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SECOND INTERNATIONAL SYMPOSIUM
ON THE ROLE OF SOY
IN PREVENTING AND TREATING CHRONIC DISEASE

September 15-18, 1996
Brussells, Belgium

SCIENTIFIC PROGRAM

Satellite Symposium

Current Understanding of Soy and Infant Health

Soy Proteins for the Prevention and Treatment of Children With Cow's Milk Allergy
L. Businco, G. Bruno, P.G. Giampietro
Division of Allergy and Clinical Immunology, Department of Pediatrics, University "La Sapienza," Rome, Italy.

Primary and secondary prevention of cow's milk allergy (CMA) is antigen specific. Therefore to prevent CMA in a predisposed newborn or prevent symptoms in an already sensitized baby, a formula without immunogenic or allergenic epitopes should be given. Soy protein formulae (SPFe) have been widely used to feed infants with CMA since the early '20. Although SPFe are less allergenic than CM formulae their use for prevention and treatment of CMA is controversial. Many studies have stressed soy allergenicity, but very few studies employed the challenge test for the diagnosis of soy allergy. In according to our own large experience SPFe should be the first choice for feeding babies with CMA and for prevention of CMA in high-risk infants, because SPFe do not contain any CM proteins, and soy proteins are less immunogenic than CM proteins. In the last decades partially and extensively cow's milk hydrolysate formulae (HFe) became available on the market for prevention and treatment of CMA. Some of these products (partially hydrolysate) have been marked by the companies as "hypoallergenic" and are promoted for the prevention of atopic diseases in atopic prone babies. However, it is very difficult to agree with a definition of "hypoallergenic" for products which trigger symptoms in about 50% of children with CMA and which contains significant amounts of intact CM proteins. Even extensively HFe can induce severe symptoms in exquisitive sensitized children. Although this is a rare phenomenon according to the position paper of the European Society of Pediatric Allergy and Clinical Immunology, skin prick tests with a fresh sample of extensively HFe should be done before starting treatment. If they are positive, an open challenge should be performed under supervision of a qualified physician, before daily usage is started.

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