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Infants with an allergy to cow’s milk can increase their tolerance with hydrolysed casein treatment and probiotic formula

7 October 2015

In a study supported jointly by agencies in Italy and the US, R Berni Canani and colleagues, working in Naples and Chicago,have demonstrated the importance of gut bacteria in the tolerance of infants to cow’s milk, one of the most common food allergies of infancy and early childhood.

It has been suggested that the unprecedented increase in allergic responses to food cannot be accounted for in genetic variation alone. Some evidence indicates that widespread antibiotic use, consumption of a high-fat/low fiber diet, reduced exposure to infectious disease, Caesarean birth and formula feeding may have altered our commensal microbiota. The research examined a commercially available extensively hydrolyzed casein formula (EHCF, Nutramigen, Mead Johnson, Rome, Italy) supplemented with Lactobacillus rhamnosus GG (at 4.5 × 107–8.5 × 107 colony-forming units per gram of powder). It was shown that 5 of the 12 patients treated with this supplement developed tolerance to cow’s milk proteins. Whereas all (n=7) of the EHCF- treated patients, with no supplementation remained allergic.

R Berni Canani et al. have demonstrated that treatment with LGG-supplemented EHCF increases the relative abundance of butyrate-producing bacteria and thus faecal butyrate levels over a period of 12 months. While some patients did develop a tolerance to cow’s milk, there were significant differences in bacterial composition of the faecal samples of the patients that had developed a tolerance and the healthy control patients.

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