Short-term symptom improvement in infants with suspected cow's milk protein allergy using amino acid formula: a prospective cohort analysis

Michael J Wilsey; Jessica V Baran; Luke Lamos; Jesse Beacker; Jared Florio; Lea Oliveros; Panida Sriaroon; Jerry M Brown; Jon A Vanderhoof

doi:10.3389/fnut.2023.1208334

Short-term symptom improvement in infants with suspected cow's milk protein allergy using amino acid formula: a prospective cohort analysis

Front Nutr. 2023 Jun 20:10:1208334. doi: 10.3389/fnut.2023.1208334. eCollection 2023.

Authors

Affiliations

¹ Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL, United States.
² Pediatric Gastroenterology, Hepatology, and Nutrition of Florida, St. Petersburg, FL, United States.
³ Office of Medical Education, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, FL, United States.
⁴ Department of Pediatrics, Division of Allergy and Immunology, University of South Florida Morsani College of Medicine, Tampa, FL, United States.
⁵ Department of Gastroenterology Hepatology and Nutrition, Boys Town Hospital, Boys Town, NE, United States.

^# Contributed equally.

Abstract

Background: Cow's milk protein allergy (CMPA) occurs commonly in infants. While the long-term efficacy of amino acid formulas for managing CMPA is well-established, there is limited data on the short-term symptom improvement of using amino acid formula (AAF).

Objective: This study aimed to determine the short-term effects of managing suspected CMPA in infants aged 6 months and under using a commercial AAF.

Methods: Healthcare providers who treated infants with suspected CMPA aged 6 months or younger (n = 104) provided de-identified survey data in this prospective study. Healthcare providers scored symptoms for severity from 0 to 3 (none, low, moderate, severe) before using a commercial AAF at Visit 1 and at Visit 2 (3-6 weeks later).

Results: Gastrointestinal (94%), skin (87%), respiratory (86%), and uncategorized symptoms (89%) improved from AAF initiation, and these findings were consistent across different follow-up visit durations.

Conclusion: This study is the most extensive prospective analysis conducted in the United States examining the short-term change in suspected CMPA symptoms using an AAF. These findings suggest that AAF may decrease the severity of suspected CMPA symptoms in infants 6 months or younger, often by the next follow-up visit. Further randomized controlled trials are required to confirm these initial findings.

Keywords: ZSMoments; amino acid formula; cow’s milk protein allergy (CMPA); eczema; infant nutrition; milk hypersensitivity.

Grants and funding

A grant (RB2073) from Reckitt supported article processing and presentation fees for this research. Additionally, Reckitt provided funding for data collection through ZS Associates.