{
  "abstract": "BackgroundRaw milk consumption has repeatedly been shown to be inversely related to asthma, respiratory infections, and allergies but carries a potential risk of life-threatening infections. The MARTHA trial (DRKS00014781) used minimally-processed pasteurized milk as a microbiologically safe proxy for raw milk and compared it against ultra-heat-treated milk for efficacy on atopic sensitization, asthma, and respiratory infections.\n\nMethodsHealthy children were recruited through birth clinics in Germany. At 6 to 12 months, they were centrally randomized to obtain minimally-processed full-cream versus ultra-heat-treated semi-skimmed cows milk daily until age 3 years. During the SARS-CoV-2 pandemic, recruitment was stopped, and the study was continued without confirmatory intention. The primary endpoint was shifted from asthma as composite parent-reported diagnosis of asthma or recurrent obstructive bronchitis until age 5 to atopic sensitization at age 3 years. Participants, caregivers, and study staff were blinded to group assignments.\n\nResultsWe randomized 130 individuals into each study arm. The intervention was unrelated to atopic sensitization (risk ratio, RR=1.13 [0.67-1.89]), which occurred in 28 individuals of the intervention (n=99) and 24 of the comparator group (n=96). Asthma showed a trend for an inverse association (hazards ratio, HR=0.55 [0.27-1.16], n=252), which was pronounced in the 82 children with a family history of asthma (post-hoc HR=0.30 [0.09-0.93]). The intervention was inversely associated with rhinitis and cough in the older half of the children (post-hoc RR=0.82 [0.67-0.998] and RR=0.75 [0.60-0.94], respectively). No adverse events were judged intervention-related.\n\nInterpretationThe intervention did not reduce atopic sensitization at age 3 years. Exploratory analyses suggested possible protective effects on asthma and respiratory symptoms, particularly in children with parental asthma and in those less affected by pandemic-related disruptions. These findings justify but do not replace a definitive trial.\n\nFundingDutch Longfonds; Bavarian State-Ministry of Health, Care and Prevention; German Center for Lung Research (DZL); FrieslandCampina.",
  "abstract_shown": true,
  "affiliations": [
    "LMU Munich; Helmholtz Munich"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "name": "M. Weber"
    },
    {
      "name": "Y. Huynh"
    },
    {
      "name": "G. Pagani"
    },
    {
      "name": "M. Depner"
    },
    {
      "name": "S. Gschwendtner"
    },
    {
      "name": "H. Demmelmair"
    },
    {
      "name": "C. Skevaki"
    },
    {
      "name": "H. H. Smits"
    },
    {
      "name": "K. Hettinga"
    },
    {
      "name": "M. Schloter"
    },
    {
      "name": "C. Strunz-Lehner"
    },
    {
      "name": "J. Heinrich"
    },
    {
      "name": "E. von Mutius"
    },
    {
      "affs": [
        0
      ],
      "name": "M. J. Ege"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/dqw0vvqkxx2ff.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.23.26363903",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.23.26363903v1.full",
  "id": "dqw0vvqkxx2ff",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.23.26363903v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "pediatrics"
    ],
    [
      "openalex",
      "2737|Asthma and respiratory diseases"
    ]
  ],
  "openalex": "W7223386917",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.23.26363903v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/dqw0vvqkxx2ff.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:34Z",
      "native_id": "10.64898/2026.10.23.26363903",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.23.26363903v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:pediatrics",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Minimally processed cow's milk and early childhood asthma-related outcomes: exploratory findings from the early terminated MARTHA randomized trial",
  "title_text": "Minimally processed cow's milk and early childhood asthma-related outcomes: exploratory findings from the early terminated MARTHA randomized trial",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:34Z",
  "url": "https://research.draconitic.com/paper/dqw0vvqkxx2ff",
  "venue": "medRxiv",
  "versions": []
}