Allergenicity of milk protein hydrolysate formulae in children with cow's milk allergy

Eur J Pediatr. 1993 Sep;152(9):760-2. doi: 10.1007/BF01953996.


Cow's milk protein hydrolysate formulae have been developed to lower or eliminate the allergenicity of cow's milk proteins, and to reduce the antigenic load and the risk of sensitization. Cross-reactivity between different hydrolysate formulae and cow's milk proteins has been demonstrated. We have studied 20 children (median age 31 months, range 15-76 months) with a history of IgE-mediated cow's milk allergy. All the children had immediate allergic respiratory and/or cutaneous and/or gastro-intestinal reactions to cow's milk ingestion. In addition, the children had positive prick skin tests and positive RAST to cow's milk. Prick skin test, RAST, and double-blind placebo controlled food challenges were performed with three different hydrolysate formulae: a casein hydrolysate formula and two whey formulae, one partially and one extensively hydrolyzed. All 20 children had immediate allergic reactions after the challenge test with cow's milk. Only 2/20 children had a positive challenge test with a casein hydrolysate formula (Alimentum): one developed asthma and one urticaria. Two of the 15 children challenged with an extensively hydrolysed whey formula (Profylac) developed perioral erythema. Nine out of 20 children had a positive challenge test with a partially hydrolysed whey formula (Nidina H.A.): four developed asthma, three urticaria and two lip oedema. All children had positive prick skin tests to cow's milk proteins (casein and/or lactalbumin); 9 to Nidina H.A.; 3 to Profylac, and 3 to Alimentum. Specific IgE antibodies to cow's milk were present in all children; in 13 to Nidina H.A., in 4 to Profylac, and in 3 to Alimentum.

MeSH terms

  • Allergens / immunology*
  • Caseins / immunology
  • Child
  • Child, Preschool
  • Cross Reactions
  • Humans
  • Hydrolysis
  • Immunoglobulin E / metabolism
  • Infant
  • Infant Food / adverse effects*
  • Milk Hypersensitivity / immunology*
  • Milk Proteins / chemistry
  • Milk Proteins / immunology*
  • Protein Hydrolysates / immunology*
  • Whey Proteins


  • Allergens
  • Caseins
  • Milk Proteins
  • Protein Hydrolysates
  • Whey Proteins
  • trypticase-soy broth
  • Immunoglobulin E