human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of this r and omized study was to determine if fiber-supplemented soy formula reduced regurgitation in young infants . We compared regurgitation in 179 infants r and omly assigned cow ’s milk-based ( CM , 90 ) formula or soy formula with fiber ( SF , 89 ) .  Initial daily incidence was similar ( CM , 3.6 ; SF , 3.9 episodes ) , but significantly lower after 7 days on SF ( CM , 3.4 ; SF , 2.3 ; p = 0.001 ) . Less frequent regurgitation after 7 days on SF was sustained after 28 days ( CM , 48 % ; SF , 31 % of feedings ; p = 0.001 ) . Feeding SF effectively managed regurgitation while providing balanced nutrition without altering caloric distribution as occurs with adding rice cereal to formula Purpose The use of soy products is common in young children with cow milk allergy ( CMA ) . The aim was to examine prospect ively the association between infantile consumption of soy-based formula , growth parameters and early pubertal signs , in comparison to cow milk-based formula . Methods A nested case – control study was conducted , selected from a cohort of infants prospect ively followed from birth until the age of 3 years for eating habits and the development of IgE-mediated CMA . Infants who consumed only soy-based formula  were included in the soy group . The control group was r and omly selected from those without IgE-CMA and not receiving soy formula . Study participants were reevaluated between ages 7.8 and 10.5 years by an interview , nutritional intake by 3 days diaries , and height , weight , and pubertal signs by physical examination . Results The  soy-fed group included 29 participants ( 17 males ) , median age 8.92 years IQR ( 8.21 , 9.42 ) . The control group included 60 participants ( 27 males ) , median age 8.99 years IQR ( 8.35 , 9.42 ) . The groups had comparable height and BMI z scores ( − 0.17 ± 1.08 versus − 0.16 ± 1.01 , p = 0.96 , and 0.67 ± 1.01 versus 0.53 ± 1.02 , p = 0.56 , for soy and control groups , respectively ) . Four ( three males and one female ) from the soy-group ( 13.8 % ) and eight females from the control-group ( 13.3 % ) had early pubertal signs ( p = 0.95 ) . No association was detected between puberty and infantile nutrition , after controlling for BMI and family data . No association with puberty or differences between groups were found in current daily consumption  of soy , micronutrients , energy , carbohydrates , fat , and protein . Conclusions This is the first prospect i ve , physical examination-based study , demonstrating no association between infantile soy-based formula consumption and growth and puberty parameters BACKGROUND Early feeding with cow 's milk ( CM ) may increase the risk of cow 's milk allergy ( CMA ) . OBJECTIVE We sought to examine prospect ively whether supplementary feeding of CM at the maternity hospital would increase the risk when compared with feeding with pasteurized human milk or hydrolyzed formula . METHODS We studied 6209 unselected healthy , full-term infants , of whom 5385 ( 87 % ) required supplementary milk while in the hospital . The infants were r and omly assigned to receive CM formula ( 1789 infants ) , pasteurized human milk ( 1859 infants ) , or whey hydrolysate formula ( 1737 infants ) . The comparison group ( 824 infants ) was composed of infants who were exclusively breast-fed . The infants were followed for 18 to 34 months for symptoms suggestive of CMA . The primary endpoint was a challenge-proven adverse reaction to CM after a successful CM elimination diet . RESULTS The cumulative incidence of CMA in the infants fed CM was 2.4 % compared with 1.7 % in the pasteurized human milk group ( odds ratio [ OR ] , 0.70 ; 95 % confidence interval [ CI ] , 0 . 44 - 1.12 ) and 1.5 % in the whey hydrolysate group ( OR , 0.61 ; 95 % CI , 0 . 38 - 1.00 ) . In the comparison group , CMA developed in 2.1 % of the infants . Among the infants who required supplementary feeding at hospital , both exposure to CM while in the hospital ( OR , 1.54 ; 95 % CI , 1.04 - 2.30 ; P = .03 ) and obvious parental atopy ( OR , 2.32 ; 95 % CI , 1.53 - 3.52 ; P < .001 ) increased the risk of CMA . CONCLUSIONS Our data indicate that feeding of CM at maternity hospitals increases the risk of CMA when compared with feeding of other supplements , but exclusive breast-feeding does not eliminate the risk BACKGROUND Hydrolyzed formulas used to feed infants with cow 's milk-allergy can be classified as soy based , extensively hydrolyzed ( casein , whey and mixed ) , and amino-acid based . Their unsatisfactory taste is reported by parents and physicians . OBJECTIVE The aim of this study was to ascertain the palatability of these formulas in a double-blind taste test . MATERIAL S AND METHODS Fifty healthy volunteers performed a r and omized-order double-blind test with 12 different milks .  The taste , smell , smell , and texture of each formula were evaluated o n scales ranging from 1 ( worst ) t o 5 ( best ) . The Pearson correlation coefficient between the peptide weight of each formula and the score obtained for each evaluated attribute was calculated . RESULTS The soy formulas and rice formula had the best taste scores , followed by the whey hydrolysates ; the mixed hydrolysates and the casein hydrolysates had the lowest taste scores . Individually the most palatable formula was mixed hydrolysate 1 , by total score . We found a statistically significant correlation between peptide weight , reflecting the degree of hydrolysis of each formula , and the scores obtained for taste , texture , and overall palatability . CONCLUSION The palatability of formulas is determined by the amount of bitter peptides obtained through hydrolysis . Flavorings and sweeteners may also contribute to palatability . Further studies are needed in order to determine how to modify the organoleptic properties of these products with the purpose of improving their palatability UNLABELLED B ACKGROUND : Feeding neonates with humanized milk formula in maternity hospitals may increase the prevalence of  milk allergy in infants . However , prospect i ve studies of the possible allergenic effect of very early soy-based formula feeding are lacking . OBJECTIVES To assess the prevalence of soy allergy in infants fed soy-based formula in the first 3 days of life . METHODS The study group included 982 healthy full-term infants born within a 7 month period at a hospital that routinely uses soy-based formula to supplement breastfeeding .  In-hospital feeding was recorded and the parents were interviewed once monthly over the next 6 months regarding feeding practice s and clinical symptoms suggesting soy allergy in the infant . RESULTS Ninety-nine percent of the infants received soy-based formula supplement in hospital , and 33%-42 % at home . No cases of immediate allergic reaction to soy or soy-induced enterocolitis were reported . CONCLUSIONS The use of soy-based formula in the early neonatal period does not apparently increase the prevalence of soy allergy in infants followed for the next 6 months Abstract Aim : To determine current treatment patterns for infants with cow milk allergy ( CMA ) and the associated re source implication s and budget impact , from the perspective of the UK 's National Health Service ( NHS ) . Methods : A computer-based model was constructed depicting current management of newly-diagnosed infants with CMA derived from patients suffering from this allergy in The Health Improvement Network ( THIN ) Data base . The model spanned a period of 12 months following initial presentation to a general practitioner ( GP ) and was used to estimate the 12-monthly healthcare cost ( at 2006/07 prices ) of treating an annual cohort of 18,350 infants from when they initially present to their GP . Results : Patients presenting with a combination of gastrointestinal and atopic symptoms accounted for 59 % of all patients . From the initial GP visit for CMA it took a mean 2.2 months to be put on diet , although treatment varied according to presenting symptoms . A total of 60 % of all infants were initially treated with soy , 18 % with an extensively hydrolysed formula and 3 % with an amino acid formula . A mean 9 % of patients remained symptomatic on soy and 29 % on an extensively hydrolysed formula . The total cost of managing CMA over the first 12 months following initial presentation to a GP was estimated to be £ 1,381 per patient and £ 25.6 million for an annual cohort of 18,350 infants . Limitations : Patients were not r and omised to treatment and re source use was not collected prospect ively . Nevertheless , 1,000 eligible patients have been included in the analysis , which should be a sufficiently large sample to accurately assess treatment patterns and healthcare re source use in actual clinical practice . The diagnosis of CMA may not be secure in all cases . Nevertheless , patients were diagnosed as having CMA by a clinician and have been managed by their GP as if they had CMA . Conclusion : CMA imposes a substantial burden on the NHS . Any strategy that improves healthcare delivery and thereby shortens time to treatment , time to diagnosis and time to symptom resolution should potentially decrease the burden this allergy imposes on the health service and release re sources for alternative use OBJECTIVES We conducted a prospect i ve , r and omized study to evaluate the cumulative incidence of allergy or other adverse reactions to soy formula and to extensively hydrolyzed formula up to the age of 2 years in infants with confirmed cow 's milk allergy . STUDY DESIGN Infants ( n = 170 ) with documented cow 's milk allergy were r and omly assigned to receive either a soy formula or an extensively hydrolyzed formula . If it was suspected that the formula caused symptoms , a double-blind , placebo-controlled challenge ( DBPCFC ) with the formula was performed . The children were followed to the age of 2 years , and soy-specific immunoglobulin E antibodies were measured at the time of diagnosis and at the ages of 1 and 2 years . RESULTS An adverse reaction to the formula was confirmed by challenge in 8 patients ( 10 % ; 95 % confidence interval , 4.4%-18.8 % ) r and omly assigned to soy formula and in 2 patients ( 2.2 % ; 95 % confidence interval , 0.3 % to 7.8 % ) r and omly assigned to extensively hydrolyzed formula .  Adverse reactions to soy were similar in IgE-associated and non-IgE-associated cow 's milk allergy ( 11 % and 9 % , respectively ) . IgE to soy was detected in only 2 infants with an adverse reaction to soy . Adverse reactions to soy formula  were more common in younger ( < 6 months ) than in older ( 6 to 12 months ) infants ( 5 of 20 vs 3 of 60 , respectively , P = .01 ) . CONCLUSIONS Soy formula was well tolerated by most infants with IgE-associated and non-IgE-associated cow 's milk allergy . Development of IgE-associated allergy to soy was rare . Soy formula can be recommended as a first-choice alternative for infants > or=6 months of age with cow 's milk allergy 
    Output:
    
agent
They support SIF 's  efficacy in the management of cow 's milk allergy and infant 's digestive tolerance , as well as its low cross allergy compared to cow 's milk and other formulas .
There is also evidence that demonstrates that SIFs have important advantages in terms of cost-benefit , palatability and effects on the intestinal microbiota , compared to other formulas .
Conclusions Although evidence to recommend its use in functional digestive disorders is limited , SIFs have an adequate safety profile and are still a valid option for infant feeding
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of this r and omized study was to determine if fiber-supplemented soy formula reduced regurgitation in young infants . We compared regurgitation in 179 infants r and omly assigned cow ’s milk-based ( CM , 90 ) formula or soy formula with fiber ( SF , 89 ) .  Initial daily incidence was similar ( CM , 3.6 ; SF , 3.9 episodes ) , but significantly lower after 7 days on SF ( CM , 3.4 ; SF , 2.3 ; p = 0.001 ) . Less frequent regurgitation after 7 days on SF was sustained after 28 days ( CM , 48 % ; SF , 31 % of feedings ; p = 0.001 ) . Feeding SF effectively managed regurgitation while providing balanced nutrition without altering caloric distribution as occurs with adding rice cereal to formula Purpose The use of soy products is common in young children with cow milk allergy ( CMA ) . The aim was to examine prospect ively the association between infantile consumption of soy-based formula , growth parameters and early pubertal signs , in comparison to cow milk-based formula . Methods A nested case – control study was conducted , selected from a cohort of infants prospect ively followed from birth until the age of 3 years for eating habits and the development of IgE-mediated CMA . Infants who consumed only soy-based formula  were included in the soy group . The control group was r and omly selected from those without IgE-CMA and not receiving soy formula . Study participants were reevaluated between ages 7.8 and 10.5 years by an interview , nutritional intake by 3 days diaries , and height , weight , and pubertal signs by physical examination . Results The  soy-fed group included 29 participants ( 17 males ) , median age 8.92 years IQR ( 8.21 , 9.42 ) . The control group included 60 participants ( 27 males ) , median age 8.99 years IQR ( 8.35 , 9.42 ) . The groups had comparable height and BMI z scores ( − 0.17 ± 1.08 versus − 0.16 ± 1.01 , p = 0.96 , and 0.67 ± 1.01 versus 0.53 ± 1.02 , p = 0.56 , for soy and control groups , respectively ) . Four ( three males and one female ) from the soy-group ( 13.8 % ) and eight females from the control-group ( 13.3 % ) had early pubertal signs ( p = 0.95 ) . No association was detected between puberty and infantile nutrition , after controlling for BMI and family data . No association with puberty or differences between groups were found in current daily consumption  of soy , micronutrients , energy , carbohydrates , fat , and protein . Conclusions This is the first prospect i ve , physical examination-based study , demonstrating no association between infantile soy-based formula consumption and growth and puberty parameters BACKGROUND Early feeding with cow 's milk ( CM ) may increase the risk of cow 's milk allergy ( CMA ) . OBJECTIVE We sought to examine prospect ively whether supplementary feeding of CM at the maternity hospital would increase the risk when compared with feeding with pasteurized human milk or hydrolyzed formula . METHODS We studied 6209 unselected healthy , full-term infants , of whom 5385 ( 87 % ) required supplementary milk while in the hospital . The infants were r and omly assigned to receive CM formula ( 1789 infants ) , pasteurized human milk ( 1859 infants ) , or whey hydrolysate formula ( 1737 infants ) . The comparison group ( 824 infants ) was composed of infants who were exclusively breast-fed . The infants were followed for 18 to 34 months for symptoms suggestive of CMA . The primary endpoint was a challenge-proven adverse reaction to CM after a successful CM elimination diet . RESULTS The cumulative incidence of CMA in the infants fed CM was 2.4 % compared with 1.7 % in the pasteurized human milk group ( odds ratio [ OR ] , 0.70 ; 95 % confidence interval [ CI ] , 0 . 44 - 1.12 ) and 1.5 % in the whey hydrolysate group ( OR , 0.61 ; 95 % CI , 0 . 38 - 1.00 ) . In the comparison group , CMA developed in 2.1 % of the infants . Among the infants who required supplementary feeding at hospital , both exposure to CM while in the hospital ( OR , 1.54 ; 95 % CI , 1.04 - 2.30 ; P = .03 ) and obvious parental atopy ( OR , 2.32 ; 95 % CI , 1.53 - 3.52 ; P < .001 ) increased the risk of CMA . CONCLUSIONS Our data indicate that feeding of CM at maternity hospitals increases the risk of CMA when compared with feeding of other supplements , but exclusive breast-feeding does not eliminate the risk BACKGROUND Hydrolyzed formulas used to feed infants with cow 's milk-allergy can be classified as soy based , extensively hydrolyzed ( casein , whey and mixed ) , and amino-acid based . Their unsatisfactory taste is reported by parents and physicians . OBJECTIVE The aim of this study was to ascertain the palatability of these formulas in a double-blind taste test . MATERIAL S AND METHODS Fifty healthy volunteers performed a r and omized-order double-blind test with 12 different milks .  The taste , smell , smell , and texture of each formula were evaluated o n scales ranging from 1 ( worst ) t o 5 ( best ) . The Pearson correlation coefficient between the peptide weight of each formula and the score obtained for each evaluated attribute was calculated . RESULTS The soy formulas and rice formula had the best taste scores , followed by the whey hydrolysates ; the mixed hydrolysates and the casein hydrolysates had the lowest taste scores . Individually the most palatable formula was mixed hydrolysate 1 , by total score . We found a statistically significant correlation between peptide weight , reflecting the degree of hydrolysis of each formula , and the scores obtained for taste , texture , and overall palatability . CONCLUSION The palatability of formulas is determined by the amount of bitter peptides obtained through hydrolysis . Flavorings and sweeteners may also contribute to palatability . Further studies are needed in order to determine how to modify the organoleptic properties of these products with the purpose of improving their palatability UNLABELLED B ACKGROUND : Feeding neonates with humanized milk formula in maternity hospitals may increase the prevalence of  milk allergy in infants . However , prospect i ve studies of the possible allergenic effect of very early soy-based formula feeding are lacking . OBJECTIVES To assess the prevalence of soy allergy in infants fed soy-based formula in the first 3 days of life . METHODS The study group included 982 healthy full-term infants born within a 7 month period at a hospital that routinely uses soy-based formula to supplement breastfeeding .  In-hospital feeding was recorded and the parents were interviewed once monthly over the next 6 months regarding feeding practice s and clinical symptoms suggesting soy allergy in the infant . RESULTS Ninety-nine percent of the infants received soy-based formula supplement in hospital , and 33%-42 % at home . No cases of immediate allergic reaction to soy or soy-induced enterocolitis were reported . CONCLUSIONS The use of soy-based formula in the early neonatal period does not apparently increase the prevalence of soy allergy in infants followed for the next 6 months Abstract Aim : To determine current treatment patterns for infants with cow milk allergy ( CMA ) and the associated re source implication s and budget impact , from the perspective of the UK 's National Health Service ( NHS ) . Methods : A computer-based model was constructed depicting current management of newly-diagnosed infants with CMA derived from patients suffering from this allergy in The Health Improvement Network ( THIN ) Data base . The model spanned a period of 12 months following initial presentation to a general practitioner ( GP ) and was used to estimate the 12-monthly healthcare cost ( at 2006/07 prices ) of treating an annual cohort of 18,350 infants from when they initially present to their GP . Results : Patients presenting with a combination of gastrointestinal and atopic symptoms accounted for 59 % of all patients . From the initial GP visit for CMA it took a mean 2.2 months to be put on diet , although treatment varied according to presenting symptoms . A total of 60 % of all infants were initially treated with soy , 18 % with an extensively hydrolysed formula and 3 % with an amino acid formula . A mean 9 % of patients remained symptomatic on soy and 29 % on an extensively hydrolysed formula . The total cost of managing CMA over the first 12 months following initial presentation to a GP was estimated to be £ 1,381 per patient and £ 25.6 million for an annual cohort of 18,350 infants . Limitations : Patients were not r and omised to treatment and re source use was not collected prospect ively . Nevertheless , 1,000 eligible patients have been included in the analysis , which should be a sufficiently large sample to accurately assess treatment patterns and healthcare re source use in actual clinical practice . The diagnosis of CMA may not be secure in all cases . Nevertheless , patients were diagnosed as having CMA by a clinician and have been managed by their GP as if they had CMA . Conclusion : CMA imposes a substantial burden on the NHS . Any strategy that improves healthcare delivery and thereby shortens time to treatment , time to diagnosis and time to symptom resolution should potentially decrease the burden this allergy imposes on the health service and release re sources for alternative use OBJECTIVES We conducted a prospect i ve , r and omized study to evaluate the cumulative incidence of allergy or other adverse reactions to soy formula and to extensively hydrolyzed formula up to the age of 2 years in infants with confirmed cow 's milk allergy . STUDY DESIGN Infants ( n = 170 ) with documented cow 's milk allergy were r and omly assigned to receive either a soy formula or an extensively hydrolyzed formula . If it was suspected that the formula caused symptoms , a double-blind , placebo-controlled challenge ( DBPCFC ) with the formula was performed . The children were followed to the age of 2 years , and soy-specific immunoglobulin E antibodies were measured at the time of diagnosis and at the ages of 1 and 2 years . RESULTS An adverse reaction to the formula was confirmed by challenge in 8 patients ( 10 % ; 95 % confidence interval , 4.4%-18.8 % ) r and omly assigned to soy formula and in 2 patients ( 2.2 % ; 95 % confidence interval , 0.3 % to 7.8 % ) r and omly assigned to extensively hydrolyzed formula .  Adverse reactions to soy were similar in IgE-associated and non-IgE-associated cow 's milk allergy ( 11 % and 9 % , respectively ) . IgE to soy was detected in only 2 infants with an adverse reaction to soy . Adverse reactions to soy formula  were more common in younger ( < 6 months ) than in older ( 6 to 12 months ) infants ( 5 of 20 vs 3 of 60 , respectively , P = .01 ) . CONCLUSIONS Soy formula was well tolerated by most infants with IgE-associated and non-IgE-associated cow 's milk allergy . Development of IgE-associated allergy to soy was rare . Soy formula can be recommended as a first-choice alternative for infants > or=6 months of age with cow 's milk allergy 
    Output:
    