Feeding the Infant With Possible Food Allergy: What's Best?

Jennifer S. Kim, MD

Disclosures

June 18, 2014

What About Formula Supplementation?

Evidence to support the use of a formula over breastfeeding to prevent atopic disease is inconclusive. However, for infants at increased risk for allergic disease who cannot be exclusively breastfed for the first 4-6 months of life, a hydrolyzed formula appears to offer advantages for preventing allergic disease and, specifically, cow's-milk allergy.

Evidence that soy formula prevents atopic disease is not substantial. No studies address the use of amino acid-based formulas. There is also insufficient evidence to support the use of probiotics, prebiotics, or a combination (termed "synbiotics") for the prevention or treatment of eczema in children.

Back to the Case

The mother returns to the office 4 months later with her now 7-month-old daughter. She reports that she supplemented with an extensively hydrolyzed formula and started solids when the baby was 5 months of age. Since then, she has introduced her daughter to rice, oats, sweet potatoes, squash, carrots, apples, pears, bananas, green peas, and broccoli. The child has not developed eczema, nor has she had any symptoms suggesting an allergic reaction, but the mother is still nervous about milk formula introduction, particularly because her 2-year-old son is milk allergic.

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