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Normal newborns regularly form circulating antibodies to milk proteins by 10 to 14 days of life. Concentrations of these antibodies are influenced by gestational age but not by passive maternal antibody. Secretory antibodies of the IgA and IgM-isotype directed against casein and beta-lactoglobulin are present in the saliva of normal neonates. SIgA-anti-casein is higher in saliva of newborns at risk to develop atopic disease.

Secretory immunoglobulin A (SIgA) anti-casein and SIgA anti-beta-lactoglobulin (BLG) were determined in the saliva of 158 healthy mature infants at birth and in breast milk samples using a direct Elisa technique. IgG anti-casein and anti-BLG were measured in serum samples from mothers and newborns (cord blood). A high risk of allergy was defined in 66 infants who had cord blood (CB)-IgE levels greater than or equal to 0.9 IU/ml and/or parents with atopic diseases. Thirty infants had CB levels less than 0.9 IU/ml and parents without clinical symptoms of atopy but with elevated serum IgE concentrations or type I skin reactions to common allergens (low risk). Sixty-two infants had CB-IgE levels less than 0.9 IU/ml and healthy parents (no risk). The groups were matched for social status, smoking and dietary habits. SIgA anti-casein and anti-BLG were detected in all newborns. SIgA anti-casein was significantly higher (p less than 0.05) in high risk infants (medium 157; 50% confidence limits 45-270) than in no risk (48; 25-150) or low risk infants (43; 21-130). SIgA anti-casein values correlated with maternal allergy, maternal allergy plus CB-IgE, but not with paternal allergy. Breast milk SIgA anti-BLG was depressed (p less than 0.05) in mothers with manifest allergy compared to healthy mothers. Determination of salivary SIgA anti-casein may represent an additional screening method for early detection of infants with atopic disposition.

Concentrations of IgG and IgM antibodies to casein, beta-lactoglobulin, lactalbumin and bovine serum albumin (BSA) in sera of premature infants of less than 36 weeks gestation, at 5 weeks of age, were less than in age-matched term infants. At 6 months of age IgG antibodies to BSA in preterms were still significantly lower than in term infants.

The possible influence of maternal antibody on the immune response to bovine serum albumin (BSA), a normal cow's milk protein, was investigated in fullterm human neonates. Antibody production to BSA of 12 infants with passively acquired anti-BSA (Group I) was compared to the immune response of nine infants without passive anti-BSA at birth (Group II) during the first 6 months of life. All infants were raised on commercial cow's milk formulas containing BSA in concentrations from 0.4-4.0 mg/dl. From 4 wk of age concentrations of circulating anti-BSA as measured by radioimmunoassay and enzyme-linked-immunosorbent-assay (ELISA) were higher in Group II, but differences were not statistically significant. There was no differences in the immune response between infants ingesting formulas with high BSA content compared to infants ingesting low concentrations of antigenic BSA. The main isotype associated with anti-BSA formation was IgG. IgA in measurable amounts appeared later and accounted for approximately 10% of circulating antibody in both groups at 6 months of age. Ony small amounts of IgM- and IgE-anti-BSA were detected.

Concentrations of circulating antibodies against bovine serum albumin were significantly increased in six children with recurrent pulmonary aspiration (mean: 5.54 micrograms BSA-N/ml, range: 2.05-12.87 micrograms BSA-N/ml; mean value of 76 control infants: 0.38 microgram BSA-N/ml, 95% confidence interval: 0-0.98 microgram BSA-N/ml, p less than 0.001) as determined by radioimmuno-assay. IgG- and IgA-isotypes against bovine serum albumin, lactalbumin, lactoglobulin, casein and gammaglobulin were determined in four patients by enzyme-linked-immuno-sorbent-assay. Significant differences between patients and controls were found for IgG-antibodies against casein and bovine serum albumin and IgA-antibodies against alpha-lactalbumin and bovine serum albumin. Under certain conditions, stimulation of bronchus-associated lymphoid tissue may lead to a higher immune response than oral immunization. Determination of milk antibodies may be helpful in the diagnosis of recurrent pulmonary aspiration.

Cow’s milk protein allergy (CMPA) is best treated by complete elimination of cow’s milk from the diet. For infants with CMPA who cannot be breast-fed, formulas based on extensively hydrolyzed proteins or on amino acids are the preferred substitutes for cow’s milk-based formulas. In this study, we compared the tolerance and growth of infants with CMPA who were fed a new extensively hydrolyzed formula containing lactose (eHF) with those who were fed an amino acid formula (AAF). This was a prospective, multi-center, randomized, reference-controlled study. Seventy-seven infants <12 months old with suspected CMPA were enrolled. In 66 of these, CMPA was confirmed by oral challenge in a double-blind, placebo-controlled food challenge (DBPCFC) or by a medical history of severe allergic reaction to cow’s milk and a positive skin prick test. These infants were then tested for their reaction to eHF and AAF in a DBPCFC. All infants tolerated both formulas and were randomized to receive either eHF (n = 34) or AAF (n = 32) for 180 days. Growth (weight, length, and head circumference) and tolerance [skin, gastro-intestinal, and respiratory tract symptoms of allergy] were evaluated after 30, 60, 90, and 180 days. There were no significant differences between the two groups in any of the growth measurements. Length and head circumference were similar to Euro-growth standards, but weight was slightly lower. Gastro-intestinal and respiratory tract symptoms of allergy were also similar in the two groups. However, whereas SCORAD scores for atopic dermatitis remained constant throughout the study in infants-fed eHF, there was a slight decrease in those fed AAF. Infants-fed eHF had significantly fewer incidents of vomiting than infants-fed AAF and a significantly higher frequency of soft stools. The new eHF is safe and well tolerated in infants diagnosed with CMPA. [ABSTRACT FROM AUTHOR]