<!doctype html> <!--[if lt IE 7]> <html class="no-js lt-ie10 lt-ie9 lt-ie8 lt-ie7" lang="en"> <![endif]--> <!--[if IE 7]> <html class="no-js lt-ie10 lt-ie9 lt-ie8" lang="en"> <![endif]--> <!--[if IE 8]> <html class="no-js lt-ie10 lt-ie9" lang="en"> <![endif]--> <!--[if IE 9]> <html class="no-js lt-ie10" lang="en"> <![endif]--> <!--[if gt IE 9]><!--> <html class="no-js" lang="en"> <!--<![endif]--> <head> <meta name="viewport" content="width=device-width,initial-scale=1"> <link rel="shortcut icon" href="http://bmj.com/wp-content/themes/jnp-base/favicon.ico" /> <script>(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','');</script> <script> var oas_tag = oas_tag || {}; oas_tag.url = 'oas.services.bmj.com'; oas_tag.sizes = function () { oas_tag.definePos('Top', [728,90]); oas_tag.definePos('Middle1', [300,250]); oas_tag.definePos('Bottom', [728,90]); }; oas_tag.site_page = window.location.hostname + window.location.pathname; oas_tag.query = ''; oas_tag.allowSizeOverride = true; oas_tag.analytics = true; oas_tag.taxonomy = ''; (function() { oas_tag.version ='1'; oas_tag.loadAd = oas_tag.loadAd || function(){}; var oas = document.createElement('script'), protocol = 'https:' == document.location.protocol?'https://':'http://', node = document.getElementsByTagName('script')[0]; oas.type = 'text/javascript'; oas.async = true; oas.src = protocol + oas_tag.url + '/om/' + oas_tag.version + '.js'; node.parentNode.insertBefore(oas, node); })(); </script> <link rel='dns-prefetch' href='//bmj.com' /> <link rel='dns-prefetch' href='//s.w.org' /> <script type="text/javascript"> window._wpemojiSettings = {"baseUrl":"https:\/\/s.w.org\/images\/core\/emoji\/2.2.1\/72x72\/","ext":".png","svgUrl":"https:\/\/s.w.org\/images\/core\/emoji\/2.2.1\/svg\/","svgExt":".svg","source":{"concatemoji":"http:\/\/bmj.com\/wp-includes\/js\/wp-emoji-release.min.js?ver=4.7.1"}}; !function(a,b,c){function d(a){var b,c,d,e,f=String.fromCharCode;if(!k||!k.fillText)return!1;switch(k.clearRect(0,0,j.width,j.height),k.textBaseline="top",k.font="600 32px Arial",a){case"flag":return k.fillText(f(55356,56826,55356,56819),0,0),!(j.toDataURL().length<3e3)&&(k.clearRect(0,0,j.width,j.height),k.fillText(f(55356,57331,65039,8205,55356,57096),0,0),b=j.toDataURL(),k.clearRect(0,0,j.width,j.height),k.fillText(f(55356,57331,55356,57096),0,0),c=j.toDataURL(),b!==c);case"emoji4":return k.fillText(f(55357,56425,55356,57341,8205,55357,56507),0,0),d=j.toDataURL(),k.clearRect(0,0,j.width,j.height),k.fillText(f(55357,56425,55356,57341,55357,56507),0,0),e=j.toDataURL(),d!==e}return!1}function e(a){var c=b.createElement("script");c.src=a,c.defer=c.type="text/javascript",b.getElementsByTagName("head")[0].appendChild(c)}var f,g,h,i,j=b.createElement("canvas"),k=j.getContext&&j.getContext("2d");for(i=Array("flag","emoji4"),c.supports={everything:!0,everythingExceptFlag:!0},h=0;h<i.length;h++)c.supports[i[h]]=d(i[h]),c.supports.everything=c.supports.everything&&c.supports[i[h]],"flag"!==i[h]&&(c.supports.everythingExceptFlag=c.supports.everythingExceptFlag&&c.supports[i[h]]);c.supports.everythingExceptFlag=c.supports.everythingExceptFlag&&!c.supports.flag,c.DOMReady=!1,c.readyCallback=function(){c.DOMReady=!0},c.supports.everything||(g=function(){c.readyCallback()},b.addEventListener?(b.addEventListener("DOMContentLoaded",g,!1),a.addEventListener("load",g,!1)):(a.attachEvent("onload",g),b.attachEvent("onreadystatechange",function(){"complete"===b.readyState&&c.readyCallback()})),f=c.source||{},f.concatemoji?e(f.concatemoji):f.wpemoji&&f.twemoji&&(e(f.twemoji),e(f.wpemoji)))}(window,document,window._wpemojiSettings); </script> <style type="text/css"> img.wp-smiley, img.emoji { display: inline !important; border: none !important; box-shadow: none !important; height: 1em !important; width: 1em !important; margin: 0 .07em !important; vertical-align: -0.1em !important; background: none !important; padding: 0 !important; } </style> <link rel='stylesheet' id='jnp-base-css' href='http://bmj.com/wp-content/themes/jnp-base/css/style.css?ver=4.7.1' type='text/css' media='all' /> <style id='jnp-base-inline-css' type='text/css'> .primary-color { background-color: !important; } div.widget-circles a:hover span { background-color: !important; } </style> <!--[if lt IE 9]> <script type='text/javascript' src='http://bmj.com/wp-content/themes/jnp-base/js/lib/html5shiv-3.7.3.min.js?ver=4.7.1'></script> <![endif]--> <script type='text/javascript' src='http://bmj.com/wp-includes/js/jquery/jquery.js?ver=1.12.4'></script> <script type='text/javascript' src='http://bmj.com/wp-includes/js/jquery/jquery-migrate.min.js?ver=1.4.1'></script> <script type='text/javascript'> /* <![CDATA[ */ var ajax_object = {"ajax_url":"http:\/\/bmj.com\/wp-admin\/admin-ajax.php"}; /* ]]> */ </script> <script type='text/javascript' src='http://bmj.com/wp-content/themes/jnp-base/js/jnp-base.js?ver=4.7.1'></script> <link rel='https://api.w.org/' href='http://bmj.com/wp-json/' /> <link rel="EditURI" type="application/rsd+xml" title="RSD" href="http://bmj.com/xmlrpc.php?rsd" /> <link rel="wlwmanifest" type="application/wlwmanifest+xml" href="http://bmj.com/wp-includes/wlwmanifest.xml" /> <meta name="generator" content="WordPress 4.7.1" /> <meta name='robots' content='noindex,follow' /> <style type="text/css"> .mu_register { width: 90%; margin:0 auto; } .mu_register form { margin-top: 2em; } .mu_register .error { font-weight:700; padding:10px; color:#333333; background:#FFEBE8; border:1px solid #CC0000; } .mu_register input[type="submit"], .mu_register #blog_title, .mu_register #user_email, .mu_register #blogname, .mu_register #user_name { width:100%; font-size: 24px; margin:5px 0; } .mu_register #site-language { display: block; } .mu_register .prefix_address, .mu_register .suffix_address {font-size: 18px;display:inline; } .mu_register label { font-weight:700; font-size:15px; display:block; margin:10px 0; } .mu_register label.checkbox { display:inline; } .mu_register .mu_alert { font-weight:700; padding:10px; color:#333333; background:#ffffe0; border:1px solid #e6db55; } </style> </head> <body class="home blog"> <noscript><iframe src="https://www.googletagmanager.com/ns.html?id=" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript> <div class="container"> <header> <section class="cookie closed"> <div id="close-cookie"><img src="//resources.bmj.com/repository/journals-network-project/images/wordpress/icon-close.png" srcset="data:image/svg+xml;base64,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"></div> <p>This site uses cookies. <span id="cookie-more">More info <img src="//resources.bmj.com/repository/journals-network-project/images/wordpress/icon-arrow-down.png" srcset="data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHZpZXdCb3g9IjAgMCA0OCA0OCI+PHBvbHlnb24gcG9pbnRzPSI5IDMzLjQgNy42IDMyLjEgMjQuNCAxNC42IDQwLjQgMzIuMSAzOC45IDMzLjQgMjQuNCAxNy41ICIgZmlsbD0iI2ZmZiIvPjwvc3ZnPgo="></span><span class="info">By continuing to browse the site you are agreeing to our use of cookies. <a href="http://company.bmj.com/privacy-policy/#cookies">Find out more here.</a></span></p> </section> <section class="advert"> <div id="oas_Top"> <script type="text/javascript">oas_tag.loadAd("Top");</script> </div> </section> <section class="nav-journals"> <a href="//journals.bmj.com/"><img src="//resources.bmj.com/repository/journals-network-project/images/wordpress/logo-bmj-journals.png" srcset="//resources.bmj.com/repository/journals-network-project/images/wordpress/logo-bmj-journals.svg"></a> <div class="menu-journals-menu-container"><ul id="menu-journals-menu" class="desktop menu"><li id="menu-item-69" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-69"><a href="http://bmj.com/?page_id=43">Subscribe</a></li> <li class="menu-item search-form"><form role="search" method="post" class="search-form" action="/search" id="highwire-search-quicksearch-form-1" accept-charset="UTF-8" ><input type="textbox" class="search-field" placeholder="search" value="" name="keywords" title="Search for:" ><input type="submit" class="search-submit" name="op" value="Search" ><input type="hidden" name="form_id" value="highwire_search_quicksearch_form_1" ><p class="advanced"><span><a href="/search"><span>Advanced</span> <span>search</span></a></span></p></form> </li><li class="menu-item search closed"><a href="#">Search <div class="svg-wrapper"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 48 48"><style>fill: #333; stroke: #333;</style><path d="M17.9 36.2C9.1 36.2 2 29.1 2 20.3S9.1 4.5 17.9 4.5s15.9 7.1 15.9 15.8S26.6 36.2 17.9 36.2zM17.9 6.5C10.2 6.5 4 12.7 4 20.3c0 7.6 6.2 13.8 13.9 13.8 7.7 0 13.9-6.2 13.9-13.8C31.8 12.7 25.5 6.5 17.9 6.5z"></path><polygon points="29.3 30.1 31.9 29.6 46 40.4 44.8 41.9 "></polygon><polygon points="29.3 30.1 29.5 32.7 43.6 43.5 44.8 41.9 "></polygon></svg></div></a></li></ul></div></section> <section class="nav-journal primary-color"> <div> <a href="/"><img id="journal-logo" src="//resources.bmj.com/repository/journals-network-project/images/journal-logos/logo-.png" srcset="//resources.bmj.com/repository/journals-network-project/images/journal-logos/logo-.svg"></a> <section class="nav-desktop"> <div class="journal-menu header-menu"><ul id="menu-journal-menu" class="menu"><li id="menu-item-46" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-46"><a href="//.bmj.com/content/early/recent">Online First</a></li> <li id="menu-item-47" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-47"><a href="//.bmj.com/content/current">Current Issue</a></li> <li id="menu-item-48" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-48"><a href="//.bmj.com/content/by/year">Archive</a></li> <li id="menu-item-49" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-49"><a href="http://bmj.com/?page_id=38">Authors</a></li> <li id="menu-item-50" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-50"><a href="http://bmj.com/?page_id=37">About</a></li> </ul></div></section> <section class="nav-mobile"> <ul> <li class="search closed"><img srcset="data:image/svg+xml;base64,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" src="//resources.bmj.com/repository/journals-network-project/images/wordpress/icon-search.png"></li><!-- --><li class="burger closed"><img srcset="data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHZpZXdCb3g9IjAgMCA0OCA0OCI+PHN0eWxlPi5he2ZpbGw6I2ZmZjt9PC9zdHlsZT48cmVjdCB4PSI4IiB5PSIxNC41IiB3aWR0aD0iMzIiIGhlaWdodD0iMyIgY2xhc3M9ImEiLz48cmVjdCB4PSI4IiB5PSIyMi41IiB3aWR0aD0iMzIiIGhlaWdodD0iMyIgY2xhc3M9ImEiLz48cmVjdCB4PSI4IiB5PSIzMC41IiB3aWR0aD0iMzIiIGhlaWdodD0iMyIgY2xhc3M9ImEiLz48L3N2Zz4K" src="//resources.bmj.com/repository/journals-network-project/images/wordpress/icon-hamburger-menu.png"></li> </ul> </section> </div> </section> <section class="nav-crumb"> <div> <div> <div class="crumbs"> </div> <div class="email"><a href="/alerts"><div class="svg-wrapper"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 33 22"> <style>.a{fill:none;}</style> <rect x="0.5" y="0.5" width="32" height="21" class="a"></rect> <polyline points="0.6 0.7 16.6 13.4 32.4 0.9 " class="a"></polyline> <line x1="0.8" y1="21.3" x2="11.6" y2="9.8" class="a"></line> <line x1="32.4" y1="21.5" x2="21.5" y2="9.7" style="fill:none;stroke-linejoin:round;"></line> </svg></div>Email alerts</a></div> </div> </div> </section> </header> <div id="signup-content" class="widecolumn"> <div class="mu_register wp-signup-container"> Registration has been disabled.</div> </div> <footer> <nav class="primary-color"> <div class="wrapper"> <div><div class="footer-menu-a footer-menu"><h3>Content</h3><ul id="menu-content" class="menu"><li id="menu-item-51" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-51"><a href="//.bmj.com/content/early/recent">Online First</a></li> <li id="menu-item-52" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-52"><a href="//.bmj.com/content/current">Current Issue</a></li> <li id="menu-item-53" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-53"><a href="//.bmj.com/content/by/year">Archive</a></li> <li id="menu-item-54" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-54"><a href="http://bmj.com/?page_id=41">Topic collections</a></li> <li id="menu-item-55" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-55"><a href="//.bmj.com/alerts/toc/edit?destination=">Sign up for email alerts</a></li> </ul></div></div><div><div class="footer-menu-b footer-menu"><h3>Journal</h3><ul id="menu-journal" class="menu"><li id="menu-item-56" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-56"><a href="http://bmj.com/?page_id=37">About</a></li> <li id="menu-item-57" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-57"><a href="http://bmj.com/?page_id=44">Editorial Board</a></li> <li id="menu-item-59" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-59"><a href="http://bmj.com/?page_id=45">Thank you to the reviewers</a></li> <li id="menu-item-61" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-61"><a href="http://bmj.com/?page_id=40">Most read</a></li> <li id="menu-item-64" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-64"><a href="http://bmj.com/?page_id=43">Your subscription options</a></li> </ul></div></div> </div><div class="wrapper"> <div><div class="footer-menu-c footer-menu"><h3>Authors</h3><ul id="menu-authors" class="menu"><li id="menu-item-58" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-58"><a href="http://bmj.com/?page_id=38">Instructions for authors</a></li> <li id="menu-item-60" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-60"><a href="http://mc.manuscriptcentral.com/">Submit a paper</a></li> <li id="menu-item-62" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-62"><a href="http://authors.bmj.com/open-access/">Open Access at BMJ</a></li> </ul></div></div><div><div class="footer-menu-d footer-menu"><h3>Help</h3><ul id="menu-help" class="menu"><li id="menu-item-63" class="menu-item menu-item-type-post_type menu-item-object-page menu-item-63"><a href="http://bmj.com/?page_id=39">Contact us</a></li> <li id="menu-item-65" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-65"><a href="http://journals.bmj.com/cgi/reprintform">Reprints</a></li> <li id="menu-item-66" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-66"><a href="http://www.bmj.com/company/products-services/rights-and-licensing/permissions">Permissions</a></li> <li id="menu-item-67" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-67"><a href="http://www.bmj.com/company/contact-us/advertising-sponsorship/">Advertising</a></li> <li id="menu-item-68" class="menu-item menu-item-type-custom menu-item-object-custom menu-item-68"><a href="http://myaccount.bmj.com/myaccount/customerservice/salesforce-form.html">Feedback form</a></li> </ul></div></div> </div> </nav> <section class="platform"> <div class="logo"> <a href="http://www.bmj.com/company"><img src="//resources.bmj.com/repository/journals-network-project/images/wordpress/logo-bmj-footer.png" srcset="//resources.bmj.com/repository/journals-network-project/images/wordpress/logo-bmj-footer.svg"></a> </div><div class="menu"> <ul> <li><a href="http://www.bmj.com/company/legal-information/">Website Terms &amp; Conditions</a></li> <li><a href="http://www.bmj.com/company/your-privacy/">Privacy &amp; Cookies</a></li> <li><a href="http://www.bmj.com/company/contact-us/">Contact BMJ</a></li> </ul> </div><div class="content"> <p></p> <p>Copyright &copy; 2017 . All rights reserved.</p> <p>京ICP备15042040号-3</p> </div> </section> <script type='text/javascript' src='http://bmj.com/wp-content/themes/jnp-base/js/feedbackify.js?ver=4.7.1'></script> <script type='text/javascript' src='http://bmj.com/wp-includes/js/wp-embed.min.js?ver=4.7.1'></script> </footer> </div> </body> </html>
rss
Evid Based Nurs 6:43 doi:10.1136/ebn.6.2.43
  • Treatment

Review: hydrolysed milk formula with dietary and environmental restrictions reduces asthma and wheeze in infants with a familial history of atopy


 
 QUESTION: In infants with a familial history of atopy, does dietary avoidance of cows’ milk protein prevent asthma and wheeze during the first year of life?

Data sources

Studies were identified by searching Medline (1966 to Feb 2002), CINAHL (1982 to Feb 2002), EMBASE/Excerpta Medica (1980 to Feb 2002), UK National Research Register of Trials (up to Feb 2002), the Cochrane Controlled Trials Register (1966 to Feb 2002), bibliographies of identified articles, and by contacting colleagues and experts in the field.

Study selection

Randomised controlled trials (RCTs) involving children with a familial history of atopy in ≥1 first degree relative were selected if they compared hydrolysed cows’ milk formula or soya based formula with feeding with standard cows’ milk based formula during the first 4 months of life or longer. In the hydrolysed formula, the protein source from cows’ milk was enzymatically hydrolysed and heat denatured resulting in smaller protein molecules with increased digestibility and reduced allergic potential.

Data extraction

2 reviewers independently extracted data on study quality, patient characteristics, types of feeds and duration, dietary restrictions, and outcome measures, including asthma or wheeze.

Main results

10 studies met the selection criteria; study duration ranged from 4–12 months. 7 trials evaluated hydrolysed formula for ≥4 months in addition to dietary restrictions and in some cases dust mite reduction measures. Combining data from 3 of these trials showed a reduction in newly diagnosed and ongoing asthma and wheeze during the first year of life in infants receiving hydrolysed formula (table). There was insufficient evidence to suggest that soya based formula reduced the risk of developing asthma or wheeze at any age.

Conclusions

In infants with ≥1 first degree relative with atopy, hydrolysed milk formula, in combination with dietary restriction and house mite reduction measures, reduces the risk of developing asthma or wheeze during the first year of life. There is insufficient evidence to show that soya based milk formula has any benefit.

Commentary

  1. Pamela D Hill, RN, PhD, FAAN
  1. Associate Professor
 College of Nursing, University of Illinois at Chicago
 Chicago, Illinois, USA

      The prevalence of atopic manifestations (eg, asthma and wheeze) has increased in the past 20 years in most countries,1 and up to 30% of the paediatric population is reported to have atopic symptoms.2 The systematic review by Ram et al is one of few reviews to consider RCTs related to the development of asthma or wheeze in infants during the first 12 months of life. An earlier review by Baumgartner et al examined atopic manifestions in infants, but not asthma and wheeze specifically.2 Their conclusions were similar to those of Ram et al.

      The review by Ram et al specifically addressed asthma and wheeze as the primary outcomes of interest. The review included only RCTs and excluded studies where infants were exclusively breast fed. In addition, some important co-interventions were noted, including restrictions to the mother’s and infant’s diets in one or both study groups.

      Of the 3 studies showing statistically significant differences between hydrolysed formula and cows’ milk formula, only 2 were double blind, and these studies applied restrictions on the lactating mother’s diet and the infant’s diet to avoid a range of potential allergenic foods. Furthermore, breastfeeding practices varied, which raises questions about what percentage of mother’s milk was provided to the infant and the duration of exposure. The issue of breastfeeding exposure is of concern when attempting to interpret the results of this review because the effects of mother’s milk on the infant may be dose dependent.3 The beneficial effects of feeding with hydrolysed cows’ milk formula may also be underestimated as only 1 study included infants who were not fed any mother’s milk. Researchers should collect detailed data about exposure to breast milk during the intervention period and analyse the results accordingly.

      Although the number of studies included in this review is small and important co-interventions are present, when provision of mother’s milk is not possible and supplemental feeding is required, use of hydrolysed cows’ milk formula should be considered for infants with a familial history of atopy.

      References

      Hydrolysed formula v standard cows’ milk based formula in infants with a familial history of atopy*

      
 
 QUESTION: In infants with a familial history of atopy, does dietary avoidance of cows’ milk protein prevent asthma and wheeze during the first year of life?

      Footnotes

      • For correspondence: Dr F S Ram, Department of Physiological Medicine, St George’s Hospital Medical School, London, UK. fram{at}sghms.ac.uk

      • Source of funding: no external funding.

      No Related Web Pages

      Free Sample

      This recent issue is free to all users to allow everyone the opportunity to see the full scope and typical content of EBN.
      View free sample issue >>

      EBN Journal Chat

      The EBN Journal Chat offers readers the opportunity to participate in discussion about research articles and commentaries from Evidence Based Nursing (EBN).

      How to participate >>

      Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.