Soy allergy in infants and children with IgE-associated cow’s milk allergy

• Published in: The Journal of pediatrics Vol. 134; no. 5; pp. 614 - 622
• Main Authors: Zeiger, Robert S., Sampson, Hugh A., Bock, S.Allan, Burks, A.Wesley, Harden, Kathleen, Noone, Sally, Martin, Dannette, Leung, Susan, Wilson, Gail
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-05-1999; Elsevier; Mosby-Year Book, Inc
• Subjects: Allergic diseases; Biological and medical sciences; Child, Preschool; Digestive allergic diseases; Double-Blind Method; Female; Food Hypersensitivity - diagnosis; Food Hypersensitivity - immunology; Humans; Immunoglobulin E - immunology; Immunologic Tests; Immunopathology; Infant; Infant Food - adverse effects; Male; Medical sciences; Milk Hypersensitivity - immunology; Soybean Proteins - immunology; United States; North America; America; CM; NCHS; EPH; CMA; SPT; DBPCFC; Human; Immunopathology; Allergy; Concomitant disease; Prevalence; Immunological investigation; IgE; Cow milk; Infant; Soybean; Child
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/S0022-3476(99)70249-0

Objectives: To determine the prevalence of soy allergy in IgE-associated cow’s milk allergy (CMA).
Study design: Children <3.5 years with documented IgE-associated CMA (n = 93) were evaluated for soy allergy by double-blind, placebo-controlled food challenge, open challenge, or convincing previous history of an anaphylactic reaction to soy. Children tolerant to soy at entry received soy formula and were followed up for 1 year.
Results: Of this IgE-associated CMA cohort (ages 3 to 41 months), 14% (95% CI = 7.7%-22.7%) were determined to have soy allergy, 12 definitely at entry and 1 possibly after 1 year of soy ingestion. The latter child experienced severe failure to thrive at enrollment and exhibited improved growth while receiving soy during follow-up but was diagnosed with eosinophilic esophagitis at study completion. Improved growth (
P < .05) occurred in the non-soy-allergic cohort ingesting soy formula (579 ± 31 mL/d) during the year of follow-up.
Conclusions: Soy allergy occurs in only a small minority of young children with IgE-associated CMA. As such, soy formula may provide a safe and growth-promoting alternative for the majority of children with IgE-associated CMA shown to be soy tolerant at the time of introduction of soy formula. (J Pediatr 1999;134:614-22)