Spanish experience of an extensively hydrolyzed formula with lactose and human milk oligosaccharides in cow’s milk allergy

Abstract Background Despite the evidence supporting the efficacy of extensively hydrolyzed formulas (eHF) and human milk oligosaccharides (HMO) for the management of cow’s milk protein allergy (CMPA), data on their use in clinical practice remain limited. The objective of the study was to describe the current landscape of CMPA management in Spanish primary care consultations, with particular emphasis on eHFs and novel immunomodulatory components (purified lactose or HMO). Methods ELEVA was a multicenter, descriptive, ecological study involving 191 pediatricians with experience on CMPA management. Aggregated data derived from their experience on CMPA management. Results The eHFs were the most commonly prescribed first-line option for mild and moderate CMPA (78.5% and 95.8%, respectively), while elemental formulas were mainly used in severe cases (61.8%). Infants who received an eHF supplemented with purified lactose and two HMO improved their digestive symptoms (77.4%), showed a reduction of crying and/or irritability symptoms (63.1%), normalization of stool consistency (51.6%), avoidance the rejection/difficulty for eating (48.2%), or a reduction of the number of stools (44.9%). Conclusions The ELEVA study offers detailed insights into how pediatricians in Spain manage CMPA in clinical practice. It also highlights the integration of innovative tools, such as the CoMiSS™ awareness tool for CMPA diagnosis, and novel treatment components like purified lactose and HMO. The use of an eHF supplemented with purified lactose and HMO appears effective in alleviating digestive issues and irritability symptoms. Additionally, it may influence the incidence of infections, use of medication, and number of visits to the healthcare center.

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Publication Details

Journal
BMC Primary Care
Published
2026-07-23
DOI
https://doi.org/10.1186/s12875-026-03481-5
Primary Topic
Infant Nutrition and Health
Type
article
Field-Weighted Citation Impact
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article

Spanish experience of an extensively hydrolyzed formula with lactose and human milk oligosaccharides in cow’s milk allergy

Alba de la Mata, Alicia Lizondo, Francisco J. Ponce, Borja Navas et al.
BMC Primary Care
Infant Nutrition and Health
article

Spanish experience of an extensively hydrolyzed formula with lactose and human milk oligosaccharides in cow’s milk allergy

Alba de la Mata, Alicia Lizondo, Francisco J. Ponce, Borja Navas, Carolina Blanco, Julia Fujkova, Ainhoa Muguruza, M. Layola Brias, G Roca, Alba Alcaraz, Cármen Torres, Cristóbal Coronel, Carme Valls, Amalio Fernández, Javier Perona, Georgina Catasús, Elisa Gutierrez, Amalia Cruz, Eva Carvajal, Gemma Colomé, Ángela Claver, Cynthia Crespo, Cristina M. López, Cristóbal Coronel Rodríguez, Enric Giménez, F. FERNÁNDEZ, Miguel A. Monroy, Guillermo Longo, Ana I. Rodriguez, Gonzalo Botija, Cristina Royo, Ana Martín, Cristina Sevilla, Ainhoa Izquierdo, Marta Sifre, María del Mar Roncero, Antonio Giráldez, Erika Otazu, Daniel Gómez, Ana M. Monago, Almudena Navarro, Beatriz Lorenzo, Ángel Mir, Ana M. Hervás, Amaia Iglesias, Antonio de Andrés, Marta Castell Miñana, Diana Torres, Antonio J. Castellanos, Esther Apolinar, Maria A. Carreño, Elena Aymerich, Carlos Núñez, Enrique Llerena, Gloria Giner, Jose L. Molina, Cintia C. Ago, Antonio García, Antonio Almagro, David González, Gonzalo Galicia, Fátima Diaz, Alba Oviedo, Francisco J. Jerez, Álvaro Mula, Ana I. Jiménez, Amparo S. Romero, Ana J. Llanes, Cristina Ortola, Carmen Hernandez, Fátima M. Violadé, Olga González, María L. Arroba, Anna Pizà, Claudia Vásquez, Francisco J. Recio, Eduardo Haro, Henry A. Luján, Francisco J. Sola, Cristina M. Fresno, Elia Zoido, Antonia Díez, Jorge López, Ana M. Nocea, Enrique La Orden, María D. Sebastia, Elena M. García, Ana M. Sánchez-Cañete, María I. Irles, Antonio Rosell, Eva Palaci, Bárbara Corvillo, Carolina Valle, Ana Asensio, participants from ELEVA study, Ana M. González, Carolina I. Boccardo, Marianna A. Di Campli, Carmen Martín, Conchi Gonzalo
article en

Abstract

Abstract Background Despite the evidence supporting the efficacy of extensively hydrolyzed formulas (eHF) and human milk oligosaccharides (HMO) for the management of cow’s milk protein allergy (CMPA), data on their use in clinical practice remain limited. The objective of the study was to describe the current landscape of CMPA management in Spanish primary care consultations, with particular emphasis on eHFs and novel immunomodulatory components (purified lactose or HMO). Methods ELEVA was a multicenter, descriptive, ecological study involving 191 pediatricians with experience on CMPA management. Aggregated data derived from their experience on CMPA management. Results The eHFs were the most commonly prescribed first-line option for mild and moderate CMPA (78.5% and 95.8%, respectively), while elemental formulas were mainly used in severe cases (61.8%). Infants who received an eHF supplemented with purified lactose and two HMO improved their digestive symptoms (77.4%), showed a reduction of crying and/or irritability symptoms (63.1%), normalization of stool consistency (51.6%), avoidance the rejection/difficulty for eating (48.2%), or a reduction of the number of stools (44.9%). Conclusions The ELEVA study offers detailed insights into how pediatricians in Spain manage CMPA in clinical practice. It also highlights the integration of innovative tools, such as the CoMiSS™ awareness tool for CMPA diagnosis, and novel treatment components like purified lactose and HMO. The use of an eHF supplemented with purified lactose and HMO appears effective in alleviating digestive issues and irritability symptoms. Additionally, it may influence the incidence of infections, use of medication, and number of visits to the healthcare center.

BMC Primary Care
Andalusian Health Service (ES), Veterans Health Administration (US), Catalonian Research and Innovation Centre (ES)
Openalex Percentile: Top 11%
Infant Nutrition and Health
DOIOpen Access PDFOpenAlex
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