ADVANCING THE MANAGEMENT OF SEVERE COW’S MILK PROTEIN ALLERGY
- Amino acid-based, hypoallergenic formula (AAF) for effective first-line relief from severe symptoms of cow’s milk protein allergy (CMPA) and/or multiple food allergies and/or malabsorptive conditions*1-6
- Contains 2’FL and LNnT†, to nurture infants’ developing immune systems7-11
- Designed to support gastrointestinal tolerance and to facilitate absorption in the most challenging conditions12-19
- Supports normal growth and development20,21
- Preferred taste over other AAF, which may increase long-term acceptance22
- Nutritionally complete. Suitable as a sole source of nutrition from birth or supplementary feeding from 6 months of age
Effectively relieves symptoms, supports gut recovery and healthy growth
Infants with CMPA and/or multiple food allergies may face an immediate challenge from skin, gastrointestinal and/or respiratory symptoms, while those with severe symptoms may also experience anaphylaxis, failure to thrive and/or complex gastrointestinal manifestations.4-6,23 Alfamino® HMO is proven to be hypoallergenic, provides effective symptom relief1-3 and supports normal growth.20,21
(e.g. eczema, urticaria…)
(e.g. vomiting, colic, diarrhoea…)
(e.g. inconsolable crying, failure to thrive, anaphylaxis…)
Alfamino® HMO’s unique composition is also designed to facilitate fat and calcium absorption and supports gut recovery:12-19 Lactose-free, 24% medium-chain triglycerides, structured lipids and low osmolality.
CMPA is an immune-mediated disease. It is associated with gut microbiota dysbiosis, which impacts immune system maturation and leaves infants at an increased risk of infections and future allergies.25-33 Alfamino® HMO is the only amino acid-based formula to contain 2’-fucosyllactose (2’FL) and lacto-N-neotetraose (LNnT), which are structurally identical to two significant human milk oligosaccharides (HMO).+7-11
HMO support the growth of beneficial bacteria in the gut
HMO strengthen the gut barrier by promoting intestinal cell maturation
HMO eliminate pathogens through a decoy effect
HMO guide the maturation of the immune system, leading to a more balanced Th1/Th2 response
INFANTS FED FORMULA WITH 2’FL AND LNNT† HAD FEWER INFECTIONS AND USED LESS MEDICATIONS
Reduction in upper and lower respiratory tract infections9,10,11
Reduction in antibiotic and antipyretic use9,10,11
Formula-fed and complementary feeding
Unsettled, persistent crying, vomiting & severe diarrhoea and faltering growth
Suspected multiple food allergies including CMPA
WHAT WOULD BE YOUR MOST IMPORTANT GOAL FOR SOPHIA?
For infants with severe CMPA and/or multiple food allergies who cannot be breastfed, symptom relief can be achieved by eliminating the allergen from the infant’s diet with:
- A proven amino acid-based formula like Alfamino® HMO. Alfamino has been shown to be safe and effective without any allergic reactions (n=100)3
- A complementary diet with the elimination of the foods suspected of causing an allergic reaction4,5
WHICH TYPE OF FORMULA WOULD YOU RECOMMEND FOR SOPHIA?
While extensively hydrolysed formulas (eHF) are recommended for effective management of CMPA in the majority (90%) of infants, guidelines recommend amino acid-based formulas (AAF) like Alfamino® HMO for patients with severe symptoms of CMPA, multiple food allergies and/or those with faltering growth.4
Alfamino® HMO is furthermore designed to facilitate fat and calcium absorption and support gut recovery. It contains a unique fat blend that is easily absorbed (medium-chain triglycerides and structured lipids), is lactose-free to help support intestinal recovery and has a low osmolality (333 mOsm/kg water) to support tolerability.12-19
FREQUENTLY ASKED QUESTIONS
Our range of immune-nurturing formulas for cow’s milk protein allergy
Our range of nutritional solutions are tailor-made for infants and young children with cow’s milk protein allergy and other food allergies/intolerances. The complete range has been designed to help manage cow’s milk protein allergy earlier, with the right product from the beginning.
†Structurally identical Human Milk Oligosaccharides are not sourced from human milk.
Nowak-Węgrzyn A, et al. Evaluation of Hypoallergenicity of a New, Amino Acid–Based Formula. Clin Pediatr (Phila) 2015;54:264–272.
Nowak-Wegrzyn A, et al. Confirmed Hypoallergenicity of a Novel Whey-Based Extensively Hydrolyzed Infant Formula Containing Two Human Milk Oligosaccharides. Nutrients 2019;11(7):E1447.
Cekola P, et al. Clinical use and safety of an amino acid-based infant formula in a real world setting. Abstract presented at NASPGHAN. Chicago, IL, USA, October 2019.
Koletzko S, et al. Diagnostic Approach and Management of Cow’s-Milk Protein Allergy in Infants and Children: ESPGHAN GI Committee Practical Guidelines. J Pediatr Gastroenterol Nutr 2012;55(2):221-229.
Luyt D, et al. BSACI guideline for the diagnosis and management of cow’s milk allergy. Clin Exp Allergy 2014;44(5):642-672.
Muraro A, et al. EAACI Food Allergy and Anaphylaxis Guidelines: diagnosis and management of food allergy. Allergy 2014;69(8):1008–1025.
Bode L. Human milk oligosaccharides: Every baby needs a sugar mama. Glycobiology 2012;22(9):1147-1162.
Donovan SM and Comstock SS. Human Milk Oligosaccharides Influence Neonatal Mucosal and Systemic Immunity. Ann Nutr Metab 2016;69(suppl 2):42-51.
Nestlé Health Science, data on file. CINNAMON study.
Vandenplas Y, et al. Growth, tolerance and safety of an extensively hydrolysed formula containing two human milk oligosaccharides in infants with cow’s milk protein allergy. Abstract presented at PAAM. Florence, Italy, October 19, 2019.
Puccio G, et al. Effects of Infant Formula With Human Milk Oligosaccharides on Growth and Morbidity: A Randomized Multicenter Trial. J Pediatr Gastroenterol Nutr 2017;64(4):624-631.
Heine RG, et al. Lactose intolerance and gastrointestinal cow’s milk allergy in infants and children – common misconceptions revisited. World Allergy Organ J 2017;10(1):41.
Delplanque B, et al. Lipid Quality in Infant Nutrition: Current Knowledge and Future Opportunities. J Pediatr Gastroenterol Nutr 2015;61(1):8-17.
Bach AC, et al. Medium-chain triglycerides : an update. Am J Clin Nutr 1982;36(5):950-962.
Kennedy K, et al. Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization. Am J Clin Nutr 1999;70(5):920-927.
Koletzko B. Human milk lipids. Ann Nutr Metab 2016;69(suppl 2):28-40.
Mazzocchi A, et al. The Role of Lipids in Human Milk and Infant Formulae. Nutrients 2018;10(5):E567.
American Academy of Pediatrics, Committee on Nutrition. Pediatrics 1976;57:278-285.
Nestlé Health Science, data on file. Alfamino® product composition.
Corkins M, et al. Assessment of Growth of Infants Fed an Amino Acid-Based Formula. Clin Med Insights Pediatr 2016;10:3–9.
Vandenplas Y, et al. Growth in infants with cow’s milk protein allergy fed an amino acid-based formula. Abstract N-O-013 presented at ESPGHAN, 2019. J Pediatr Gastroenterol Nutr 2019;68(Suppl 1).
Nestlé Health Science, data on file. Alfamino® versus Neocate® competitive benchmarking test.
Host A and Halken S. Cow's milk allergy: where have we come from and where are we going? Endocr Metab Immune Disord Drug Targets 2014;14(1):2-8.
Azad MB, et al. Infant gut microbiota and food sensitization: associations in the first year of life. Clin Exp Allergy 2015;45(3):632-643.
West CE, et al. The gut microbiota and its role in the development of allergic disease: a wider perspective Clin Exp Allergy 2015;45(1):43–53.
Thompson-Chagoyan OC, et al. Faecal Microbiota and Short-Chain Fatty Acid Levels in Faeces from Infants with Cow‘s Milk Protein Allergy Int Arch Allergy Immunol 2011;156(3):325–332.
Chin AM, et al. Morphogenesis and maturation of the embryonic and postnatal intestine. Semin Cell Dev Biol 2017;66:81-93.
Tanaka M and Nakayama J. Development of the gut microbiota in infancy and its impact on health in later life Allergol Int 2017;66(4):515-522.
Newburg DS and Walker WA. Protection of the Neonate by the Innate Immune System of Developing Gut and of Human Milk. Pediatr Res 2007;61(1):2-8.
Woicka-Kolejwa K, et al. Food allergy is associated with recurrent respiratory tract infections during childhood. Postepy Dermatol Alergol 2016;33(2):109-113.
Juntti H, et al. Cow’s Milk Allergy is Associated with Recurrent Otitis Media During Childhood. Acta Otolaryngol 1999;119(8):867-873.
Tikkanen S, et al. Status of children with cow’s milk allergy in infancy by 10 years of Age. Acta Paediatr 2000; 89(10):1174-1180.
Jalonen T. Identical intestinal permeability changes in children with different clinical manifestations of cow’s milk allergy. J allergy Clin Immunol 1991;88(5):737-742.
Crittenden RG and Bennett LE. Cow’s Milk Allergy: A Complex Disorder. J Am Coll Nutr 2005;24(6suppl):582S–591S.
Mothers should be encouraged to continue breastfeeding even when their infants have cow’s milk protein allergy. This usually requires qualified dietary counseling to completely exclude all sources of cow’s milk protein from the mothers’ diet. If a decision to use a special formula intended for infants is taken, it is important to give instructions on correct preparation methods, emphasizing that unboiled water, unsterilized bottles or incorrect dilution can all lead to illness. Formula for special medical purposes intended for infants must be used under medical supervision.