Use of partially hydrolysed formula in infancy and incidence of eczema, respiratory symptoms or food allergies in toddlers from the ELFE cohort

Pediatr Allergy Immunol. 2019 Sep;30(6):614-623. doi: 10.1111/pai.13094. Epub 2019 Jul 24.


Background and objectives: Partially hydrolyzed formulas (pHF) are recommended in non-breastfed infants with familial history of allergy to prevent allergy development. However, recent meta-analysis does not provide strong support for their protective effect. The present work assesses the links between 2-month infant formula use and the incidence of eczema, respiratory symptoms, or food allergies (FA) up to 2 years of age.

Methods: The nationwide ELFE birth cohort is a population-based study from mainland France. Infant feeding (breast milk only, partially hydrolyzed formula with [pHF-HA] or without a hypoallergenic label [pHF-non-HA], and non-hydrolyzed formula [Nhf]) was reported at 2 months. Eczema, FA, and respiratory symptoms such as wheezing and asthma were reported at 2 months, 1 year, and 2 years. Infants with prior FA at 2 months were excluded from analyses.

Results: Among 11 720 infants, those who received only breast milk at 2 months were at lower risk of eczema at 1 year than those who received nHF (OR[95% CI] = 0.78[0.65-0.94] in non-at-risk infants; 0.86[0.75-0.98] in at-risk infants). The use of pHF-HA, compared with nHF, at 2 months was related to higher risk of wheezing at 1 year in at-risk infants (1.68[1.24-2.28]) and higher risk of FA at 2 years both in non-at-risk infants (3.78[1.52-9.41]) and in at-risk infants (2.31[1.36-3.94]).

Conclusions: In this nationwide study, pHF-HA use was not associated with a lower risk of any of the studied outcomes. Quite the reverse, it was associated with a higher risk of wheezing and FA. This should be confirmed in further studies.

Keywords: asthma; breastfeeding; eczema; food allergy; formula feeding; infancy; partially hydrolyzed formula; wheezing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asthma / epidemiology*
  • Child, Preschool
  • Cohort Studies
  • Eczema / epidemiology*
  • Female
  • Food Hypersensitivity / epidemiology*
  • France
  • Humans
  • Hydrolysis
  • Incidence
  • Infant
  • Infant Formula
  • Infant, Newborn
  • Male
  • Milk, Human
  • Respiratory Hypersensitivity / epidemiology*
  • Respiratory Sounds
  • Risk