This meta-analysis reviewed studies comparing the use of soy formula to other formulas for preventing allergy and food intolerance in infants. It found:
1) No eligible studies comparing soy formula to human milk or comparing early, short-term soy formula use.
2) For prolonged soy formula use in high-risk infants, meta-analyses found no significant differences in outcomes like allergy, asthma, eczema, or rhinitis compared to cow's milk formula.
3) Only one study with adequate methodology directly compared soy formula to cow's milk formula, and it also found no significant differences in outcomes.
4) No eligible studies compared soy formula to hydrolyzed protein formulas.
Probiotic administration in early life, atopy, and asthma, a meta analysis of...Ariyanto Harsono
The document summarizes a meta-analysis of clinical trials on the effects of probiotic supplementation in children. The analysis found that prenatal and early-life probiotic administration reduced the risk of atopic sensitization and decreased total immunoglobulin E levels. However, probiotic administration may not reduce the risk of asthma or wheezing. The effects also depended on the probiotic strain used and the duration of follow-up. While probiotics seemed to reduce infant eczema, the evidence was heterogeneous and did not find an effect on confirmed atopic eczema. Overall, the review concluded there was insufficient evidence that probiotics prevent allergic disease or food hypersensitivity in infants.
Evidence the use of probiotics in infants for prevention of allergic diseaseAriyanto Harsono
This document summarizes a review of evidence on using probiotics in infants to prevent allergic disease and food hypersensitivity. The review found insufficient evidence that probiotics reduce the risk of allergic disease or food hypersensitivity in infants. While probiotic use was associated with a reduction in infant eczema in some studies, the effect was inconsistent between studies and all studies had substantial losses to follow up, indicating caution is needed in interpreting the results due to methodological limitations. In conclusion, the review found the evidence is currently insufficient to recommend adding probiotics to infant feeds to prevent allergic conditions.
1) While family history increases the risk of developing allergies, it is not a reliable predictor as most children with allergies do not have a family history and most children with a family history do not develop allergies.
2) Studies on maternal dietary avoidance during pregnancy show no significant difference in rates of eczema, allergic rhinitis, or asthma in children at age 5.
3) Introduction of solid foods like peanut products, eggs, and milk/milk products between 4-12 months based on individual risk is not associated with increased risk of asthma or allergy according to several studies. Delayed introduction beyond 12 months may be associated with increased risk.
This systematic review and meta-analysis examined the relationship between maternal intake of omega-3 long-chain polyunsaturated fatty acids (LC-PUFAs) during pregnancy and allergic disease outcomes in offspring. The review included 13 observational studies and 7 randomized controlled trials. Pooled results from 3 randomized trials found a significant reduction in atopic eczema, positive skin prick tests, sensitization to egg, and sensitization to any food in offspring in the first 12 months of life for mothers who consumed higher levels of omega-3 LC-PUFAs during pregnancy. However, inconsistencies in results prevented a definitive conclusion about the relationship between maternal omega-3 intake and childhood allergic disease.
This document discusses the prevalence of food allergies in Southeast Asia based on a presentation by Dr. BW Lee from the National University of Singapore. It provides data on the prevalence of various food allergies like peanut allergy from studies in countries in the region. It notes that food allergy patterns may be related to environmental allergens through cross-reactivity. It also presents several case studies of allergic reactions triggered by novel allergens like prebiotics in cow's milk formula and discusses mechanisms of carbohydrate allergen epitopes.
Join Us! Professor Ruby Pawankar, President of the World Allergy Organization (WAO), and Professor Motohiro Ebisawa, Chair of the WAO Communications Council, warmly welcome WAO Member Societies to World Allergy Week 2013 (8-14 April). This year’s theme is “Food Allergy—A Rising Global Health Problem”, and there are many ways Member Societies can participate to help highlight food allergies, provide information about the their increasing prevalence, and explain the need for enhanced education and patient care services to improve safey, prevention, and quality of life.
WAO will again provide resources for its member societies to use for local activities.
This study evaluated the effects of maternal dietary yeast supplementation on immunoglobulin concentrations in foals from birth to four months of age. Eight pregnant mares were randomly assigned to either a yeast supplement or control group. Blood samples were taken from the foals at various intervals. While most immunoglobulin levels did not differ, IgG(T) concentrations were significantly higher in foals from yeast-supplemented mares at 60 days. Overall, maternal yeast supplementation did not significantly influence immunoglobulin levels in the foals.
Probiotic administration in early life, atopy, and asthma, a meta analysis of...Ariyanto Harsono
The document summarizes a meta-analysis of clinical trials on the effects of probiotic supplementation in children. The analysis found that prenatal and early-life probiotic administration reduced the risk of atopic sensitization and decreased total immunoglobulin E levels. However, probiotic administration may not reduce the risk of asthma or wheezing. The effects also depended on the probiotic strain used and the duration of follow-up. While probiotics seemed to reduce infant eczema, the evidence was heterogeneous and did not find an effect on confirmed atopic eczema. Overall, the review concluded there was insufficient evidence that probiotics prevent allergic disease or food hypersensitivity in infants.
Evidence the use of probiotics in infants for prevention of allergic diseaseAriyanto Harsono
This document summarizes a review of evidence on using probiotics in infants to prevent allergic disease and food hypersensitivity. The review found insufficient evidence that probiotics reduce the risk of allergic disease or food hypersensitivity in infants. While probiotic use was associated with a reduction in infant eczema in some studies, the effect was inconsistent between studies and all studies had substantial losses to follow up, indicating caution is needed in interpreting the results due to methodological limitations. In conclusion, the review found the evidence is currently insufficient to recommend adding probiotics to infant feeds to prevent allergic conditions.
1) While family history increases the risk of developing allergies, it is not a reliable predictor as most children with allergies do not have a family history and most children with a family history do not develop allergies.
2) Studies on maternal dietary avoidance during pregnancy show no significant difference in rates of eczema, allergic rhinitis, or asthma in children at age 5.
3) Introduction of solid foods like peanut products, eggs, and milk/milk products between 4-12 months based on individual risk is not associated with increased risk of asthma or allergy according to several studies. Delayed introduction beyond 12 months may be associated with increased risk.
This systematic review and meta-analysis examined the relationship between maternal intake of omega-3 long-chain polyunsaturated fatty acids (LC-PUFAs) during pregnancy and allergic disease outcomes in offspring. The review included 13 observational studies and 7 randomized controlled trials. Pooled results from 3 randomized trials found a significant reduction in atopic eczema, positive skin prick tests, sensitization to egg, and sensitization to any food in offspring in the first 12 months of life for mothers who consumed higher levels of omega-3 LC-PUFAs during pregnancy. However, inconsistencies in results prevented a definitive conclusion about the relationship between maternal omega-3 intake and childhood allergic disease.
This document discusses the prevalence of food allergies in Southeast Asia based on a presentation by Dr. BW Lee from the National University of Singapore. It provides data on the prevalence of various food allergies like peanut allergy from studies in countries in the region. It notes that food allergy patterns may be related to environmental allergens through cross-reactivity. It also presents several case studies of allergic reactions triggered by novel allergens like prebiotics in cow's milk formula and discusses mechanisms of carbohydrate allergen epitopes.
Join Us! Professor Ruby Pawankar, President of the World Allergy Organization (WAO), and Professor Motohiro Ebisawa, Chair of the WAO Communications Council, warmly welcome WAO Member Societies to World Allergy Week 2013 (8-14 April). This year’s theme is “Food Allergy—A Rising Global Health Problem”, and there are many ways Member Societies can participate to help highlight food allergies, provide information about the their increasing prevalence, and explain the need for enhanced education and patient care services to improve safey, prevention, and quality of life.
WAO will again provide resources for its member societies to use for local activities.
This study evaluated the effects of maternal dietary yeast supplementation on immunoglobulin concentrations in foals from birth to four months of age. Eight pregnant mares were randomly assigned to either a yeast supplement or control group. Blood samples were taken from the foals at various intervals. While most immunoglobulin levels did not differ, IgG(T) concentrations were significantly higher in foals from yeast-supplemented mares at 60 days. Overall, maternal yeast supplementation did not significantly influence immunoglobulin levels in the foals.
Prebiotics in infants for prevention of allergic disease and food hypersensit...Ariyanto Harsono
This document summarizes a meta-analysis on the effect of prebiotics in infants for the prevention of allergic disease and food hypersensitivity. Seven studies with a total of 432 infants were included. One study found a significant reduction in eczema in infants up to six months of age who received a mixture of fructo- and galacto-oligosaccharides. However, another study found no significant difference in eczema in infants who were not selected based on allergy risk. No significant differences in growth were found. The review concluded that there is insufficient evidence to support the use of prebiotics to prevent allergic disease or food hypersensitivity in infants.
Effect of a partially hydrolyzed whey infant formula at weaning on risk of allergic disease in high risk children a randomized controlled trial
Presented by Sadudee Boonmee, MD.
This study compared the incidence of acute respiratory infections (ARI) in exclusively breastfed infants versus not exclusively breastfed infants aged 61-180 days. A total of 200 infants were followed prospectively for 4 months each and divided into two groups: 100 exclusively breastfed infants and 100 not exclusively breastfed infants. A total of 232 ARI episodes were recorded, with 67 episodes in the exclusively breastfed group and 165 episodes in the not exclusively breastfed group. The incidence of ARI was higher in the not exclusively breastfed group compared to the exclusively breastfed group. Exclusive breastfeeding for the first 6 months was found to be effective in preventing ARI in infants aged 61-180 days.
This study compared the incidence of acute respiratory infections (ARI) in exclusively breastfed infants versus not exclusively breastfed infants aged 61-180 days. A total of 200 infants were followed prospectively for 4 months each and divided into two groups: 100 exclusively breastfed infants and 100 not exclusively breastfed infants. A total of 232 ARI episodes were recorded, with 67 episodes in the exclusively breastfed group and 165 episodes in the not exclusively breastfed group. The incidence of ARI was higher in the not exclusively breastfed group compared to the exclusively breastfed group. Exclusive breastfeeding for the first 6 months was found to be effective in preventing ARI in infants aged 61-180 days.
RTI in Exclusive breast feed baby vs Not Exclusively breast feed baby Journal...MinhajulIslam83
Comparison of incidence of acute respiratory infection
in exclusively breastfed infants and not exclusively
breastfed infants from 61 to 180 days of age:
A prospective cohort study
Effectiveness Of Exclusive Breastfeeding Promotion In Low Income Mothers A Ra...Biblioteca Virtual
The study compared the antifungal effects of human milk, cow's milk, and various infant formulas against environmental fungi. Human milk showed significantly greater antifungal activity than the other substances tested, inhibiting nearly all fungal growth. Both prebiotic and probiotic formulas also demonstrated antifungal effects, though to a lesser degree than human milk. The results indicate that human milk protects infants from fungal infections not only through nutrition but also via its antifungal properties.
This document discusses concerns about vaccines and their ingredients like mercury and aluminum. It notes that while vaccines have reduced diseases, more children now have chronic illnesses, learning disabilities, and autoimmune disorders. It questions if vaccines may be overstressing immune systems or if too many are given too early. It also notes a lack of safety studies on vaccine combinations, subgroups of people, and how ingredients interact with each other and other toxins. It provides data showing past mercury levels in vaccines exceeded EPA safety guidelines and discusses mercury's neurotoxicity and impacts on development. It associates environmental mercury with increased autism rates and impaired detoxification in autistic children.
This document summarizes concerns about vaccine safety and alternatives to vaccination. It discusses the potential risks of mercury, aluminum, and other components in vaccines on immune and neurological development. While not suggesting abandoning vaccines, it notes the lack of long-term safety studies and the possibility that vaccines may exacerbate underlying immune issues or metabolic disorders in some children.
This study examined the long-term relationship between breastfeeding and asthma/atopy in a New Zealand birth cohort of over 1,000 children followed up to age 26. The study found that breastfeeding for over 4 weeks doubled the risk of diagnosed asthma in childhood and these effects persisted into adulthood. Additionally, breastfeeding for over 13 weeks increased the likelihood of skin test response to allergens. However, the study had limitations such as unclear definitions of breastfeeding and potential recall and selection biases. Overall, the study did not support the idea that breastfeeding protects against asthma or atopy.
Efficacy and safety of immunomodulators in pediatric age - Slideset by Profes...WAidid
«The first cause of recurrent infections in children is... childhood itself.» (J. Gary Wheeler)
Is it possibe to treat and prevent recurrent respiratory infections (RTIs) in pediatric age? Some studies have shown that immunostimulants/immunomodulators can reduce and prevent RTIs in children.
To learn more please visit www.waidid.org
The document discusses allergy skin testing. It provides details on common allergy symptoms and causes. It then describes different types of skin tests including prick and intradermal tests. Predictive values and contraindications for skin tests are presented. Blood tests for allergy are also discussed. Advantages of skin tests include being fast, safe, sensitive and allowing for identification of allergies in one visit. Risks of skin tests are very low.
<마더세이프라운드> Pregnancy outcome of women exposed to lactobacillus during preg...mothersafe
This study examined the pregnancy outcomes of 104 women who took probiotics during early pregnancy. The results showed no meaningful correlations between probiotic exposure and adverse infant outcomes like preterm birth, low birth weight, or birth defects. Previous studies have found probiotics may help prevent allergic diseases by modulating immune function and intestinal microbiota in early life. A review found certain probiotic strains were safe during pregnancy but their effect on allergic disease requires more research.
2009 08 15 Vaccines, Adverse Reactions, and the Florida Lawdrdavid999
The document discusses concerns about vaccines including whether they may overstress the immune system, the lack of safety studies on vaccine components like thimerosal and aluminum, and the high levels of mercury infants received from vaccines prior to 2001. It notes signs of mercury toxicity are the same as symptoms seen in autistic children and that children with autism have impaired ability to detoxify metals like mercury.
The document discusses food immunotherapy for treating food allergies. It provides definitions and outlines immune mechanisms and efficacy evidence from studies on peanut, cow's milk, egg, and wheat oral immunotherapy (OIT). Peanut OIT studies showed 67-78% of children achieved desensitization and 21-46% achieved sustained unresponsiveness. Cow's milk and egg OIT also demonstrated desensitization in 50-75% of children. Wheat OIT studies found 52-69% achieved desensitization. OIT was effective at increasing tolerance but also increased rates of adverse events during treatment.
The document provides information about cow's milk protein allergy (CMPA), including:
- CMPA is a common food allergy in infants and young children under 3 years old.
- It can present with nonspecific symptoms that are difficult to distinguish from other conditions like GERD.
- The majority (over 95%) of cases present in the first year of life, with most in the first 6 months.
- Presentation can involve different organ systems like skin, GI, and respiratory. IgE-mediated reactions are immediate while non-IgE reactions are delayed.
- Common GI symptoms include diarrhea, vomiting, poor feeding, and rectal bleeding. Failure to thrive can
The document provides information on cow's milk protein allergy (CMPA) including its epidemiology, clinical presentation, diagnostic procedures, and treatment. It notes that CMPA peaks in the first year of life with a prevalence of 2-3% in infants. The majority present with symptoms in the first 6 months. Clinical presentation can vary widely and involve different organ systems, making it difficult to differentiate between IgE and non-IgE mediated reactions. Diagnostic procedures discussed include skin prick tests, serum IgE tests, and oral food challenges.
1) Pediatric Sjogren Syndrome is a rare inflammatory disorder that involves the exocrine glands and causes dryness of the mouth and eyes.
2) It can present as a primary condition or secondary to other autoimmune disorders like SLE. Common features include parotid gland enlargement, dry eyes/mouth, arthritis, and skin rashes.
3) Diagnosis is based on criteria including symptoms, presence of autoantibodies, and histologic findings from biopsies of salivary glands showing lymphocytic infiltration.
Dokumen tersebut membahas 9 obat yang umumnya digunakan untuk mengobati asma alergi, yaitu kortikosteroid inhalasi, antagonis reseptor leukotrien, agonis beta short-acting, long-acting agonis beta, antihistamin, omalizumab, imunoterapi, kortikosteroid oral, dan teofilin. Kombinasi 2-3 obat biasanya digunakan untuk mengobati asma yang merupakan penyakit multifaktor.
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Prebiotics in infants for prevention of allergic disease and food hypersensit...Ariyanto Harsono
This document summarizes a meta-analysis on the effect of prebiotics in infants for the prevention of allergic disease and food hypersensitivity. Seven studies with a total of 432 infants were included. One study found a significant reduction in eczema in infants up to six months of age who received a mixture of fructo- and galacto-oligosaccharides. However, another study found no significant difference in eczema in infants who were not selected based on allergy risk. No significant differences in growth were found. The review concluded that there is insufficient evidence to support the use of prebiotics to prevent allergic disease or food hypersensitivity in infants.
Effect of a partially hydrolyzed whey infant formula at weaning on risk of allergic disease in high risk children a randomized controlled trial
Presented by Sadudee Boonmee, MD.
This study compared the incidence of acute respiratory infections (ARI) in exclusively breastfed infants versus not exclusively breastfed infants aged 61-180 days. A total of 200 infants were followed prospectively for 4 months each and divided into two groups: 100 exclusively breastfed infants and 100 not exclusively breastfed infants. A total of 232 ARI episodes were recorded, with 67 episodes in the exclusively breastfed group and 165 episodes in the not exclusively breastfed group. The incidence of ARI was higher in the not exclusively breastfed group compared to the exclusively breastfed group. Exclusive breastfeeding for the first 6 months was found to be effective in preventing ARI in infants aged 61-180 days.
This study compared the incidence of acute respiratory infections (ARI) in exclusively breastfed infants versus not exclusively breastfed infants aged 61-180 days. A total of 200 infants were followed prospectively for 4 months each and divided into two groups: 100 exclusively breastfed infants and 100 not exclusively breastfed infants. A total of 232 ARI episodes were recorded, with 67 episodes in the exclusively breastfed group and 165 episodes in the not exclusively breastfed group. The incidence of ARI was higher in the not exclusively breastfed group compared to the exclusively breastfed group. Exclusive breastfeeding for the first 6 months was found to be effective in preventing ARI in infants aged 61-180 days.
RTI in Exclusive breast feed baby vs Not Exclusively breast feed baby Journal...MinhajulIslam83
Comparison of incidence of acute respiratory infection
in exclusively breastfed infants and not exclusively
breastfed infants from 61 to 180 days of age:
A prospective cohort study
Effectiveness Of Exclusive Breastfeeding Promotion In Low Income Mothers A Ra...Biblioteca Virtual
The study compared the antifungal effects of human milk, cow's milk, and various infant formulas against environmental fungi. Human milk showed significantly greater antifungal activity than the other substances tested, inhibiting nearly all fungal growth. Both prebiotic and probiotic formulas also demonstrated antifungal effects, though to a lesser degree than human milk. The results indicate that human milk protects infants from fungal infections not only through nutrition but also via its antifungal properties.
This document discusses concerns about vaccines and their ingredients like mercury and aluminum. It notes that while vaccines have reduced diseases, more children now have chronic illnesses, learning disabilities, and autoimmune disorders. It questions if vaccines may be overstressing immune systems or if too many are given too early. It also notes a lack of safety studies on vaccine combinations, subgroups of people, and how ingredients interact with each other and other toxins. It provides data showing past mercury levels in vaccines exceeded EPA safety guidelines and discusses mercury's neurotoxicity and impacts on development. It associates environmental mercury with increased autism rates and impaired detoxification in autistic children.
This document summarizes concerns about vaccine safety and alternatives to vaccination. It discusses the potential risks of mercury, aluminum, and other components in vaccines on immune and neurological development. While not suggesting abandoning vaccines, it notes the lack of long-term safety studies and the possibility that vaccines may exacerbate underlying immune issues or metabolic disorders in some children.
This study examined the long-term relationship between breastfeeding and asthma/atopy in a New Zealand birth cohort of over 1,000 children followed up to age 26. The study found that breastfeeding for over 4 weeks doubled the risk of diagnosed asthma in childhood and these effects persisted into adulthood. Additionally, breastfeeding for over 13 weeks increased the likelihood of skin test response to allergens. However, the study had limitations such as unclear definitions of breastfeeding and potential recall and selection biases. Overall, the study did not support the idea that breastfeeding protects against asthma or atopy.
Efficacy and safety of immunomodulators in pediatric age - Slideset by Profes...WAidid
«The first cause of recurrent infections in children is... childhood itself.» (J. Gary Wheeler)
Is it possibe to treat and prevent recurrent respiratory infections (RTIs) in pediatric age? Some studies have shown that immunostimulants/immunomodulators can reduce and prevent RTIs in children.
To learn more please visit www.waidid.org
The document discusses allergy skin testing. It provides details on common allergy symptoms and causes. It then describes different types of skin tests including prick and intradermal tests. Predictive values and contraindications for skin tests are presented. Blood tests for allergy are also discussed. Advantages of skin tests include being fast, safe, sensitive and allowing for identification of allergies in one visit. Risks of skin tests are very low.
<마더세이프라운드> Pregnancy outcome of women exposed to lactobacillus during preg...mothersafe
This study examined the pregnancy outcomes of 104 women who took probiotics during early pregnancy. The results showed no meaningful correlations between probiotic exposure and adverse infant outcomes like preterm birth, low birth weight, or birth defects. Previous studies have found probiotics may help prevent allergic diseases by modulating immune function and intestinal microbiota in early life. A review found certain probiotic strains were safe during pregnancy but their effect on allergic disease requires more research.
2009 08 15 Vaccines, Adverse Reactions, and the Florida Lawdrdavid999
The document discusses concerns about vaccines including whether they may overstress the immune system, the lack of safety studies on vaccine components like thimerosal and aluminum, and the high levels of mercury infants received from vaccines prior to 2001. It notes signs of mercury toxicity are the same as symptoms seen in autistic children and that children with autism have impaired ability to detoxify metals like mercury.
The document discusses food immunotherapy for treating food allergies. It provides definitions and outlines immune mechanisms and efficacy evidence from studies on peanut, cow's milk, egg, and wheat oral immunotherapy (OIT). Peanut OIT studies showed 67-78% of children achieved desensitization and 21-46% achieved sustained unresponsiveness. Cow's milk and egg OIT also demonstrated desensitization in 50-75% of children. Wheat OIT studies found 52-69% achieved desensitization. OIT was effective at increasing tolerance but also increased rates of adverse events during treatment.
The document provides information about cow's milk protein allergy (CMPA), including:
- CMPA is a common food allergy in infants and young children under 3 years old.
- It can present with nonspecific symptoms that are difficult to distinguish from other conditions like GERD.
- The majority (over 95%) of cases present in the first year of life, with most in the first 6 months.
- Presentation can involve different organ systems like skin, GI, and respiratory. IgE-mediated reactions are immediate while non-IgE reactions are delayed.
- Common GI symptoms include diarrhea, vomiting, poor feeding, and rectal bleeding. Failure to thrive can
The document provides information on cow's milk protein allergy (CMPA) including its epidemiology, clinical presentation, diagnostic procedures, and treatment. It notes that CMPA peaks in the first year of life with a prevalence of 2-3% in infants. The majority present with symptoms in the first 6 months. Clinical presentation can vary widely and involve different organ systems, making it difficult to differentiate between IgE and non-IgE mediated reactions. Diagnostic procedures discussed include skin prick tests, serum IgE tests, and oral food challenges.
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1) Pediatric Sjogren Syndrome is a rare inflammatory disorder that involves the exocrine glands and causes dryness of the mouth and eyes.
2) It can present as a primary condition or secondary to other autoimmune disorders like SLE. Common features include parotid gland enlargement, dry eyes/mouth, arthritis, and skin rashes.
3) Diagnosis is based on criteria including symptoms, presence of autoantibodies, and histologic findings from biopsies of salivary glands showing lymphocytic infiltration.
Dokumen tersebut membahas 9 obat yang umumnya digunakan untuk mengobati asma alergi, yaitu kortikosteroid inhalasi, antagonis reseptor leukotrien, agonis beta short-acting, long-acting agonis beta, antihistamin, omalizumab, imunoterapi, kortikosteroid oral, dan teofilin. Kombinasi 2-3 obat biasanya digunakan untuk mengobati asma yang merupakan penyakit multifaktor.
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Health economics perspective in allergy prevention in childrenAriyanto Harsono
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Soy formula for prevention of allergy and food intolerance in infants, a meta analysis
1. Soy formula for prevention of allergy
and food intolerance in infants
A Meta Analysis
Prof Ariyanto Harsono MD PhD SpA(K)
2. 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.
Prof Ariyanto Harsono MD PhD SpA(K) 2
3. Objectives
To determine the effect of feeding adapted soy
formula compared to human milk, cow’s milk
formula or a hydrolyzed protein formula on
preventing allergy or food intolerance in
infants without clinical evidence of allergy or
food intolerance.
Prof Ariyanto Harsono MD PhD SpA(K) 3
4. Selection criteria
Randomized and quasi-randomized trials that
compare the use of an adapted soy formula to
human milk, an adapted cow’s milk or a
hydrolyzed protein formula for feeding infants
without clinical allergy or food intolerance in
the first six months of life. Only trials with >
80% follow up of participants and reported in
group of assignment were eligible for
inclusion.
Prof Ariyanto Harsono MD PhD SpA(K) 4
5. Data collection and analysis
Eligibility of studies for inclusion, methodological
quality and data extraction were assessed
independently by each review author. Primary
outcomes included clinical allergy, specific
allergies and food intolerance. Where no
heterogeneity of treatment effect was found, the
fixed effect model was used for meta-analysis.
Where significant or apparent heterogeneity was
found, results were reported using the random
effects model and potential causes of the
heterogeneity were sought.
Prof Ariyanto Harsono MD PhD SpA(K) 5
6. Main results
Three eligible studies enrolling high risk infants with a
history of allergy in a first degree relative were
included. No eligible study enrolled infants fed human
milk. No study examined the effect of early, short term
soy formula feeding. All compared prolonged soy
formula to cow’s milk formula feeding. One study was
of adequate methodology and without unbalanced
allergy preventing co-interventions in treatment
groups. One study with unclear allocation concealment
and 19.5% losses reported a significant reduction in
infant allergy, asthma and allergic rhinitis. However, no
other study reported any significant benefits from the
use of a soy formula.
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7. Meta-analysis found no significant difference in
childhood allergy incidence (2 studies; typical
RR 0.73, 95%CI 0.37, 1.44). No significant
difference was reported in one study in infant
asthma (RR 1.10, 95% CI 0.86, 1.40), infant
eczema (RR 1.20, 95% CI 0.95, 1.52),
childhood eczema prevalence (RR 1.10, 95% CI
0.73, 1.68), infant rhinitis (RR 0.94, 95% CI
0.76, 1.16) or childhood rhinitis prevalence
(RR 1.20, 95% CI 0.73, 2.00).
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8. Meta-analysis found no significant difference in childhood
asthma incidence (3 studies, 728 infants; typical RR
0.71, 95% CI 0.26, 1.92), childhood eczema incidence (2
studies, 283 infants; typical RR 1.57, 95% CI 0.90, 2.75)
or childhood rhinitis incidence (2 studies, 283 infants;
typical RR 0.69, 95% CI 0.06, 8.00). One study reported
no significant difference in infant CMPI (RR 1.09, 95%
CI 0.45, 2.62), infant CMA (RR 1.09, 95% CI
0.24, 4.86), childhood soy protein allergy incidence (RR
3.26, 95% CI 0.36, 29.17) and urticaria. No study
compared soy formula to hydrolyzed protein formula.
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9. COMPARISONS 1-2: SOY FORMULA VERSUS HUMAN
MILK
No eligible studies were found that compared
use of a soy formula with human milk
feeding, either for early short term or
prolonged infant feeding.
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10. COMPARISON 3: EARLY SHORT TERM FEEDING: SOY
FORMULA VERSUS COW’S MILK FORMULA
No eligible studies were found that compared
early short term feeding with a soy formula
compared to a cow’s milk formula.
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11. COMPARISON 4: PROLONGED FEEDING: SOY FOR-
MULA VERSUS COW’S MILK FORMULA - ALL STUDIES
Outcome 04.01: All allergy
Three studies (Johnstone 1966; Kjellman 1979; Miskelly 1988)
compared prolonged infant feeding with a soy formula
compared to a cow’s milk formula in the first months of life.
No study reported infant allergy. Two studies (Johnstone
1966; Kjellman 1979) enrolling a total of 283 infants
reported childhood allergy cumulative incidence. Johnstone
1966 reported a significant reduction in childhood allergy
cumulative incidence diagnosed between 3-10 years of age
(RR 0.37, 95% CI 0.24, 0.56) . The chisquare test for
heterogeneity found significant (p < 0.00001) and
substantial (I2 = 94.9%) heterogeneity between the studies.
Meta analysis of the two studies found no significant
difference in childhood allergy cumulative incidence
(typical RR 0.67, 95% 0.18, 2.46).
Prof Ariyanto Harsono MD PhD SpA(K) 11
19. Outcome 04.05: CMPI Kjellman 1979 reported no significant
difference in infant CMPI cumulative incidence (RR 1.09, 95% CI
0.45, 2.62).
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20. Outcome 04.06: CMA Kjellman 1979 reported no significant
difference in infant CMA cumulative incidence (RR 1.09, 95% CI
0.24, 4.86).
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21. Outcome 04.07: Soy protein allergy Kjellman 1979 reported no
significant difference in childhood soy protein allergy cumulative
incidence (RR 3.26, 95% CI 0.36, 29.17).
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22. Outcome 04.08: Urticaria Kjellman 1979 reported no significant
difference in childhood urticaria cumulative incidence (RR
0.36, 95% CI 0.11, 1.18).
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23. COMPARISON 5: PROLONGED FEEDING: SOY FORMULA VERSUS
COW’S MILK FORMULA - STUDIES WITH NO UNBALANCED CO-
INTERVENTIONS, ADEQUATE METHODOLOGY
Only Kjellman 1979 compared prolonged soy
formula to cow’s milk formula feeding with no
differential (unbalanced) allergy preventing co-
interventions and with adequate methodology.
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25. Outcome 05.01: All allergy Kjellman 1979 reported no significant
difference in childhood allergy cumulative incidence (RR
1.23, 95% CI 0.82, 1.84).
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26. Outcome 05.02: Asthma Kjellman 1979 reported no significant
difference in childhood asthma cumulative incidence (RR
7.58, 95% CI 0.41, 139.32).
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27. Outcome 05.03: Eczema Kjellman 1979 reported no significant
difference in childhood eczema cumulative incidence (RR
1.28, 95% CI 0.73, 2.27).
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28. Outcome 05.04: Allergic rhinitis Kjellman 1979 reported no
significant difference in childhood rhinitis cumulative incidence
(RR 2.54, 95% CI 0.74, 8.66).
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29. Outcome 05.05: CMPI Kjellman 1979 reported no significant
difference in infant CMPI cumulative incidence (RR 1.09, 95% CI
0.45, 2.62).
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30. Outcome 05.06: CMA Kjellman 1979 reported no significant
difference in infant CMA cumulative incidence (RR 1.09, 95% CI
0.24, 4.86).
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31. Outcome 05.07: Soy protein allergy Kjellman 1979 reported no
significant difference in childhood soy protein allergy cumulative
incidence (RR 3.26, 95% CI 0.36, 29.17).
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32. Outcome 05.08: Urticaria Kjellman 1979 reported no significant
difference in childhood urticaria cumulative incidence (RR 0.36,
95% CI 0.11, 1.18).
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33. Prof Ariyanto Harsono MD PhD SpA(K) 33
•COMPARISON 08: PROLONGED FEEDING: SOY FORMULA VERSUS PARTIALLY
HYDROLYSED FORMULA No eligible studies were found that compared prolonged
feeding of soy formula with partially hydrolyzed formula
•COMPARISON 09: PROLONGED FEEDING: SOY FORMULA VERSUS EXTENSIVELY
HYDROLYSED FORMULA No eligible studies were fond that compared prolonged
feeding of soy formula versus extensively hydrolysed formula.
•COMPARISON 07: PROLONGED FEEDING: SOY FORMULA VERSUS HYDROLYSED
FORMULA No eligible studies were found that compared early short term feeding
with a soy formula compared to a hydrolyzed formula.
•COMPARISON 06: EARLY SHORT TERM FEEDING: SOY FORMULA VS HYDROLYZED
FORMULA. No eligible studies were found that compared early short term feeding
with a soy formula compared to a hydrolyzed formula.
•Outcome 05.09: Growth Kjellman 1979 compared soy formula versus cow’s milk
formula feeding. Weight gain was stated to be normal in both groups with no
significant differences between groups, but no data were re ported and duration of
follow up of weight gain not reported. No other study reported growth parameters.
34. D I S C U S S I O N
No eligible studies were found comparing soy
formula with human milk feeding, or for the
early short term use of a soy formula
compared to a cow’s milk or a hydrolyzed
formula. In high risk infants receiving
prolonged formula feeding, this review found
no evidence of benefit from use of a soy
formula compared to a cow’s milk formula for
prevention of allergy or food intolerance.
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35. Evidence from one trial of a reduction in childhood
cumulative incidence of allergy, asthma and allergic
rhinitis was not supported by other trials or the overall
meta-analyses. In addition, there are methodological
concerns with this trial regarding concealment. This
review found no eligible studies comparing use of a soy
formula to a hydrolyzed protein formula in high risk
infants. Studies to date suggest that soy formula
cannot be recommended for feeding of high risk
infants for the prevention of allergy or food
intolerance. This review found no eligible studies that
enrolled low risk infants, although this population is
even less likely to benefit.
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36. No studies reported outcomes beyond 10 years, so
no conclusion can be made about the effect of
soy formula on adolescent or adult allergy. This
review should be viewed in conjunction with the
review ’Formulas containing hydrolyzed protein
for prevention of allergy and food intolerance in
infants’ (Osborn 2003), which found limited
evidence of benefit from use of a hydrolyzed
protein formula compared to a cow’s milk
formula for preventing allergy in high risk infants.
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37. Caution should be taken in interpreting the
conclusions of this review. In the analysis of soy
formula compared to cow’s milk formula that
included only studies of adequate methodology
with no unbalanced co-interventions, only one
relatively small study was eligible. All studies
reported commercial sponsorship. A beneficial
effect from use of soy formula for prevention of
allergy or food intolerance cannot be excluded
due to the limited power of the included
studies, particularly for the prevention of CMPI or
CMA.
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38. A trend to increased soy protein allergy was
reported by one study suggesting a possible
mechanism for the development of allergy in
infants receiving a soy formula. Given the limited
size of included studies, the conclusions of this
review may be sensitive to the findings of
unpublished studies. Given the limitations to the
evidence, where soy formulas are commonly
used, further studies of soy formula may be
warranted.
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39. Conclusion
Feeding with a soy formula cannot be
recommended for prevention of allergy or food
intolerance in infants at high risk of allergy or food
intolerance.
Further research may still be warranted to
determine the role of soy formula for prevention
of allergy or food intolerance in infants unable to
be breast fed with a strong family history of
allergy or cow’s milk protein intolerance
39Prof Ariyanto Harsono MD PhD SpA(K)
40. Reference
Osborn DA, Sinn J: Soy formula for prevention of
allergy and food intolerance in infants
(Review), The Cochrane Library 2008, Issue 2
40Prof Ariyanto Harsono MD PhD SpA(K)