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Cows’ milk allergy and the importance of palatability

If a baby is not being breastfed, then palatability is an important factor to consider when managing cows’ milk allergy, because often by the time infants are prescribed an extensively hydrolysed formula (EHF) their taste preferences have already developed¹`².

An audit of GP data and a recent survey with over 2,500 mums shows the first prescription of specialised formula is generally over five months of age³, by which time the “window of acceptance”, from birth until three and half to four months, has already closed. After this window they are less likely to accept bitter tastes and the chances of rejection are high¹`². Therefore the more palatable the formula the more likely it is to be accepted by the infant.

EHF can taste bitter

EHFs are the first-line choice for most formula-fed infants with CMA⁴. The protein in the EHF is broken down to produce a mixture of short peptides and free amino acids, which are less likely to trigger an allergic reaction⁵. Unfortunately, the resulting formula can taste bitter which can be a problem as infants over four months of age are likely to strongly reject newly introduced bitter tastes⁶.

We’re aware how stressful allergies are for Mums to accept and how hard it is to find the correct solution, and this can be the cause of a very stressful period within the family home. Having done the hard work of diagnosing cows’ milk allergy it is important that the EHF prescribed by the HCP is not then rejected by the baby on the basis of poor palatability⁷.

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IMPORTANT NOTICE: Breastfeeding is best for babies. Infant formula is suitable from birth when babies are not breastfed. Follow-on milk is only for babies over 6 months, as part of a mixed diet and should not be used as a breastmilk substitute before 6 months. We advise that all formula milks including the decision to start weaning should be made on the advice of a doctor, midwife, health visitor, public health nurse, dietitian, pharmacist or other professional responsible for maternal and child care. Foods for special medical purposes should only be used under medical supervision. May be suitable for use as the sole source of nutrition for infants from birth, and/or as part of a balanced diet from 6–12 months. Refer to label for details.