{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:53:15Z","timestamp":1791359595956,"version":"4.3.1"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100013342","name":"NIHR Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Experimental Allergy"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infants with non\u2010specific symptoms are sometimes labelled as cow's milk allergic and managed with specialized formula. These products differ from standard infant formula in protein and carbohydrate source, typically containing lower quality protein and free\/added sugars such as glucose polymers or sucrose. We evaluated the frequency, timing, duration and estimated volume of specialized formula prescribed to young children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We undertook a retrospective population\u2010based cohort study of children up to age 2\u2009years born between 2009 and 2021 who were registered with a contributing UK general practice, predominantly in England. Community prescribing and demographic data were obtained from the Clinical Practice Research Datalink (CPRD) Aurum, a de\u2010identified primary care database representing approximately 24% of the population. National prescribing data for England were used to estimate community prescribing rates for 2022\u20132025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 4,203,276 children born between 2009\u20132021 in the database, 1,944,323 (46.3%) were registered by age 3\u2009months with complete data to age 2\u2009years and were included. Of these, 111,478 (5.7%) were prescribed specialized formula, rising from 1.7% of children born in 2009 to 7.9% in 2021 and an estimated 9.7% in 2025. Prescriptions were most commonly initiated at age 0\u20132\u2009months. Multiple prescriptions were documented for 85,370 (76.6%) of these children. Children with multiple amino\u2010acid formula prescriptions consumed an estimated mean total of 242\u2009L; those with multiple extensively hydrolysed formula prescriptions 203\u2009L; and those with multiple soya formula prescriptions 137\u2009L. Among these children, the median interval between first and last prescription was 257\u2009days for amino\u2010acid formula, 213\u2009days for extensively hydrolysed formula and 152\u2009days for soya formula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Community prescribing of specialized formula in England increased approximately five\u2010fold over the study period, potentially triggering significant free sugars exposure during infancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cea.70447","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:31:07Z","timestamp":1791358267000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Frequency and Timing of Specialized Formula Prescriptions for Children Under 2\u2009Years"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7476-0932","authenticated-orcid":false,"given":"Nikita","family":"Punjabi","sequence":"first","affiliation":[{"name":"School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Cunningham","sequence":"additional","affiliation":[{"name":"School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3664-8100","authenticated-orcid":false,"given":"Kimberley","family":"Foley","sequence":"additional","affiliation":[{"name":"School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9838-3625","authenticated-orcid":false,"given":"Frank","family":"Moriarty","sequence":"additional","affiliation":[{"name":"School of Pharmacy and Biomolecular Sciences RCSI University of Medicine and Health Sciences  Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3787-2083","authenticated-orcid":false,"given":"Sonia","family":"Saxena","sequence":"additional","affiliation":[{"name":"School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0149-4869","authenticated-orcid":false,"given":"Jennifer K.","family":"Quint","sequence":"additional","affiliation":[{"name":"School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dougal","family":"Hargreaves","sequence":"additional","affiliation":[{"name":"School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4913-7580","authenticated-orcid":false,"given":"Robert J.","family":"Boyle","sequence":"additional","affiliation":[{"name":"School of Public Health Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"issue":"1","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1111\/all.16203","article-title":"Prevalence and Risk Factors for Milk Allergy Overdiagnosis in the BEEP Trial Cohort","volume":"80","author":"Allen H. I.","year":"2025","journal-title":"Allergy"},{"key":"e_1_2_10_3_1","first-page":"e07074","article-title":"Tolerable Upper Intake Level for Dietary Sugars","volume":"20","author":"Turck D.","year":"2022","journal-title":"EFSA Journal. European Food Safety Authority"},{"key":"e_1_2_10_4_1","volume-title":"Guideline: Sugars Intake for Adults and Children","author":"WHO Guidelines Approved by the Guidelines Review Committee","year":"2015"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1111\/cea.14570","article-title":"Time Trends, Regional Variation and Associations of Low\u2010Allergy Formula Prescribing in England","volume":"54","author":"Li K. H. T.","year":"2024","journal-title":"Clinical and Experimental Allergy"},{"issue":"7","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/cea.14180","article-title":"Trends in Use of Specialised Formula for Managing Cow's Milk Allergy in Young Children","volume":"52","author":"Mehta S.","year":"2022","journal-title":"Clinical and Experimental Allergy"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/cea.14275","article-title":"Trends in Specialized Low\u2010Allergy Infant Formula Dispensing in Ireland: 2016\u20102021","volume":"53","author":"O'Reilly D.","year":"2023","journal-title":"Clinical and Experimental Allergy"},{"key":"e_1_2_10_8_1","volume-title":"CPRD Aurum June 2024 Dataset","author":"Clinical Practice Research Datalink","year":"2024"},{"issue":"6","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1093\/ije\/dyz034","article-title":"Data Resource Profile: Clinical Practice Research Datalink (CPRD) Aurum","volume":"48","author":"Wolf A.","year":"2019","journal-title":"International Journal of Epidemiology"},{"key":"e_1_2_10_10_1","unstructured":"Specialized Formulas: Infant and Child British National Formulary for Children. NICE."},{"key":"e_1_2_10_11_1","unstructured":"Births in England and Wales: Summary Tables. Office for National Statistics."},{"issue":"6725","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1126\/science.adn5421","article-title":"Exposure to Sugar Rationing in the First 1000\u2009Days of Life Protected Against Chronic Disease","volume":"386","author":"Gracner T.","year":"2024","journal-title":"Science"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"e083890","DOI":"10.1136\/bmj-2024-083890","article-title":"Exposure to Sugar Rationing in First 1000\u2009Days After Conception and Long Term Cardiovascular Outcomes: Natural Experiment Study","volume":"391","author":"Zheng J.","year":"2025","journal-title":"BMJ"},{"issue":"8","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1111\/all.12630","article-title":"Incidence and Natural History of Challenge\u2010Proven Cow's Milk Allergy in European Children: EuroPrevall Birth Cohort","volume":"70","author":"Schoemaker A. A.","year":"2015","journal-title":"Allergy"},{"issue":"4","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1111\/cdev.13760","article-title":"Crying in the First 12 Months of Life: A Systematic Review and Meta\u2010Analysis of Cross\u2010Country Parent\u2010Reported Data and Modeling of the \u201cCry Curve\u201d","volume":"93","author":"Vermillet A. Q.","year":"2022","journal-title":"Child Development"},{"issue":"1","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1111\/cea.14060","article-title":"Frequency of Guideline\u2010Defined Cow's Milk Allergy Symptoms in Infants: Secondary Analysis of EAT Trial Data","volume":"52","author":"Vincent R.","year":"2022","journal-title":"Clinical and Experimental Allergy"},{"issue":"9","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"1636","DOI":"10.1017\/S136898001800085X","article-title":"A Definition of Free Sugars for the UK","volume":"21","author":"Swan G. E.","year":"2018","journal-title":"Public Health Nutrition"},{"issue":"18","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"2414","DOI":"10.1001\/jama.287.18.2414","article-title":"The Glycemic Index: Physiological Mechanisms Relating to Obesity, Diabetes, and Cardiovascular Disease","volume":"287","author":"Ludwig D. S.","year":"2002","journal-title":"Journal of the American Medical Association"},{"issue":"3","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s40368-016-0228-x","article-title":"The Cariogenicity of Commercial Infant Formulas: A Systematic Review","volume":"17","author":"Tan S. F.","year":"2016","journal-title":"European Archives of Paediatric Dentistry"},{"issue":"4","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1093\/ajcn\/nqac173","article-title":"Lactose\u2010Reduced Infant Formula With Corn Syrup Solids and Obesity Risk Among Participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)","volume":"116","author":"Anderson C. E.","year":"2022","journal-title":"American Journal of Clinical Nutrition"},{"key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"111807","DOI":"10.1016\/j.mehy.2025.111807","article-title":"Integration of Parenteral Nutrition With Galactose May Improve Neurodevelopmental Outcomes for Preterm Newborns","volume":"205","author":"Panfoli I.","year":"2025","journal-title":"Medical Hypotheses"},{"issue":"4","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1093\/ajcn\/nqac191","article-title":"Weight Gain Acceleration by Glucose\u2010Based Infant Formula","volume":"116","author":"Brand\u2010Miller J. C.","year":"2022","journal-title":"American Journal of Clinical Nutrition"},{"issue":"7","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1001\/jama.2026.0283","article-title":"The 2025\u20132030 Dietary Guidelines for Americans","volume":"335","author":"Mozaffarian D.","year":"2026","journal-title":"Journal of the American Medical Association"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2011.212563.25"}],"container-title":["Clinical &amp; Experimental Allergy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cea.70447","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cea.70447","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cea.70447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T07:31:11Z","timestamp":1791358271000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cea.70447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":23,"alternative-id":["10.1111\/cea.70447"],"URL":"https:\/\/doi.org\/10.1111\/cea.70447","archive":["Portico"],"relation":{},"ISSN":["0954-7894","1365-2222"],"issn-type":[{"value":"0954-7894","type":"print"},{"value":"1365-2222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"assertion":[{"value":"2026-03-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"cea.70447"}}