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The application of synbiotics (specific pre\u2010 and probiotics) in extensively hydrolyzed formulae (eHFs) is a relatively new concept.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate a synbiotic\u2010containing, whey\u2010based eHF (SeHF) with galacto\u2010oligosaccharides, fructo\u2010oligosaccharides, and bifidobacterium breve M\u201016V in infants with CMA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A 31\u2010day one\u2010arm pilot study in 29 infants with CMA (mean age 30.8 weeks [SD 11]) was undertaken, with outcomes including gastrointestinal tolerance, atopic dermatitis symptoms, dietary intake, growth, SeHF acceptability, caregiver quality of life, and hospital\u2010related healthcare use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Significant improvements (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) in the severity of abdominal pain (in 57%), burping (in 46%), flatulence (in 79%), constipation (in 14%), rhinitis (41%), and itchy eyes (73%), as well as atopic dermatitis in those with severe baseline symptoms (PO\u2010SCORAD<jats:sup>\u00a9<\/jats:sup>reduction: 34.7\u201318.2 (<jats:italic>p<\/jats:italic>\u2009=\u2009.003),<jats:italic>n<\/jats:italic>\u2009=\u20096) were observed over time. Growth and caregiver quality of life scores significantly increased (+26.7%,<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05) over time. Hospital visits and medications significantly reduced (\u22121.61 and \u22122.23, respectively,<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.005) in the 6 months after SeHF initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>In this small, single\u2010arm, pilot study, the use of SeHF enhanced the management of infants with non\u2010IgE mediated CMA who were already established on eHF. Conclusion: Whilst this study adds to the evidence base for the use of SeHF in CMA, further robust research to explore the longer\u2010term benefits of synbiotics, specifically the blend used in this study, for the clinical management of infants with CMA is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/iid3.636","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T12:32:30Z","timestamp":1652963550000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Synbiotic containing extensively hydrolyzed formula improves gastrointestinal and atopic symptom severity, growth, caregiver quality of life, and hospital\u2010related healthcare use in infants with cow's milk allergy"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6029-6446","authenticated-orcid":false,"given":"Gary P.","family":"Hubbard","sequence":"first","affiliation":[{"name":"Nutricia Ltd 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