Download Help Build Oral Tolerance to Cow`s Milk Protein

Help Build Oral Tolerance to Cow’s Milk Protein
Several steps, including food challenges, are often required to identify CMA. The ultimate goal of the dietary
management of CMA is not only to modify the course of the allergy, but to build oral tolerance, meaning that the infant
does not react negatively to cow’s milk proteins†.
Recent studies have demonstrated that an infant with CMA can build tolerance to cow’s milk when fed an extensively
hydrolyzed formula with the added probiotic LGG®1-3,‡.
In one study with otherwise healthy infants referred to a tertiary care allergy center for suspected CMA, more infants
built a tolerance to cow’s milk protein after 6 months (P=0.004) and 12 months (P=0.027) of feeding Nutramigen® with
LGG vs Nutramigen without LGG1,2. LGG is the most extensively studied probiotic for allergy management.
Nutramigen
Nutramigen LGG
90
80
P=0.0274
81%
Infants who built tolerance (%)
70
60
P=0.0044
50
59%
54%
40
30
20
21%
10
0
At 6 months
Cumulative at 12 months
R
esults persisted 6 months after last food challenge
†Tolerance is the presence of a negative, double-blind, placebo-controlled food challenge in the study.
‡ LGG is a registered trademark of Valio Ltd.
Extensively
hydrolyzed proteins +
LGG helps build oral
tolerance sooner
The results show the selection
of a particular type of formula
influences tolerance building
in infants with CMA1. These
two studies suggest that
infants affected with CMA
who received extensively
hydrolyzed casein formula
(EHCF) containing LGG built
tolerance more frequently than
those receiving other formulas
or formula without LGG in the
study1-3,†.
Cumulative after 12 months
80
79%
80% more infants
built oral tolerance than closest study group
70
Infants who built tolerance (%)
In a second study, Nutramigen®
LGG® was demonstrated
to help more infants build
tolerance to cow’s milk than
other formulas used in the
study for CMA management
after 12 months of feeding
(P<0.05)3.
60
50
44%
40
33%
30
24%
20
10
0
Nutramigen LGG
Extensively hydrolyzed
casein formula (EHCF)
Rice hydrolysate
formula (RHF)
Soy formula (SF)
18%
Amino acid
formula (AAF)
Studies did not include Nutramigen® LGG® Toddler.
†EHCF: Nutramigen®, Nutribén hydrolyzed®, RHF: Risolac®, SF: Isomil®, Sinelac®, Nutrilon Soya,
AAF: Neocate®, Nutramigen AA® or Sineall®
Nutramigen LGG—first line for infants with CMA
Nutramigen LGG has proven results and it works fast, when colic is due to CMA4. About 90% of infants with colic due
to CMA experienced relief within 48 hours4. For those infants with suspected CMA, adding the probiotic LGG to an eHF
(extensively hydrolyzed formula) results in 0% of infants with blood in stools vs 64% in Nutramigen without LGG at 4
weeks5.
Nutramigen LGG is WIC®‡ eligible in all 50 states, regardless of who has the
state Women, Infants and Children Program contract.
References: 1. Berni Canani R, et al. J Allergy Clin Immunol. 2012;129:580-582. 2. Berni Canani R. email. April 23, 2012. 3. Berni Canani R et al. J Pediatr.
2013;163:771-777. 4. Lothe L, et al. Pediatrics. 1989;83:262-266. 5. Baldassarre ME et al. J Pediatr. 2010;156:397-401.
‡ WIC is a registered trademark of the United States Department of Agriculture (USDA) for Women, Infants and Children Program.
Nutribén hydrolyzed, Risolac, Isomil, Sinelac, Nutrilon Soya, Neocate and Sineall are registered trademarks of entities unrelated to Mead Johnson & Company, LLC.