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

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.