Controlled trials investigating the use of one partially hydrolyzed whey formula for dietary prevention of atopic manifestations until 60 months of age: An overview using meta-analytical techniques

As much as 30% of the pediatric population is reported to be affected by atopic symptoms, at least temporarily. Therefore, efforts at prevention at an early age are of paramount importance. A meta-analysis was undertaken with the aim of combining the results of 15 prospective, controlled trials which measure the effect of exclusive feeding (minimum of three months) of a moderately hydrolyzed whey formula (Nestle HA formula) on the development of atopic symptoms between 3-6 and 60 months of age in children at high risk for allergy. Odds ratios, statistical methods of meta-analysis (Mantel-Haenszel, Bayesian approach), and "the number needed to treat" analysis at specific time intervals are reported. The meta-analysis of clinical data at 3-6 months of age indicates that the proportion of infants developing atopic symptoms when fed with HA is about one-fourth of the proportion of those fed with the standard cow milk formula (OR 0.25, 95% CI 0.18-0.36). For the 12 months data, the proportion with HA is about one-third of the proportion in the cow milk formula group (OR 0.29, 95% CI 0.19-0.44). The odds ratios between 12-24 and 60 months of age also showed a significant influence of the HA formula. No significant differences were found when the HA group was compared with breastfed infants. Computation of the "number needed to treat" resulted in an estimate that feeding three to five high risk infants HA formula rather than cow milk formula, will protect one infant from atopic symptoms. Breastfeeding or exclusive feeding of a moderately hydrolyzed formula (Nestle HA formula) for at least three months in infants at high risk for the development of allergic disease, decreases the incidence of atopic manifestations until 60 months of age. (C) 1998 Elsevier Science Inc.