Feeding high-risk infants with family history of allergy.

Since the turn of the century, CM (cow's milk) formulas have become progressively more common as breast milk substitutes when mother's milk is unavailable, and CM allergy (CMA) has thus gradually become a more common disorder. Therefore the management of CMA infants confronts pediatricians and allergists with one of the most demanding challenges. In the first year of life of many children, CM provides almost the entire dietary supply of proteins, carbohydrates, and fat; its high nutritional value and low cost should be noted. However, children with CMA can avoid CM without nutritional loss if nutrients are provided by other foods such as meat, fish, vegetables and fruit. Thus the choice of an adequate CM substitute for high-risk infants with family history of allergy is mandatory. The ideal CM substitute should be hypoallergenic; have an adequate nutritional value according to the infant's age; be easily available and inexpensive; and be palatable in order to obtain a good compliance. CM substitutes now available are soy protein formulas (SPF) and hydrolysate formulas (HF). Consequently pediatricians are now over-whelmed with a variety of information on new formulas called hypoallergenic and are faced with a difficult choice among them.