Real-life data on the effectiveness of extensively hydrolyzed protein-based formula and amino acid–based formula in regaining weight and height in infants on a cow’s milk protein elimination diet

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Dayane Pêdra Batista de Faria
Marcela Duarte de Sillos
Patrícia da Graça Leite Speridião
Mauro Batista de Morais


Hypersensitivity to Milk, Food Hypersensitivity, Nutritional Status, Height


Objective: To compare the effectiveness of extensively hydrolyzed protein-based formula (EHF) or amino acid–based formula (AAF) in reversing the weight and height deficit in infants on a cow’s milk protein elimination diet.

Methods: Infants from a retrospective cohort who were fed EHF (n = 17) or AAF (n = 16) for at least 2 months on a cow’s milk protein elimination diet were included. The weight and height values recorded in the infants’ medical records were obtained.

Results: The mean age of the infants at the start of EHF and AAF were 5.8 ± 2.6 and 4.4 ± 2.5 months, respectively (P = 0.061). There was no difference between the groups in terms of the monthly weight gain (373.0 ± 212.2 and 453.1 ± 138.5 g, P = 0.223, respectively, for EHF and AAF), while the monthly increase in height was greater in the group fed with AAF (1.3 ± 0.5 and 1.8 ± 0.6, P = 0.030). A comparison between the difference in the initial z-score and in the oral challenge test of weight-for-age (+0.7 ± 1.2 and +1.3 ± 1.4, P = 0.262, respectively, for the EHF and AAF groups), height-for-age (+0.2 ± 1.1 and +1.2 ± 1.8, P = 0.090), and body mass index (BMI)-for-age (+0.7 ± 1.3 and +0.7 ± 1.5, P = 0.971) did not reveal a statistically significant difference between the groups. Correlation coefficients showed that the greater the initial nutritional deficit, the greater the positive variation between the beginning of each formula and the oral challenge test.

Conclusion: EHF and AAF provided similar increases in the weight-for-age, height-for-age, and BMI-for-age z-scores in both groups. The monthly increase in height was greater in infants who received AAF.

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