On 7 October, Dr. Louise Michaelis from the Great North Children’s Hospital, Newcastle-upon-Tyne, UK presented the initial clinical study results of the first hypoallergenic formula to bring the gut microbiota of infants with severe cow’s milk protein allergy (CMPA) closer to that of healthy breastfed infants, by offering both pre-and-probiotics. The results are of specific interest, since they signal the next step in the dietary management of CMPA, beyond the resolution of the acute allergic symptoms. Over eight years of research, including three clinical studies, form the foundation of the hypoallergenic formula. The study results were presented at the WCPGHAN congress in Montreal, Canada, 5-8 October 2016. The formula has been previously clinically shown in CMPA infants to effectively resolve food allergy symptoms and to support adequate growth and development (Harvey et al (2014); Burks et al (2015)).
Children with a cow’s milk protein allergy
About 2 to 5% of the children suffer from CMPA, making it one of the most common allergies in infants and children. Symptoms range from mild to severe and can affect multiple organs, like the gut, skin and airways. Symptoms can be avoided by eliminating cow’s milk protein from the child’s diet.
Under the supervision of a healthcare professional, there are options for the management of an infant with this allergy. Options include breast milk (with or without a mother’s exclusion diet), or if breast feeding is not possible, hydrolyzed formulas (containing proteins which have been broken down) or formulas with no added cow’s milk protein, e.g. based on amino acids (amino acid-based formulas (AAF)).
The gut microbiota between allergic and non-allergic infants differ and this difference is poorly understood
Research has linked food allergies in infancy, including CMPA, with gut microbiota dysbiosis. The gut microbiota plays a pivotal role in developing the immune system of infants and young children. Gut dysbiosis is a change, or imbalance of the bacterial communities compared to healthy individuals. Whilst dietary management with existing amino acid-based formulas can help effectively resolve observable symptoms, including distress (crying), eczema, diarrhea, abdominal pain, colic, vomiting and in some infants nasal blockage, they do not address the hidden, underlying gut dysbiosis.
The concept behind dietary management with the new hypoallergenic AAF was that it should both help resolve symptoms and help address the underlying gut dysbiosis. It is also the only hypoallergenic formula containing both pre- and probiotics, specifically selected for infants with CMPA. This helps balance the gut microbiota of food allergic infants to more closely reflect that of healthy, breastfed infants. Physicians in the US will be able to prescribe the new formula containing pre- and probiotics from November 2016. Luckily, most children outgrow food allergies later in life.
WCPGHAN 2016 congress
WCPGHAN stands for World Congress Pediatric, Gastroenterology, Hepatology and Nutrition, 5-8 October 2016 in Montreal, QC Canada.
Picture: Dr. Louise Michaelis (in the middle) at the panel discussion during the symposium at WCPGHAN 2016.