Short- and long-term effects of feeding hydrolyzed protein infant formulas on growth at ≤6 y of age: Results from the German Infant Nutritional Intervention Study

Peter Rzehak, Stefanie Sausenthaler, Sibylle Koletzko, Dietrich Reinhardt, Andrea Von Berg, Ursula Krämer, Dietrich Berdel, Christina Bollrath, Armin Grübl, Carl Peter Bauer, H. Erich Wichmann, Joachim Heinrich

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

Abstract

Background: The short- and long-term effects of feeding with hydrolyzed formulas on growth are uncertain. Objective: Our aim was to investigate the potential differences in body mass index (BMI) over the first 6 y of life between infants fed with partially hydrolyzed whey (pHF-W), extensively hydrolyzed whey (eHF-W), extensively hydrolyzed casein (eHF-C), or cow-milk formula (CMF) and infants exclusively breastfed for the first 16 wk of life. Design: We established a prospective, randomized, double-blind trial of full-term neonates with atopic heredity in the German birth cohort followed by the German Infant Nutritional Intervention Study through the first 6 y of life. Intention-to-treat and per-protocol analyses of absolute and World Health Organization-standardized BMI trajectories for 1840 infants (pHF-W: n = 253; eHF-W: n = 265; eHF-C: n = 250, CMF: n = 276; breastfed: n = 796) were performed. Results: No significant differences in absolute or World Health Organization-standardized BMI trajectories were found among the pHF-W, eHF-W, CMF, and breastfed groups during the 6-y follow-up. However, in the eHF-C group, both intention-to-treat and per-protocol analyses showed a significantly slower sex-adjusted BMI gain through the 8th to 48th week of life (-0.1 to -0.2 lower BMI z score) but not beyond. Analyses of weight and length revealed that this difference is due to a slightly diminished weight gain in the first year of life because growth in length did not differ among study groups for the entire follow-up. Conclusions: To our knowledge, this is the first randomized trial investigating both short- and long-term effects of partially and extensively hydrolyzed formula (pHF-W, eHF-W, eHF-C), CMF, and breastfeeding on growth in one trial. Feeding with eHF-C led to a transient lower weight gain in the first year of life. No long-term consequences of different formulas on BMI were observed.

Original languageEnglish
Pages (from-to)1846-1856
Number of pages11
JournalAmerican Journal of Clinical Nutrition
Volume89
Issue number6
DOIs
StatePublished - 6 Jan 2009

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