Hydrolyzed Rice Formula for the Management of Cow’s Milk Allergy in Infants and Young Children: A Systematic Review of Randomized Controlled Trials
6 affiliations
- 1Department of Paediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland.
- 2Department of Pediatrics, Gastroenterology and Nutrition, University of Warmia and Mazury, 10-719 Olsztyn, Poland.
- 3Department of Pediatrics, Jagiellonian University Medical College, 31-007 Krakow, Poland.
- 4Department of Nutrition, Institute of Mother and Child, 01-211 Warsaw, Poland.
- 5Department of Functional and Organic Food, Warsaw University of Life Sciences, 02-787 Warsaw, Poland.
- 6Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 40-555 Zabrze, Poland.
Abstract
Background/Objectives: Hydrolyzed rice formula (HRF) is an alternative to extensively hydrolyzed cow’s milk formula (eHF) or soy formula for infants with cow’s milk allergy (CMA). We evaluated its effects on acquisition of tolerance to cow’s milk protein, growth, safety, and tolerability in infants and young children with confirmed CMA. Methods: PubMed, Embase, and CENTRAL were searched through 26 May 2026 without language restrictions (PROSPERO CRD420261445267). Risk of bias was assessed using the Cochrane Risk of Bias 2 tool for tolerance acquisition and growth, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) for tolerance acquisition. Owing to heterogeneity, results were synthesized narratively. Results: Four RCTs (321 participants; range, 16–108) were included. Two reported tolerance acquisition, assessed at 12 months of age in one trial and during 12 months of follow-up in the other. Estimates were imprecise and in opposite directions: RR 0.84 (95% CI 0.53–1.32; 18/41 vs. 21/40) and RR 1.35 (95% CI 0.95–1.91; 26/36 vs. 22/41). Certainty of evidence was very low. Growth did not differ significantly between HRF and eHF in two trials. In another trial, an unadjusted advantage for HRF and casein hydrolysate over soy formula did not persist after correction for multiple comparisons. Allergic reactions were rare, with no clear differences in adverse events between formulas. Conclusions: Available evidence does not establish whether HRF is equivalent, superior, or inferior to eHF or soy formula for tolerance acquisition or growth in infants with CMA. Adequately powered RCTs using standardized outcome definitions are needed.
Related
- Short-course versus standard- or longer-course oral antibiotic therapy for pneumonia and lower respiratory tract infection in children: a systematic review and meta-analysis of randomized controlled trials
- Hypnosis for Postoperative Pain Management After Colectomies: A Single-Centre Randomized Controlled Feasibility Trial
- Photobiomodulation versus stabilization splint, both combined with self-management, for acute temporomandibular myalgia: 48-week outcomes of a partially randomized controlled study
- Effect of nutrition counseling on complementary feeding practices among mothers with children aged 6–23 months in West Gojjam Zone, Northwest Ethiopia: A cluster-randomized controlled trial
- Can physical exercise improve allergic rhinitis symptoms in adults? A systematic review of randomized controlled trials
BibTeX
@article{szajewska2026hydrolyzed,
title = {{Hydrolyzed Rice Formula for the Management of Cow’s Milk Allergy in Infants and Young Children: A Systematic Review of Randomized Controlled Trials}},
author = {Hania Szajewska and Elżbieta Jarocka-Cyrta and Agata Stróżyk and Andrea Horvath and Urszula Jedynak-Wąsowicz and Anna Liber and Joanna Rachtan-Janicka and Jarosław Kwiecień},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18203429},
url = {https://www.mdpi.com/2072-6643/18/20/3429},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Hydrolyzed Rice Formula for the Management of Cow’s Milk Allergy in Infants and Young Children: A Systematic Review of Randomized Controlled Trials
AU - Hania Szajewska
AU - Elżbieta Jarocka-Cyrta
AU - Agata Stróżyk
AU - Andrea Horvath
AU - Urszula Jedynak-Wąsowicz
AU - Anna Liber
AU - Joanna Rachtan-Janicka
AU - Jarosław Kwiecień
PY - 2026
DA - 2026/10/19
JO - Nutrients
DO - 10.3390/nu18203429
UR - https://www.mdpi.com/2072-6643/18/20/3429
AB - Background/Objectives: Hydrolyzed rice formula (HRF) is an alternative to extensively hydrolyzed cow’s milk formula (eHF) or soy formula for infants with cow’s milk allergy (CMA). We evaluated its effects on acquisition of tolerance to cow’s milk protein, growth, safety, and tolerability in infants and young children with confirmed CMA. Methods: PubMed, Embase, and CENTRAL were searched through 26 May 2026 without language restrictions (PROSPERO CRD420261445267). Risk of bias was assessed using the Cochrane Risk of Bias 2 tool for tolerance acquisition and growth, and certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) for tolerance acquisition. Owing to heterogeneity, results were synthesized narratively. Results: Four RCTs (321 participants; range, 16–108) were included. Two reported tolerance acquisition, assessed at 12 months of age in one trial and during 12 months of follow-up in the other. Estimates were imprecise and in opposite directions: RR 0.84 (95% CI 0.53–1.32; 18/41 vs. 21/40) and RR 1.35 (95% CI 0.95–1.91; 26/36 vs. 22/41). Certainty of evidence was very low. Growth did not differ significantly between HRF and eHF in two trials. In another trial, an unadjusted advantage for HRF and casein hydrolysate over soy formula did not persist after correction for multiple comparisons. Allergic reactions were rare, with no clear differences in adverse events between formulas. Conclusions: Available evidence does not establish whether HRF is equivalent, superior, or inferior to eHF or soy formula for tolerance acquisition or growth in infants with CMA. Adequately powered RCTs using standardized outcome definitions are needed.
SN - 2072-6643
ER -