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Milk and Soy-based Formulas

The protein found in basic dairy- and soy-based infant formulas are composed of intact, complete protein chains.  These protein chains can trigger an allergic reaction in children with dairy and soy protein allergies. 

The use of soy protein-based formula in cow milk allergy and intolerance

For those bottle-fed infants who are unable to tolerate standard cow milk based formulas because they are allergic to the cow milk protein, soy formulas have been used as a substitute.  These formulas contain soy protein instead of cow milk protein. Soy formulas have a long history of use, not just for cow milk allergy, but also for lactose intolerance, and galactosaemia. Before the availability of therapeutic formulas based on cow milk protein hydrolysates and amino acids, soy formula was the only dietetic product available for feeding infants with cow milk protein allergy.

However, it is estimated that up to 50% of infants allergic to milk protein are also allergic to soy protein.¹ For this reason, the American Academy of Pediatrics recommends that infants with cow milk protein allergy should not be given isolated soy protein-based formula.²

In addition, a joint statement of the European Society for Paediatric Gastroenterology Hepatology (ESPGHAN) and Nutrition Committee on Nutrition and the European Society for Pediatric Allergology and Clinical Immunology (ESPACI) suggest that:

• in general, soy based formulas are not recommended for the initial treatment of food allergy in infants;
• soy protein formulas should not be used in infants with food allergy during the first 6 months of life;
• after the age of 6 months soy protein formulas can be used as an alternative nutrient due its low cost and better acceptance. Tolerance to soy protein should first be established by a healthcare professional.
• commercial soy milk may be useful as part of a varied diet for children from the age of 1 year with Cow Milk Allergy who are tolerant to soy.

European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Recommendations

1. J Pediatr.1990
2. PEDIATRICS Vol. 101 No. 1 January 1998