Partial Whey Hydrolysates: for Whom?

Children with cow’s milk allergies have a significantly lower BMI than non-allergic children who were not drinking milk. The size of the protein was found to have an influence on its allergic potential and both partial and extensively hydrolyzed protein are outside of that allergenic range. Of all the studies done, none showed that partially hydrolyzed protein was worse than intact cow’s milk, however certain studies found improved symptoms. Implementing a dietary regiment is an effective way to prevent allergic disease in high risk children. In these patients, breastfeeding combined with avoidance of solid food and cow’s milk for at least 4-6 months is the most effective preventative regiment. In the absence of breastfeeding, formulas with documented reduced allergenicity should be used exclusively for at least the first 4-6 months.

Partially hydrolyzed protein formulas are mostly used for children at high risk of developing allergies as allergy risk depends on family history. But should we be giving pHF to all children that are not exclusively breastfed, as growth curves of infants on pHF is exactly the same as on modern formulas. In one intervention study, it was found that partial hydrolysate is closer to breastfeeding than intact cow’s milk protein. There is no intact cow’s milk protein in breast milk. There is maybe not even “intact protein” in breast milk as it contains proteases to hydrolyse “immediately” the protein in breast milk. In this presentation, it is suggested that if exclusive breastfeeding isn’t possible, infants that are partially breastfed should be given a partially hydrolyzed formula. Infants that are not breasfed at all and have a history of atopy should be given a pHF or eHF and if they do not have a history of atopy a standard infant formula or pHF.