Dietary products used in infants for treatment and prevention of food allergy. Joint statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI) Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition

TREATMENT OF ALLERGIC REACTIONS TO FOOD PROTEINS: Infants with confirmed food protein allergy should be treated by complete exclusion of the causal protein - In exclusively breast fed infants, a strict elimination of the causal protein from the diet of the lactating mother should be tried - Infants with cows' milk protein allergy who are not breast fed should receive a dietary product with highly reduced allergenicity based on 'extensively' hydrolysed protein or, in selected cases, a product based on an amino acid mixture - In infants with adverse reactions to food proteins and malabsorptive enteropathy, the use of a formula with highly reduced allergenicity (extensively hydrolysed formula or amino acid mixture) without lactose and with medium chain triglycerides might be useful until normal absorptive function of the mucosa is regained - For the treatment of most infants with food allergy whose digestive and absorptive functions show no major disturbances, products with highly reduced allergenicity based on extensively hydrolysed protein or amino acid mixtures, but whose other compositional characteristics meet the European union criteria for infant formulas, is recommended - Diets based on unmodified proteins of other species' milk (for example, goats' or sheep's milk), or so called 'partially' hydrolysed formulas should not be used for the treatment of cows' milk protein allergy. - PREVENTION OF ADVERSE REACTIONS TO FOOD PROTEINS: Exclusive breast feeding during the first 4-6 months of life might greatly reduce the incidence of allergic manifestations and is strongly recommended - Supplementary foods should not be introduced before the 5th month of life - In bottle fed infants with a documented hereditary atopy risk (affected parent or sibling), the exclusive feeding of a formula with a confirmed reduced allergenicity is recommended because it can reduce the incidence of adverse reactions to food, especially to cows' milk protein - More studies comparing the preventive effects of formulas that have highly reduced allergenicity with formulas that have moderately reduced allergenicity are needed - Dietary products used for preventive purposes in infancy need to be evaluated carefully with respect to their preventive and nutritional effects in appropriate clinical studies - There is no conclusive evidence to support the use of formulas with reduced allergenicity for preventive purposes in healthy infants without a family history of allergic disease.