Feeding Babies Cow’s Milk-Based Formula May Reduce Risk For Cow’s Milk Protein Allergy—But, At What Cost?

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Consumer Watchdog Group Takes Aim At Children’s Menus

Three Cheers For Breastfeeding!

by Amy Spangler
September 06, 2010

At a time when health care organizations are struggling to increase breastfeeding rates—particularly rates of exclusivity—it seems unconscionable for researchers to suggest that breastfed babies be given cow’s milk-based formula during the first 14 days after birth simply as a means for reducing the risk of intolerance or allergy to cow’s milk protein (CMP). And yet, that’s exactly what researchers at Assaf Harofeh Medical Center, Zerifin, Israel are suggesting based on the results of a recent study funded by the Israel Dairy Board.

Research
More than 13,000 babies born over a two-year period (2004-2006) at a hospital in Zerifin, Israel participated in the study. Mothers choosing to breastfeed were encouraged to continue; those choosing to formula-feed or to combine breastfeeding and formula-feeding were instructed to use a cow’s milk-based formula. Mothers were asked to contact the clinic 14 to 30 days after introducing formula—or sooner if their babies developed any symptoms of intolerance or allergy such as colic, diarrhea, wheezing, or skin rash. If the mothers did not contact the clinic within three months, they were contacted by a member of the research team. Contacts continued at two month intervals until babies were no longer exclusively breastfeeding. Babies (144) not exposed to CMP during the first year were excluded from the study. A skin prick test was used to confirm a diagnosis of cow’s milk allergy (CMA).

Results

More than 50 percent of the babies were given CMP during the first two weeks and regularly thereafter.

Sixty-six babies (one-half of one percent) tested positive for CMA, suggesting that CMA is lower than perviously thought.

The sooner CMP was introduced, the lower the risk for CMA. The risk was .05 percent in babies given CMP during the first 14 days and increased to 1.75 percent in babies receiving CMP between days 105 to 194. The risk for CMA decreased to 0.5 percent in babies given CMP after day 194—a decrease the researchers couldn’t explain.

While 80 percent of the Arab-Muslim mothers initiated breastfeeding, less than 30 percent breastfed exclusively, compared to 57 percent of the Jewish mothers.

Seventy percent of the Arab-Muslim babies received CMP in the first week of life compared to 42 percent of the Jewish babies.

Only one of the 1,806 Arab-Muslim babies tested positive for CMA, compared to 55 of the 10,135 Jewish babies.

None of the 66 babies diagnosed with CMA tested positive for soy allergy, despite previous findings showing that 10-14 percent of babies who test positive for CMP will also test positive for soy protein allergy.

Calculating the cost of cow’s milk
Early introduction of cow’s milk-based formula may result in greater tolerance for CMP and less CMA, but at what cost? Lower rates of exclusive breastfeeding, shorter duration of breastfeeding, and a higher incidence of ear infections, upper respiratory infections, and gastrointestinal infections seem like a high price to pay to drink another mammal’s milk.

Given that the incidence of CMA is small, the results of this study beg the question—if giving babies CMP early and often is the only way to reduce the risk for intolerance and CMA, why not just avoid CMP altogether? Perhaps humans were never meant to drink cow’s milk, goat’s milk, sheep’s milk, or any other mammal’s milk.

http://www.wombtobreast.com Anne

I think the biggest red flag here is that this “research” was funded by the Israeli Dairy Board! This would present a clear bias in the eyes of many other “authorities” in breastfeeding research. I’m disappointed that this fact wasn’t taken into consideration before posting this article actually. Marsha Walker’s article “Just One Bottle Won’t Hurt, or Will It?” would be a very good rebuttal to this “information” that is presented in this article.
http://www.babygooroo.com Amy Spangler

You’re absolutely right to raise concerns over funding sources. Sadly, very little research conducted today is without questionable funding. Given that harsh reality, it’s imperative that funding sources be disclosed (as was done in paragraph one of my article) so that readers are well aware of the potential for conflict of interest and can judge the results accordingly. The potential for bias is an important consideration whenever study results are evaluated.
Anonymous

There are several very serious problems with this study.

First and foremost, the control group (those NOT exposed to CMP at all) was eliminated, so the conclusion is meaningless.

Second, the standard of ‘allergic’ was set as a positive skin prick test. These are well know to have many false negatives in general, and the incidents of false negative are so common before the age of 3-4 years that most reputable allergists consider them a waste of time for the majority of toddlers. They also only (sometimes) catch one type of reaction, IgE. Other forms of insensitivity to CMP are often far more damaging, may well be INDUCED by early introduction of CMP, and are completely ignored in this study.

Third, history of allergy in the family was never taken into consideration. It makes sense that those with a history of allergy in the family would greatly delay or avoid introduction of CMP, skewing the results.

Finally, the division of mothers between “Arab” and “Jewish” is strange, considering these are arbitrary and cultural. It smacks more of eugenics than valid scientific research.

While your statement is valid, that the risks of early introduction of CMP far outweigh the perceived ‘benefit’ of fewer IgE allergies, that ‘benefit’ is only PERCEIVED. It has not been proven by any stretch of the imagination. This study is complete bunk, and should be ignored based on the fact that it does not contain sound science.
http://www.babygooroo.com Amy Spangler

Thank you so much for your thoughtful comment. While the intent of my article was to call into question the use of cow’s milk at any age, your examination of the study itself helps our readers realize that all science is not created equal. Even articles published in respected journals should be suspect until proven otherwise. Unfortunately, the majority of people rarely examine the actual study but rely upon secondary sources for information and come away believing headlines (and articles) like the one that appeared in the National Post–“Drinking cow’s milk may offer early health benefits.”