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Background <p>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).</p> Methods <p>ELEVA was a multicenter, descriptive, ecological study involving 191 pediatricians with experience on CMPA management. Aggregated data derived from their experience on CMPA management.</p> Results <p>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%).</p> Conclusions <p>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.</p>

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

  • 期刊论文

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  • 发表日期：

    2026年7月23日

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  • Cristóbal Coronel-Rodríguez,
  • Marta Castell Miñana,
  • Miquel Layola Brias,
  • Ainhoa Izquierdo,
  • Alba Alcaraz,
  • Alba Oviedo,
  • Amaia Iglesias,
  • Amalio Fernández,
  • Ana M. Nocea,
  • Ana Martín,
  • Antonio J. Castellanos,
  • Borja Navas,
  • Carme Valls,
  • Carmen Martín,
  • Carmen Torres,
  • Cristina M. Fresno,
  • Daniel Gómez,
  • David González,
  • Elena Aymerich,
  • Elena M. García,
  • Francisco J. Sola,
  • Henry A. Luján,
  • Javier Perona,
  • Jorge López,
  • Jose L. Molina,
  • Julia Fujkova,
  • Maria A. Carreño,
  • María del Mar Roncero,
  • María D. Sebastia,
  • María I. Irles,
  • María L. Arroba,
  • Marianna A. Di Campli,
  • Marta Sifre,
  • Miguel A. Monroy,
  • Olga González,
  • Ainhoa Muguruza,
  • Alba de la Mata,
  • Alicia Lizondo,
  • Almudena Navarro,
  • Álvaro Mula,
  • Amalia Cruz,
  • Amparo S. Romero,
  • Ana Asensio,
  • Ana I. Jiménez,
  • Ana I. Rodríguez,
  • Ana J. Llanes,
  • Ana M. Monago,
  • Ana M. González,
  • Ana M. Hervás,
  • Ana M. Sánchez-Cañete,
  • Ángel Mir,
  • Angela Claver,
  • Anna Pizà,
  • Antonia Díez,
  • Antonio Almagro,
  • Antonio de Andrés,
  • Antonio García,
  • Antonio Giráldez,
  • Antonio Rosell,
  • Bárbara Corvillo,
  • Beatriz Lorenzo,
  • Carlos Núñez,
  • Carmen Hernandez,
  • Carolina Blanco,
  • Carolina I. Boccardo,
  • Carolina Valle,
  • Cintia C. Ago,
  • Claudia Vásquez,
  • Conchi Gonzalo,
  • Cristina M. López,
  • Cristina Ortola,
  • Cristina Royo,
  • Cristina Sevilla,
  • Cristóbal Coronel,
  • Cynthia Crespo,
  • Diana Torres,
  • Eduardo Haro,
  • Elia Zoido,
  • Elisa Gutiérrez,
  • Enric Giménez,
  • Enrique La Orden,
  • Enrique Llerena,
  • Erika Otazu,
  • Esther Apolinar,
  • Eva Carvajal,
  • Eva Palaci,
  • Fátima Diaz,
  • Fátima M. Violadé,
  • Francisco Fernández,
  • Francisco J. Jerez,
  • Francisco J. Recio,
  • Francisco J. Ponce,
  • Gemma Colomé,
  • Georgina Catasús,
  • Gisela Roca,
  • Gloria Giner,
  • Gonzalo Botija,
  • Gonzalo Galicia,
  • Guillermo Longo,
  • Ignacio Domingo,
  • Ignacio Güemes,
  • Ilse Medrano,
  • Inés Cervera,
  • Irene García,
  • Irene M. Satorre,
  • Janice M. Quiroz,
  • Javier Artero,
  • Javier Villalba,
  • Jesús González,
  • Jesús Rodríguez,
  • Joaquín Roig,
  • Jorge Martínez,
  • José J. Ruiz,
  • Juan C. Juliá,
  • Juan I. Manrique,
  • Juan J. Roeschlin,
  • Juan P. Ferrer,
  • Kilian Arias,
  • Laura Calvo,
  • Laura Orsola,
  • Laura Quinzá,
  • Laura Viñas,
  • Leandro Picó,
  • Leticia Postigo,
  • Lexuri Zugadi,
  • Lidia Aulet,
  • Lorena Hidalgo,
  • Lorena Rodríguez,
  • Lucia Barahona,
  • María T. Joval,
  • María A. Tormos,
  • Mara Cerqueiro,
  • María A. Sarría,
  • Maria A. Mate,
  • María del Mar Corral,
  • Maria D. Saavedra,
  • Maria E. Jaime,
  • Maria J. Serrano,
  • María Martínez,
  • Maria T. Alcayde,
  • Maria T. Guerra,
  • Maria Valls,
  • Mariel Navarro,
  • Marina García,
  • Marina Rodríguez,
  • Marta Espinet,
  • Marta Garín,
  • Marta Muñoz,
  • Marta Pozuelo,
  • Marta Sarría,
  • Miguel Gallardo,
  • Mireia Corominas,
  • Mónica García,
  • Montserrat Hernández,
  • Neelam M. Dadlani,
  • Neyda A. Landaeta,
  • Nieves García,
  • Nieves Torres,
  • Noelia Ruiz,
  • Nuria Barros,
  • Nuria Doñate,
  • Nuria Puente,
  • Nuria Roig,
  • Nuria Sanchis,
  • Octavio Berbel,
  • Olga K. Maco,
  • Oliva Piera,
  • Pablo O. Goicolea,
  • Paloma Cañete,
  • Patricia Villegas,
  • Paula Ribó,
  • Paula Soriano,
  • Rebeca Corral,
  • Rocio Collado,
  • Rocío Mendívil,
  • Rocío Ramírez,
  • Sandra Aycart,
  • Sandra Mayola,
  • Sandra Rodríguez,
  • Sergio Negre,
  • Silvia Monteagudo,
  • Silvia Pin,
  • Souheil El-Solh,
  • Susana Domínguez,
  • Yohanka Rabelo,
  • Yusty M. Herazo,
  • Zoraima Martínez,
  • Paula Gacimartín,
  • Salvador Ariza,
  • Silvia Marqués,
  • Susana Pardo,
  • Susana Villanueva,
  • Víctor Fernández,
  • Violeta Campos,
  • Lusmey Fernández,
  • Feliciano Rubio

摘要

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.