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Even for children who outgrow the allergy, CMPA can still lead to nutritional deficiencies that impair growth and bone density.
By Pesach Benson, TPS
Israeli doctors issued a critical warning about the potential dangers of temporarily feeding newborns with formula in the first days of life, stressing that this practice could significantly increase the risk of developing an allergy to cow’s milk.
A position paper released on Sunday by the Israeli Association for Allergy and Clinical Immunology (IAACI) cautioned that even brief early exposure to formula may lead to long-term health consequences for infants.
The IAACI’s warning comes amid rising concern over food allergies, especially cow’s milk protein allergy (CMPA), among infants in Israel. Over the past two decades, the prevalence of CMPA in Israel has more than doubled, increasing from 0.3%-0.5% in the early 2000s to an estimated 0.85%-1% of children today.
This significant rise mirrors global trends, where food allergies have become more prevalent in infancy.
Cow’s milk protein allergy, an allergy mediated by Immunoglobulin E (IgE), is one of the most common and serious food allergies in infants. IgE is best known for its involvement in allergic responses.
When the immune system identifies a substance such as pollen, pet dander, or certain foods as harmful, it may produce IgE antibodies specific to that allergen.
Many children — around 60-70% — outgrow the CMPA by early childhood, but the consequences can be severe. The most immediate risk to children with CMPA is anaphylaxis, a life-threatening allergic reaction that can affect the respiratory, circulatory, and gastrointestinal systems.
Even for children who outgrow the allergy, CMPA can still lead to nutritional deficiencies that impair growth and bone density.
The IAACI’s position paper also focused on the role of early feeding practices in the development of allergies.
Recent studies and the recommendations of the European Association for Allergy and Clinical Immunology (EAACI) suggest that introducing allergenic foods, such as peanuts and eggs, between 4 to 6 months of age can help prevent allergies to these foods.
However, the case of cow’s milk is more complex. While breastfeeding is universally endorsed for its numerous health benefits, including its role in preventing allergies, the introduction of formula in the first few days of life has emerged as a potential risk factor for CMPA.
Studies conducted in Israel have shown that infants who received formula supplementation shortly after birth, even if they were subsequently exclusively breastfed, were more likely to develop CMPA compared to those who were either exclusively breastfed or consistently fed a combination of breast milk and formula.
In response to these findings, the IAACI recommendations aim to reduce the risk of CMPA. For mothers who plan to breastfeed exclusively, the association advises against supplementing with formula in the first days of life. If formula is introduced, even in small amounts, it should be continued regularly alongside breastfeeding to mitigate the risk of developing an allergy.
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