ADVANCING THE DIETARY MANAGEMENT OF COW’S MILK ALLERGY
- Extensively hydrolysed, hypoallergenic, whey-based formula (eHF) for the effective first line dietary management of the majority (~90%) of infants with cows’ milk allergy (CMA) and other conditions where an extensively hydrolysed formula is indicated1–4 in formula fed babies.
- The only Halal certified and vegetarian eHF on the market in the UK8
- The only ehf to show similar efficacy to an amino acid formulaǂ (AAF) in an RCT with mild-severe CMA.1
- Supports normal growth and development1,2
- Preferred taste over other casein based eHF which may help feeding acceptance, tolerance and health economic savings2,6-8
- Nutritionally complete. Suitable as a sole source of nutrition from birth or supplementary feeding from 6 months of age
ǂSMA Althéra® is not recommended where only an amino acid formula is indicated
KEY FACTS ABOUT SMA® ALTHÉRA® THE DIFFERENCE IS IN THE DETAIL
You’ll find references and further reading below.
- UK Guidance recommends that if a child is exclusively breastfed or mixed feeding to actively support continued breastfeeding, but if that is not an option then a trial of Extensively Hydrolysed Formula should be the first line option.
Breast milk is best for babies and breastfeeding should continue for as long as possible. (MIMS 2020). Specialist formula must be used under medical supervision.
- NICE Clinical Knowledge Summary. 2019. Cow’s Milk Allergy in Children. NICE. October 2020. Available from: https://cks.nice.org.uk/topics/cows-milk-allergy-in-children/
- Fox, A., et al. An update to the Milk Allergy in Primary Care guideline. Clin Transl Allergy. 2019;9(40):1-7.
- Luyt, D., et al. Executive summary of BSACI guideline for the diagnosis and management of cow's milk allergy. British Society for Allergy & Clinical Immunology (BSACI). Clinl & Experimental Allergy. 2014;44:642–672
- Local Guidelines
Greater Manchester Joint Commissioning Team. Prescribing infant formula for cow’s milk protein allergy in primary care. Version 3. April 2020. Available from: http://gmmmg.nhs.uk/docs/guidance/GMMMG-CMPA-final-3-0.pdf
Midlands and Lancashire CSU. Prescribing Guidelines for Specialist Infant Formula Feeds. December 2017. Available from: https://www.lancsmmg.nhs.uk/media/1430/prescribing-guidelines-for-specialist-infant-formula-feeds-v31-final-for-website.pdf
- Demonstrated safety and efficacy vs an amino acid
Niggemann, B. et al. Safety and efficacy of a new extensively hydrolyzed formula for infants with cows milk protein allergy. Pediatr Allergy Immunol. 2008;194(4):348.
- Plant and microbial derived enzyme
Nowak-Węgrzyn A, et al. Hypoallergenicity of a whey-based, extensively hydrolyzed infant formula prepared with nonporcine enzymes. Allergy 2019; 74: 1582-4.
- MIMS (accessed October 2020)
SMA® ALTHÉRA®: NOT ALL EHFs ARE CREATED THE SAME
† SMA Althera is not recommended where an Amino Acid Formula is recommended
Frequently asked questions
OTHER PRODUCTS IN OUR RANGE OF SPECIALIST FORMULAS FOR COW’S MILK ALLERGY
- Niggemann B et al. Pediatr Allergy Immunol 2008; 194(4): 348–354.
- Vandenplas Y et al. Acta Paediatr 2013; 102(8): 990–998.
- Meyer R et al. EMJ Allergy and Immunol 2017; 2(1): 41–51.
- Madrazo-de la Garza J et al. EMJ Allergy and Immunol. 2018; 31(1): 56–58.
- Information from product data cards; Nutramigen with LGG, Alimentum, Aptamil Pepti, Aptamil Syneo. July 2021
- Data on File. Althéra® versus casein-based formulas. Independent competitive benchmarking test.
- Rapp M et al. Poster presentation: Food Allergy and Anaphylaxis Meeting (FAAM 2013) Nice, France. 7-9 February 2013.
- Maslin K. et al. Pediatr Allergy Immunol 2018; 29(8): 857–862.
- Greater Manchester Joint Commissioning Team. Prescribing infant formula for cow’s milk protein allergy in primary care. Version 3. April 2020. Available from: http://gmmmg.nhs.uk/docs/guidance/GMMMG-CMPA-final-3-0.pdf
- Midlands and Lancashire CSU. Prescribing Guidelines for Specialist Infant Formula Feeds. December 2017. Available from: https://www.lancsmmg.nhs.uk/media/1430/prescribing-guidelines-for-specialist-infant-formula-feeds-v31-final-for-website.pdf
- Nowak-Wegrzyn A, et al. Allergy. 2019; 74:1582-4
- Guidance for Health Professionals on safe preparation storage and handling of powdered infant formula. 2007. Food Standards Agency. Department of Health. UK. Available from http://www.foof.gov.uk.
- Data on File. EHF used for calculation is SMA Althera (vs. Aptamil Pepti, Nutramigen with LGG & Similac Alimentum) & AAF used for calculation is SMA Alfamino (vs. Neocate LCP, Neocate Syneo, Neocate Junior, Elecare and Puramino). MAT to June 2020.
- MIMS, accessed July 2021
- Vanderplas Y et al. Abstract. Pediatric Allergy and Asthma Meeting 2019, Florence, Italy.
- Lambers, TT. Et al. Food Sci Nutr. 2015;3:81-90
- Nutten, S. et al. Allergy. 2020. Jun; 75(6):1446-1449
- Francavilla, R. et al. Pediatr allergy Immunol. 2012; 23:420-427
- O’Mahony, L. et al. EMJ Allergy and Immunol. 2018; 31(1):56-58.
- Waddell, L. Clinical Nutrition 2016;15(6):23-28
- Luyt, D. et al. Clin Exp Allergy, 2014; 44:642-672.
- Rapp, M. et al. Clin Transl Allergy, 2013; 3(3):132
- Abram, S. et al. Am J Clin Nutr. 2002; 76(2):442-446
- Ziegler, E & Fomon, J. J Pediatr Gastroenterol Nutr, 1983; 288-294.
- CODEX ALIMENTUS: Standard for infant formula and formulas for special medical purposes intended for infants. 2007. (accessed January 2020; www.fao.org)
- Koletzko, S. et al. J Pediatr Gastroenterology Nut, 2012; 55: 221-229.
- Paoli G. Harthett E. Overview of a risk assessment model for Enterobacter sakazahii in Powdered Infant Formula.2007. Joint FAO/WHO Expert Meetings on Microbiological Risk Assessment (JEMRA). Available from: www.who.int/foodstaftey/micro.jemra.
- Heyman MB et al. Committee on Nutrition. Lactose intolerance in infants, children, and adolescents. Pediatrics. 2006;118(3):1279–86.
- Martin C et al. Review of Infant Feeding: Key Features of Breast Milk and Infant Formula. Nutrients 2016, 8, 279
- NIH. Lactose intolerance. Available at: https://ghr.nlm.nih.gov/condition/lactose-intolerance#statistics (accessed April 2021).
- Venter, C., Pereira, B., Voigt, K. et al. (2008) Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life. Allergy 63(3), 354-359
- Koletzko B et al, Am J Clin Nutr, 2009. 89: p. 1836-1845.
- Koletzko B et al, Am J Clin Nutr, 2009. 85: p. 1502S-1508S.
FOOTNOTES & ABBREVIATIONS
AAF, amino acid formula
CMA, cows’ milk allergy
eHF, extensively hydrolysed formula
FAQs, frequently asked questions
MFPA, multiple food protein allergies
WHO, World Health Organisation
DOH, Department of Health
Nestlé Health Science produces a range of foods for special medical purposes (FSMP) for use under medical supervision. A sample product should only be requested for a patient if deemed suitable following a professional evaluation from an appropriate healthcare professional. Althera® and Alfamino® are infant FSMPs and should only be used after the full consideration of the feeding options available, including breastfeeding.
The Nestlé Health Science Sample Service is available to healthcare professionals only, who require sample products for professional evaluation when they have no sample product or if a patient has insufficient product to cover their needs. This service is not intended as a long term solution for a patient.
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IMPORTANT NOTICE: Mothers should be encouraged to continue breastfeeding even when their babies have cows' milk protein allergy. This usually requires qualified dietary counselling to completely exclude all sources of cows' milk protein from the mothers’ diet. If a decision to use a special formula intended for infants is taken, it is important to follow the instructions on the label. Unboiled water, unboiled bottles or incorrect dilution can make babies ill. Incorrect storage, handling, preparation and feeding can eventually lead to adverse effects on the health of babies. Formula for special medical purposes intended for infants must be used under medical supervision.
Nestlé Health Science UK Statement on Demand for Specialist Infant Formulas for Cows’ Milk and Multiple Food Allergies
We believe breast milk is the best food for infants. When in consultation with their healthcare professional, mothers and families find that optimal breastfeeding is not possible due to their infant’s medical condition, formulas for special medical purposes play a vital role in providing essential nutrients to infants. We have a global commitment to market breast-milk substitutes responsibly.
This website is about the management of cows’ milk protein allergy and nutritional solutions intended for infants. By continuing on this website, you accept that Nestlé Health Science supplies the information at your own request.
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