Vandenplas Y, et al. Safety and adequacy of a semi-elemental formula for children with gastro-intestinal disease. Amino Acids. 2010;38(3):909–14. IMPORTANT NOTICE: Breast milk is best for babies and provides ideal nutrition. Good maternal nutrition is important for the preparation and maintenance of breastfeeding. Introducing partial bottle feeding could negatively affect breastfeeding and reversing a decision not to breastfeed is difficult. Professional advice should be followed on infant feeding. Infant formula should be prepared and used exactly as directed or it could pose a health hazard. The preparation requirements and weekly cost of providing infant formula until 12 months of age should be considered before making a decision to formula feed. Mothers should be encouraged to continue breastfeeding even when their infants have cow’s milk protein allergy. If a decision to use an infant formula for special dietary use is taken, it must be used under medical supervision. The World Health Organisation (WHO) has recommended that pregnant women and new mothers be informed on the benefits and superiority of breastfeeding – in particular the fact that it provides the best nutrition and protection from illness for babies. Mothers should be given guidance on the preparation for, and maintenance of, lactation, with special emphasis on the importance of a well-balanced diet both during pregnancy and after delivery. Unnecessary introduction of partial bottle-feeding or other foods and drinks should be discouraged since it will have a negative effect on breastfeeding. Similarly, mothers should be warned of the difficulty of reversing a decision not to breastfeed. Before advising a mother to use an infant formula, she should be advised of the social and financial implications of her decision: for example, if a baby is exclusively bottle-fed, more than one can (400 g) per week will be needed, so the family circumstances and costs should be kept in mind. Mothers should be reminded that breast milk is not only the best, but also the most economical food for babies. If a decision to use an infant formula is taken, it is important to give instructions on correct preparation methods, emphasising that unboiled water, unsterilised bottles or incorrect dilution can all lead to illness. IgE mediated –rapid onset allergic reactions and can occur within 15 minutes after consuming cows’ milk or dairy products. Niggemann B, et al. Safety and efficacy of a new extensively hydrolyzed formula for infants with cow’s milk protein allergy. Pediatr Allergy Immunol. 2008;19(4):348–54.

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.Azad MB, et al. Infant gut microbiota and food sensitization: associations in the first year of life. Clin Exp Allergy 2015;45(3):632-643. Vandenplas Y, et al.Growth in infants with cow’s milk protein allergy fed an amino acid-based formula.Abstract N-O-013 presented at ESPGHAN, 2019. JPediatrGastroenterolNutr2019;68(Suppl1).

Thompson-ChagoyanOC, et al.Faecal Microbiota and Short-Chain Fatty Acid Levels in Faeces from Infants withCow‘s Milk Protein Allergy Int Arch Allergy Immunol 2011;156(3):325–332. Azad MB et al. Human Milk Oligosaccharide Concentrations Are Associated with Multiple Fixed and Modifiable Maternal Characteristics, Environmental Factors, and Feeding Practices J Nutr 2018;148(11):1733-1742. Kennedy K, et al.Double-blind, randomized trial of a synthetic triacylglycerol in formula-fed term infants: effects on stool biochemistry, stool characteristics, and bone mineralization.Am J ClinNutr1999;70(5):920-927. Bode L. Human milk oligosaccharides: Every baby needs a sugar mama. Glycobiology 2012;22(9):1147-1162. Breast milk is best for baby and provides ideal nutrition. Good maternal nutrition is important for preparation and maintenance of breastfeeding. Introducing partial bottle feeding could negatively affect breastfeeding and reversing a decision not to breastfeed is difficult. Professional advice should be followed on infant feeding. Infant formula should be prepared and used exactly as directed or it could pose a health hazard. The preparation requirements and cost of providing infant formula until 12 months of age should be considered before making a decision to formula feed.Corkins M, et al.Assessment of Growth of Infants Fed an Amino Acid-Based Formula. Clin Med InsightsPediatr2016;10:3–9.

Bode L, Human milk oligosaccharides: Every baby needs a sugar mama. Glycobiology, 2012. 22(9): p. 1147-1162. Thompson-Chagoyan OC, et al. Faecal Microbiota and Short-Chain Fatty Acid Levels in Faeces from Infants with Cow‘s Milk Protein Allergy Int Arch Allergy Immunol 2011;156(3):325–332.Rapp M, et al. Characterization of an extensively hydrolyzed whey infant formula with a low bitterness. Clin Transl Allergy. 2013; 3(Suppl 3): P132. Nowak-Wegrzyn A, et al. Hypoallergenicity of a whey-based, extensively hydrolysed infant formula prepared with nonporcine enzymes. Allergy 2019;74(8):1582-1584. Host A and Halken S. Cow's milk allergy: where have we come from and where are we going? EndocrMetabImmuneDisordDrug Targets 2014;14(1):2-8.