Praktické lekárnictvo 1/2021

Extensive hydrolysates and their role in clinical practice

Cow’s milk protein allergy (CMPA) is a common health problem encountered by paediatric general practitioners. After establishment of the diagnosis, an elimination diet is indicated. Mothers of fully breast-fed infants should be recommended a strict dairy-free diet. Extensively hydrolysed formulas (eHF) are usually sufficient in the treatment of 90% of formula fed infants. Amino acid formulas (AAF) are indicated less frequently. Results of clinical studies regarding eHF have various and often conflicting results. This seems to be due to different degrees of hydrolysis and residual allergenicity between various eHF. It seems that long-term use of eHF does not affect the thriving of children negatively. However, it would seem that children fed with whey-based eHF have better weight gains than their casein-based eHF fed counterparts. Usage of eHF with the highest level of hydrolysis and contents of peptides with a molecular weight <1000 Da should be used in clinical practice.

Keywords: cow’s milk protein allergy, extensively hydrolysed formula, amino acid formula, molecular weight, whey, casein