ALFAMINO® HMO:
ADVANCING THE MANAGEMENT OF SEVERE COW’S MILK PROTEIN ALLERGY

HOW TO PREPARE ALFAMINO® HMO
INGREDIENTS AND COMPOSITION

Effectively relieves symptoms, supports gut recovery and healthy growth

Infants with CMPA and/or multiple food allergies may face an immediate challenge from skin, gastrointestinal and/or respiratory symptoms, while those with severe symptoms may also experience anaphylaxis, failure to thrive and/or complex gastrointestinal manifestations.4-6,23 Alfamino® HMO is proven to be hypoallergenic, provides effective symptom relief1-3 and supports normal growth.20,21

Skin symptoms

(e.g. eczema, urticaria…)

Gastrointestinal symptoms

(e.g. vomiting, colic, diarrhoea…)

Respiratory symptoms

(e.g. wheezing…)

General symptoms

(e.g. inconsolable crying, failure to thrive, anaphylaxis…)

Alfamino® HMO’s is also designed to facilitate fat and calcium absorption and supports gut recovery.12-19 This is due to it’s unique composition which is lactose-free and low in osmolality. It also contains 24% medium-chain triglycerides (of total fat) and structured lipids.

Immune-nurturing benefits

CMPA is an immune-mediated disease. It is associated with gut microbiota dysbiosis, which impacts immune system maturation and leaves infants at an increased risk of infections and future allergies.25-33 Alfamino® HMO is the only amino acid-based formula to contain 2’-fucosyllactose (2’FL) and lacto-N-neotetraose (LNnT), which are structurally identical to two significant human milk oligosaccharides (HMO).+7-11

HMO support the growth of beneficial bacteria in the gut

HMO strengthen the gut barrier by promoting intestinal cell maturation

HMO eliminate pathogens through a decoy effect

HMO guide the maturation of the immune system, leading to a more balanced Th1/Th2 response

REDUCING INFECTIONS AND MEDICATION USE


Infants fed formula with 2’FL and LNnT had fewer upper and lower respiratory tract infections6-8


Infants fed formula with 2’FL and LNnT had lower antibiotic and antipyretic use6-8

MEET SOPHIA

Feeding:

Formula-fed and complementary feeding


Symptoms:

Unsettled, persistent crying, vomiting & severe diarrhoea and faltering growth


Diagnosis:

Suspected multiple food allergies including CMPA



Fictional patient profile for illustrative purpose only

WHAT WOULD BE YOUR MOST IMPORTANT GOAL FOR SOPHIA?

  • SYMPTOM RELIEF​
  • SUPPORT GROWTH​
  • SUPPORT IMMUNE HEALTH

For infants with multiple food allergies, including CMPA, who are complementary feeding but cannot be breastfed, symptom relief can be achieved by:


  • A complementary diet with the elimination of the foods suspected of causing an allergic reaction4,5
  • A proven amino acid-based formula, such as Alfamino® HMO, which has been shown to be safe and effective for infants with CMPA:1-3

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CMPA and food allergies in general may impair growth as some symptoms may affect nutritional intake and/or the absorption of nutrients.4,5 Alfamino® HMO is nutritionally tailored for infants with severe symptoms of CMPA and other food allergies, and has been proven to support healthy growth and development:20,21


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The development of the immune system of infants with CMPA is affected by gut microbiota dysbiosis and increased gut permeability.24-26,34 


Alfamino® HMO is the only amino acid-based formula with 2’FL and LNnT to support the development of the immune system and reduce the risk of infections and associated medication use:9-11


HEALTHY INFANTS8
​Mean trial duration: 12 months​
INFANTS WITH CMPA6,7
Mean trial duration: 8.8 months​
EAR INFECTIONS -46%‡​ -71%‡​
LOWER RESPIRATORY TRACT INFECTIONS ​ -55%* -34%
BRONCHITIS -70%**
GASTROINTESTINAL INFECTIONS​ -40%
FREQUENCY OF UPPER RESPIRATORY TRACT INFECTIONS -42%*
ANTIBIOTIC USE​ -53%* -6%
ANTIPYRETIC USE​ -56%*** -11%

*p ≤ 0.05; **p ≤ 0.01; ***p ≤ 0.05 at 4 months only; p = N.S. ​

FREQUENTLY ASKED QUESTIONS

Our range of immune-nurturing formulas for cow’s milk protein allergy


Our range of nutritional solutions are tailor-made for infants and young children with cow’s milk protein allergy and other food allergies/intolerances. The complete range has been designed to help manage cow’s milk protein allergy earlier, with the right product from the beginning.

Structurally identical Human Milk Oligosaccharides are not sourced from human milk.

REFERENCES

  1. Nowak-Węgrzyn A, et al. Evaluation of Hypoallergenicity of a New, Amino Acid–Based Formula. Clin Pediatr (Phila) 2015;54:264–272. 

  2. Nowak-Wegrzyn A, et al. Confirmed Hypoallergenicity of a Novel Whey-Based Extensively Hydrolyzed Infant Formula Containing Two Human Milk Oligosaccharides. Nutrients 2019;11(7):E1447.  

  3. Cekola P, et al. Clinical use and safety of an amino acid-based infant formula in a real world setting. Abstract presented at NASPGHAN. Chicago, IL, USA, October 2019. 

  4. Koletzko S, et al. Diagnostic Approach and Management of Cow’s-Milk Protein Allergy in Infants and Children: ESPGHAN GI Committee Practical Guidelines. J Pediatr Gastroenterol Nutr 2012;55(2):221-229. 

  5. Luyt D, et al. BSACI guideline for the diagnosis and management of cow’s milk allergy. Clin Exp Allergy 2014;44(5):642-672. 

  6. Muraro A, et al. EAACI Food Allergy and Anaphylaxis Guidelines: diagnosis and management of food allergy. Allergy 2014;69(8):1008–1025. 

  7. Bode L. Human milk oligosaccharides: Every baby needs a sugar mama. Glycobiology 2012;22(9):1147-1162. 

  8. Donovan SM and Comstock SS. Human Milk Oligosaccharides Influence Neonatal Mucosal and Systemic Immunity. Ann Nutr Metab 2016;69(suppl 2):42-51. 

  9. Nestlé Health Science, data on file. CINNAMON study. 

  10. Vandenplas Y, et al. Growth, tolerance and safety of an extensively hydrolysed formula containing two human milk oligosaccharides in infants with cow’s milk protein allergy. Abstract presented at PAAM. Florence, Italy, October 19, 2019. 

  11. Puccio G, et al. Effects of Infant Formula With Human Milk Oligosaccharides on Growth and Morbidity: A Randomized Multicenter Trial. J Pediatr Gastroenterol Nutr 2017;64(4):624-631. 

  12. Heine RG, et al. Lactose intolerance and gastrointestinal cow’s milk allergy in infants and children – common misconceptions revisited. World Allergy Organ J 2017;10(1):41. 

  13. Delplanque B, et al. Lipid Quality in Infant Nutrition: Current Knowledge and Future Opportunities. J Pediatr Gastroenterol Nutr 2015;61(1):8-17. 

  14. Bach AC, et al. Medium-chain triglycerides : an update. Am J Clin Nutr 1982;36(5):950-962. 

  15. 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 Clin Nutr 1999;70(5):920-927.  

  16. Koletzko B. Human milk lipids. Ann Nutr Metab 2016;69(suppl 2):28-40. 

  17. Mazzocchi A, et al. The Role of Lipids in Human Milk and Infant Formulae. Nutrients 2018;10(5):E567. 

  18. American Academy of Pediatrics, Committee on Nutrition. Pediatrics 1976;57:278-285. 

  19. Nestlé Health Science, data on file. Alfamino® product composition. 

  20. Corkins M, et al. Assessment of Growth of Infants Fed an Amino Acid-Based Formula. Clin Med Insights Pediatr 2016;10:3–9. 

  21. 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. J Pediatr Gastroenterol Nutr 2019;68(Suppl 1). 

  22. Nestlé Health Science, data on file. Alfamino® versus Neocate® competitive benchmarking test. 

  23. Host A and Halken S. Cow's milk allergy: where have we come from and where are we going? Endocr Metab Immune Disord Drug Targets 2014;14(1):2-8. 

  24. 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. 

  25. West CE, et al. The gut microbiota and its role in the development of allergic disease: a wider perspective Clin Exp Allergy 2015;45(1):43–53.  

  26. 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. 

  27. Chin AM, et al. Morphogenesis and maturation of the embryonic and postnatal intestine. Semin Cell Dev Biol 2017;66:81-93. 

  28. Tanaka M and Nakayama J. Development of the gut microbiota in infancy and its impact on health in later life Allergol Int 2017;66(4):515-522. 

  29. Newburg DS and Walker WA. Protection of the Neonate by the Innate Immune System of Developing Gut and of Human Milk. Pediatr Res 2007;61(1):2-8. 

  30. Woicka-Kolejwa K, et al. Food allergy is associated with recurrent respiratory tract infections during childhood. Postepy Dermatol Alergol 2016;33(2):109-113. 

  31. Juntti H, et al. Cow’s Milk Allergy is Associated with Recurrent Otitis Media During Childhood. Acta Otolaryngol 1999;119(8):867-873. 

  32. Tikkanen S, et al. Status of children with cow’s milk allergy in infancy by 10 years of Age. Acta Paediatr 2000; 89(10):1174-1180. 

  33. Jalonen T. Identical intestinal permeability changes in children with different clinical manifestations of cow’s milk allergy.  J allergy Clin Immunol 1991;88(5):737-742. 

  34. Crittenden RG and Bennett LE. Cow’s Milk Allergy: A Complex Disorder. J Am Coll Nutr 2005;24(6suppl):582S–591S. 

 


IMPORTANT NOTICE:

 

Mothers should be encouraged to continue breastfeeding even when their infants have cow’s milk protein allergy. This usually requires qualified dietary counseling to completely exclude all sources of cow’s milk protein from the mothers’ diet. If a decision to use a special formula intended for infants is taken, it is important to give instructions on correct preparation methods, emphasizing that unboiled water, unsterilized bottles or incorrect dilution can all lead to illness. Formula for special medical purposes intended for infants must be used under medical supervision.