrogen absorption ( 83 % vs 90 % ) and retention ( 64 vs 70 % ) as well as in phosphorus absorption ( 78 vs 89 % ) was observed . Calcium retention was similar ( 48 vs 45 mg/kg/d ) but calcium intake was significantly higher in infants fed hydrolysate formulas 120 vs 91 mg/kg/d . Plasma amino acid concentrations were related to amino acid composition of the formulas . Compared with the st and ard preterm formulas , all three protein hydrolysate formulas led to a significant increase in plasma threonine and a decrease in tyrosine and phenylalanine concentrations . In addition , there was a reduction in plasma histidine , valine , leucine , cystine , methionine and /or tryptophane with some of the hydrolysate formulas used . In conclusion , these studies provide evidence that protein hydrolysed formulas are not equivalent to whole protein formulas in terms of nutritional efficiency for preterm and term infants . Therefore further extensive nutritional studies on growth , biochemical indices of protein metabolism and metabolic balance , including minerals and trace elements , appear to be necessary before maintaining and promoting the use of such formulas for teh potential benefits on atopic disease in preterm and in full-term newborn infants The soybean protein isolate used in powdered soybean formula is hydrolyzed more extensively than the isolate which is used in liquid soybean formula in most commercial soybean formulas . Previous in vitro studies have shown differences in human antibody response to these soybean protein isolates . Therefore , a prospect i ve clinical study was undertaken to determine if there were differences in adverse reaction rates to these soybean protein isolates . Forty-three patients with possible milk- and /or soy-protein enterocolitis were enrolled in this study . Patients had 3 separate oral food challenges ; using milk formula , soybean powder formula and soybean liquid formula . Ten ( 23 % ) patients challenged with milk had positive challenges . Fourteen ( 33 % ) patients challenged with powdered soy formula had positive challenges while thirteen ( 30 % ) challenged with liquid soy formula had positive challenges . In the 10 patients with positive milk challenges , 6 ( 60 % ) had a positive soy challenge . In the group with positive soy challenges , 5 reacted to the  powdered soy  challenge done first , but not the second challenge with the liquid soy formula , and 4 patients reacted to the liquid soy formula challenge done first , but not the second challenge with the powdered soy formula . These results indicate that a significant number of patients with milk protein enterocolitis have soy protein enterocolitis . In addition , an order effect can be demonstrated in the soy challenges because of the tendency to react to the first soy challenge regardless of the type of isolate . These results suggest that a local immune effect caused by the protein may be present It has been reported that the feeding of cow 's milk may enhance the development of atopy in predisposed infants . A prospect i ve study following children from birth through 15 years of age in a private pediatric practice was design ed to determine if the food ingested during the first months of life is related to the development of atopy in the offspring of allergic families . Each of 328 children with a positive family history of allergy was assigned to one of three groups . according to the feeding preference of the parents : 48 were fed breast milk ; 79 , soy-based formula ; and 201 , cow 's milk formula . All groups had egg , citrus , tomato , and wheat restrictions as well as inhalant allergen avoidance . These were compared to a control group of 580 children with no family history of allergy . Breast fed infants were found to have approximately one-half the incidence of atopy of cow 's milk or soy formula fed infants from atopic families when followed for up to 15 years . Soy feeding produced no advantage over cow 's milk in the prophylaxis of allergic disease . There was a threefold increase in clinical ly apparent atopic disease in offspring of allergic families when compared to controls but only a two-fold increase if the infant was breast fed . These results support the hypothesis that breast feeding and delay of exposure to known allergens may reduce the frequency of clinical allergic disease in the offspring of allergic families OBJECTIVE The objective of this study was to examine the effects of soy formulas with and without added soy fiber in children who developed diarrhea while receiving antibiotics .  DESIGN In a masked , r and omized parallel study , older infants and toddlers were fed commercial soy formulas with or without added soy fiber for 10 days on occurrence of diarrhea during the administration of antibiotics . Subjects were stratified by feeding ( formula versus cow 's milk ) . The primary variables were duration of diarrhea , stool characteristics , and intake . Secondary variables were weight and spit-up . RESULTS All 45 children who completed the 10-day study received > 30 % of their caloric intake from formula . Fiber intake from other foods did not differ between groups and averaged 0.5 g/day . Total median fiber intake of the group fed the formula with added fiber was 6.53 g/day . The mean duration of diarrhea was 25.1 + /- 5.2 hours for children fed the formula with added fiber and 51.6 + /- 10.7 hours for those fed the regular formula ( P = .0013 ) . CONCLUSION The duration of antibiotic-induced diarrhea in children fed the soy formula with added soy fiber was significantly reduced The effect of feeding different infant formulas on incidence of atopic disease was assessed in a prospect i ve double-blind r and omized controlled trial among " high risk " infants with family history of atopy among first-degree relatives . The incidence of atopic eczema , wheezing , rhinitis , gastrointestinal symptoms , and colic was noted and serum IgE antibodies to milk were estimated . Seventy-two infants were recruited into each of the following groups : cow milk whey hydrolysate formula ( NAN/HA ) , conventional cow milk formula ( Similac ) , soy-based formula ( Isomil ) , and exclusive breast feeding for greater than or equal to 4 months .  The number of infants who exited for reasons other than atopy and were excluded from analysis were 4 , 5 , 4 , and 12 in the four groups , respectively . The incidence of one or more symptoms of possible allergic etiology was five of 68 infants fed NAN/HA , 24 of 67 infants fed Similac , 25 of 68 infants fed Isomil , and 12 of 60 breast-fed infants . Among symptomatic infants , skin prick test to milk proteins was positive in four out of five infants fed NAN/HA , 16 of 24 fed Similac , 2 of 25 fed Isomil , and 7 of 12 breast-fed . IgE antibodies to milk were found in 2 of 68 , 9 of 67 , 0 of 68 , and 6 of 60 infants in the four groups , respectively . It is concluded that exclusive breast feeding for more than 4 months is partially protective against the development of atopic disease among high risk infants . ( ABSTRACT TRUNCATED AT 250 WORDS OBJECTIVE The purpose of this study was to compare growth and protein status of healthy term infants from 2 to 112 days of age fed a commercially available soy-based formula ( IS ) and a similar formula ( EF )  containing less protein ( 2.91 vs 2.45 g/100 kcal ) . DESIGN A controlled , r and omized , blind parallel clinical trial was conducted in 32 male and 32 female infants . Infants were enrolled at 2 days of age , and their assigned formula was their only feeding to 112 days of age . At this time their weight , length , and head circumference were measured . Weight , length , and head circumference were measured and formula intake , formula intolerance and stool characteristics were recorded at 8 , 28 , 56 , and 112 days of age . Plasma urea nitrogen ( PUN ) , total protein , albumin , and transthyretin were determined at 56 and 112 days . RESULTS There were no statistically significant differences in weight , length , head circumference , or gains in these measures . PUN concentration was significantly lower in infants fed EF than IS at 56 and 112 days . Plasma total protein , albumin , and transthyretin concentrations were not different between the two feeding groups at the two testing periods . Tolerance to the two formulas was similar . Stool characteristics did not differ between the two groups . CONCLUSION A soy-based formula containing 2.45 g protein/100 kcal and approximately 640 mumol of total sulfur containing amino acids/100 kcal adequately meets the protein needs of term infants from 2 to 112 days of age Treating the infant colic syndrome by counseling the  parents  concerning more effective responses to the infant crying is compared to the elimination of soy or cow 's milk protein from the infant 's diet in a r and omized clinical trial . Because symptoms of vomiting and diarrhea are not part of the infant colic syndrome , infants with these gastrointestinal symptoms were excluded from the study .  Dietary changes were accomplished by either feeding the infants a hydrolyzed casein formula or by requiring mothers to eliminate milk from their diets . In phase 1 of the study , the group receiving counseling  ( n = 10 ) had a decrease in crying from 3.21 + /- 1.10 h/d to 1.08 + /- 0.70 h/d ( P = .001 ) . The crying in the group that received dietary changes ( n = 10 ) decreased from 3.19 + /- 0.69 h/d to 2.03 + /- 1.07 h/d ( P = .01 ) , a level still greater than twice normal . The decrease in those receiving counseling was faster and greater than that of those given dietary changes ( P less than .02 ) . In the second phase of the study , group 2 infants were reexposed to cow 's milk or soy protein and the parents received counseling . In this phase , counseling again decreased crying significantly from 2.09 + /- 1.07 h/d to 1.19 + /- 0.60 h/d ( P = .05 ) . No infant in the study who improved with changes in his or her diet had a significant increase in crying , with reexposure to soy or cow 's milk protein . ( ABSTRACT TRUNCATED AT 250 WORDS Infants ( n = 18 ) with intolerance to extensively hydrolyzed formulas and soy who responded to an L-amino acid-based elemental formula ( AAF ) were studied until 3 years of age . By 2 years of age most tolerated non-formula foods , and by 3 years only 3 required AAF .  Growth normalized during AAF feeding in 4 infants with failure to thrive The protective effect of breast feeding against atopic disease ( AD ) has been confirmed in several prospect i ve studies , while some retrospective studies have yielded controversial results . We have evaluated the prophylactic effect of prolonged breast feeding on the development of AD in 101 newborns at hereditary risk for allergic disease . The study design also included a strict dietary avoidance regimen of the nursing mothers . Our data demonstrate that breast feeding or breast feeding supplemented with soy milk exert a prophylactic effect on the development of AD in these at-risk infants . Mechanisms by which breast feeding protects from atopy are discussed For 16 years the double-blind , placebo-controlled food challenge ( DBPCFC ) has been used at the National Jewish Center for Immunology and Respiratory Medicine to determine whether adverse reactions to foods do occur in children . The objective of these studies was to explore these reproducible adverse reactions and to characterize them . Although skin testing was performed on all subjects , a history of an adverse reaction to food and to subsequent DBPCFC were the only criteria for entry into this study . Of 480 children studied , 185 ( 39 % ) have had positive DBPCFC results . In these 480 children , 245 ( 24 % ) of 1014 DBPCFCs showed positive results . Egg , peanut , and cow milk accounted for 73 % of the positive DBPCFC reactions , but many foods produced reactions . Skin test results were positive in most children with a positive DBPCFC reaction , but the large number of patients with asymptomatic hypersensitivity limited the accuracy of a positive skin test result alone as a predictor of clinical symptoms during food ingestion . Evaluation of results in this large number of children for a prolonged period revealed reproducible patterns of symptoms , timing , and incriminated foods . Placebo reactions were rare . The procedure was safe . Twelve youngsters with a negative DBPCFC result subsequently had positive reactions to open challenges when large amounts of the challenge food were used . In each of these cases the reactions were limited to areas of direct contact with the food or could be explained by the larger amount of food ingested during the open challenge . Multiple food hypersensitivity has been a rare finding . The DBPCFC should be the " gold st and ard " for both research and clinical diagnostic evaluations until it is superseded by methods that have yet to be developed For a minimum of one month ( mean , 54 days ) , 287 infants and children less than 8 years of age were fed an isolated soy-protein formula . Prior to entry into the study , a cow 's milk formula was being fed to 71 % , a soy formula to 9 % , and cow 's milk or other formulas to 20 % . Intolerance to cow 's milk was reported in 35 % of the patients , symptoms indicative of cow 's milk intolerance in 23 % , diarrhea or gastroenteritis in 18 % , a family history of allergy in 13 % , and insufficient weight gain , intolerance to other formulas , or constipation in 11 % . The patients showed normal increases in weight and length during the study . A significant decrease in the following symptoms were reported in the patients from before to after treatment : abdominal cramps , bloating or gas , colic , diarrhea , fussiness , rashes or eczema , spitting up , waking up crying at night , wheezing , and vomiting . It is concluded that , while receiving soy formula , infants and children continued to thrive normally and that the formula was well tolerated . After receiving soy formula , the frequency of undesirable feeding-related symptoms was reduced in the majority of infants and children In an attempt to prevent or reduce the manifestations of atopic disease , a group of infants considered to be genetically at high risk of atopy was entered in a prenatally r and omized , controlled study . A prophylactic group ( n= 58 ) was either breast‐fed with their mothers excluding foods regarded as highly antigenic from their diets , or given an extensively hydrolysed formula . In addition , strenuous efforts were made to reduce exposure to the house‐dust mite by application of acaricide to the bedroom and living room carpets and upholstered furniture . A control group ( n= 62 )  was fed conventionally by breast or on formula , and no specific environmental measures were taken . The results ( previously reported ) after 1 year showed significantly less total allergy , asthma , and eczema in the prophylactic group . Similar results were obtained at 2 years although the reduction in asthma no longer achieved statistical significance . However , there was significantly less sensitization , as shown by a battery of skin prick tests ( SPTs ) , to both dietary allergens and aeroallergens in the prophylactic group . A11 the children have now been review ed at the age of 4 years , and SPTs to a wide range of dietary allergens and aeroallergens have been performed . The control group continues to show more total allergy ( odds ratio [ OR ] 2.73 , 95 % confidence interval [ CI ] 1.21–6.13 , P<0.02 ) , definite allergy ( allergic symptoms plus positive SPT ) ( OR 5.6 , CI 1.8–17.9 , P<0.005 ) , and eczema ( OR 3.4 , CI 1.2–10.1 , P<0.05 ) . More control children have positive SPTs ( OR 3.7 , CI 1.3–10.0 , P<0.02 ) . A dual approach to the prevention of allergic disease , avoiding as far as possible sensitization to food and aeroallergens , significantly reduces the risk of atopic disease . This should be reserved for infants considered at very high risk of atopy , and close medical and dietetic supervision must be available The role of cow 's milk in infantile colic in formula-fed infants was estimated in a double-blind study . Sixty colicky infants were given a cow 's milk-containing formula ( Enfamil ) and a cow 's milk-free formula based on soy ( ProSobee ) . Eleven infants ( 18 % ) were free of symptoms while receiving soy formula .  Symptoms of 32 infants ( 53 % ) were unchanged or worse when they were fed cow 's milk formula and soy formula , but symptoms disappeared when they were fed a formula containing hydrolyzed casein ( Nutramigen ) . Symptoms of 17 infants ( 29 % ) could not be related to the diet ; these infants were permitted to continue on a cow 's milk-based formula . A challenge with cow 's milk-based formula after one month ( at approximately age 3 months ) produced symptoms of infantile colic in 22 infants ( 36 % ) . At age 6 months , a challenge with cow 's milk was positive in 11 infants ( 18 % ) with epidermal and gastrointestinal symptoms . Eight infants ( 13 % ) at 12 months of age and five infants ( 8 % ) at 16 months of age were still intolerant to cow 's milk . Cow 's milk seems to be a major cause of infantile colic  in formula-fed infants . A dietary treatment is suggested for moderate or severe forms of the colic . Cow 's milk protein intolerance is common later in infancy in these infants STUDY OBJECTIVE : To identify environmental determinants of six symptoms associated with allergic disease in infancy . DESIGN : Infants were participants in a prospect i ve r and omised controlled trial of feeding practice s in families with a history of atopy . SETTING : Infants were recruited in two maternity hospitals in S Wales and followed up in the community for 1 year . PARTICIPANTS : Mothers of 519 infants agreed to participate , but 36 were excluded ( mainly for moving home or failing to attend for follow-up ) , leaving 483 in the study ( 253 male , 230 female ) . Infants were followed up and examined for evidence of allergic disease at 3 , 6 , and 12 months . MEASUREMENTS AND MAIN RESULTS : At each examination , mothers were question ed about episodes of illness in the infant , and the data presented relate to ( reported and observed ) eczema and nasal discharge , and ( reported ) wheeze , prolonged colds , diarrhoea and vomiting . Mothers kept a diary with details of feeding for the first 6 months . All homes were visited by a nurse who took sample s of dust for dust mite antigen analysis . Extensive socio-demographic data were collected . None of the factors studied showed a convincing relationship with eczema . In a multiple logistic regression analysis breast feeding appeared to protect against wheeze , nasal discharge , colds , vomiting and diarrhoea . Having more siblings increased the likelihood of prolonged colds , and ( together with overcrowding ) of wheeze and nasal discharge . Maternal smoking and low social class were associated with wheeze , and house dust antigen with prolonged colds . Respiratory symptoms were associated with some aspects of housing but these could not be distinguished clearly from other social factors . Babies born in Autumn were at increased risk of wheeze , vomiting and diarrhoea . CONCLUSIONS : Environmental factors play an important part in determining risk of symptoms in potentially atopic babies . These factors are in principle open to manipulation OBJECTIVES We conducted a prospect i ve , r and omized study to evaluate the cumulative incidence of allergy or other adverse reactions to soy formula and to extensively hydrolyzed formula up to the age of 2 years in infants with confirmed cow 's milk allergy . STUDY DESIGN Infants ( n = 170 ) with documented cow 's milk allergy were r and omly assigned to receive either a soy formula or an extensively hydrolyzed formula . If it was suspected that the formula caused symptoms , a double-blind , placebo-controlled challenge ( DBPCFC ) with the formula was performed . The children were followed to the age of 2 years , and soy-specific immunoglobulin E antibodies were measured at the time of diagnosis and at the ages of 1 and 2 years . RESULTS An adverse reaction to the formula was confirmed by challenge in 8 patients ( 10 % ; 95 % confidence interval , 4.4%-18.8 % ) r and omly assigned to soy formula and in 2 patients ( 2.2 % ; 95 % confidence interval , 0.3 % to 7.8 % ) r and omly assigned to extensively hydrolyzed formula .  Adverse reactions to soy were similar in IgE-associated and non-IgE-associated cow 's milk allergy ( 11 % and 9 % , respectively ) . IgE to soy was detected in only 2 infants with an adverse reaction to soy . Adverse reactions to soy formula  were more common in younger ( < 6 months ) than in older ( 6 to 12 months ) infants ( 5 of 20 vs 3 of 60 , respectively , P = .01 ) . CONCLUSIONS Soy formula was well tolerated by most infants with IgE-associated and non-IgE-associated cow 's milk allergy . Development of IgE-associated allergy to soy was rare . Soy formula can be recommended as a first-choice alternative for infants > or=6 months of age with cow 's milk allergy BACKGROUND Distinct wheezing disorders co-exist in young ( preschool ) children , some of which ( early transient wheeze and viral wheeze ) are thought to be unrelated to atopy . Investigation of changes in prevalence of wheezing disorders in preschool children could provide important clues about underlying mechanisms responsible for increasing prevalence of asthma in schoolchildren . METHODS Repeated population surveys of the prevalence of respiratory symptoms were done by parent-completed postal question naires in r and om sample s of 1650 ( 1990 ) and 2600 ( 1998 ) caucasian children aged 1 - 5 years living in the county of Leicestershire , UK . FINDINGS The response rates were 86 % ( 1422 of 1650 ) in 1990 and 84 % ( 2127 of 2522 ) in 1998 . Between 1990 and 1998 , there was a significant increase in the prevalance of reported wheeze ever ( 16 % to 29 % , p<0.0001 ) , current wheeze ( 12 % to 26 % , p<0.0001 ) , diagnosis of asthma ( 11 % to 19 % , p<0.0001 ) , treatment for wheeze ( 15 % to 26 % , p<0.0001 ) , and admission for wheeze or other chest trouble ( 6 % to 10 % , p<0.0001 ) . The increase occurred both in children with viral wheeze ( 9 % to 19 % ) and in those with the classic asthma pattern of wheezing with multiple triggers ( 6 % to 10 % ) . There was also an increase in transient early wheezers ( 3 % to 5 % ) , persistent wheezers ( 5 % to 13 % ) , and late-onset wheezers ( 6 % to 8 % ) , and in all severity groups . The increase could not be accounted for by putative household risk factors because these declined between the 2 years . INTERPRETATION The fact that all preschool wheezing disorders increased ( including viral wheeze ) makes it probable that factors unrelated to atopy are implicated in the changing epidemiology of wheeze in childhood Retraction On 28 October 2015 , The BMJ retracted this article , published in 1989 : Ch and ra RK , Puri S , Hamed A. Influence of maternal diet during lactation and use of formula feeds on development of atopic eczema in high risk infants . BMJ 1989;299:228–30 . The BMJ has retracted the article after receiving a copy of an inquiry into the research of R K Ch and ra , which was conducted by the Memorial University of Newfoundl and and completed in August 1995 . The university did not publish the inquiry report at the time . Nor did it notify the editors of journals that had published articles by Ch and ra that were considered in the report . The BMJ obtained a copy of the report when it came into the public domain as a result of Ch and ra taking and losing a legal action against the Canadian Broadcasting Corporation ( CBC ) , which aired television programmes about Ch and ra in 2006 . The inquiring committee experienced great difficulty with its work , but its final conclusion was that “ scientific misconduct has been committed by Dr Ch and ra . ” It looked at three studies and found that : “ absolutely no raw data ( or files ) of any kind were exhibited ” “ the Committee can not identify anyone who did the recruiting , can not identify anyone who did or remembers a significant amount of work ” “ the coauathors had little or very likely nothing to do with the work ” “ it is unbelievable that there are essentially no hospital records to support the study in question ” “ the committee can not accept that the Carnation study was done anywhere near to completeness or with the accuracy reported in the Annals of Allergy and Journal of Clinical Nutrition , For that matter , the same can probably be said for the Mead Johnson work published in the British Medical Journal . ” When asked by The BMJ in 2015 why it had not published the report in 1995 , Memorial University of Newfoundl and said that the report “ was the product of a flawed investigation process and could not be relied upon . ” In the CBC programmes , however , a university spokesman said that the university had not acted on the report because of legal threats from Ch and ra . The university further told The BMJ : “ In the spirit of being helpful , we acknowledge that over the years serious questions have been raised about the 1989 publication , leading to much controversy . If [ The ] BMJ decides to retract the paper on the basis of evidence apart from the findings of the 1995 report , then we would underst and your decision in this regard . ” The BMJ is retracting the paper because of the 1995 report , and because of the convincing evidence given in the CBC television programmes and the court case that the work of R K Ch and ra is not to be trusted . For more information , see The BMJ 's feature article(1 ) and editorial,(2 ) published on 28 October 2015
target: AUTHORS ' CONCLUSIONS Feeding with a soy formula can not be recommended for prevention of allergy or food intolerance in infants at high risk of allergy or food intolerance .
background: BACKGROUND Allergies and food reactions in infants and children are common and may be associated with a variety of foods including adapted cow 's milk formula .
  Soy based formulas have been used to treat infants with allergy or food intolerance .
  However , it is unclear whether they can help prevent allergy and food intolerance in infants without clinical evidence of allergy or food intolerance .
  OBJECTIVES To determine the effect of feeding adapted soy formula compared to human milk , cow 's milk formula or a hydrolysed protein formula on preventing allergy or food intolerance in infants without clinical evidence of allergy or food intolerance .