婴幼儿牛奶过敏管理专用配方使用趋势。
Trends in use of specialized formula for managing cow's milk allergy in young children.
机构信息
National Heart and Lung Institute, Imperial College London, London, UK.
Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
出版信息
Clin Exp Allergy. 2022 Jul;52(7):839-847. doi: 10.1111/cea.14180.
BACKGROUND
Excessive use of specialized formula for cow's milk allergy was reported in England, but complete analysis has not been undertaken and trends in other countries are unknown. Some specialized formula products, especially amino-acid formula (AAF), have high free sugars content. We evaluated specialized formula trends in countries with public databases documenting national prescription rates.
METHODS
Cross-sectional analysis of national prescription databases in the United Kingdom, Norway and Australia. Outcomes were volume and cost of specialized formula, and proportion of infants prescribed specialized formula. Expected volumes assumed 1% cow's milk allergy incidence and similar formula feeding rates between infants with and without milk allergy.
RESULTS
Prescribed volumes of specialized formula for infants rose 2.8-fold in England from 2007 to 2018, with similar trends in other regions of the United Kingdom. Volumes rose 2.2-fold in Norway from 2009 to 2020 and 3.2-fold in Australia from 2001 to 2012. In 2020, total volumes were 9.7- to 12.6-fold greater than expected in England, 8.3- to 15.6-fold greater than expected in Norway and 3.3- to 4.5-fold greater than expected in Australia, where prescribing restrictions were introduced in 2012. In Norway, the proportion of infants prescribed specialized formula increased from 2.2% in 2009 to 6.9% in 2020, or 11.2- to 13.3-fold greater than expected. In 2020, specialized formula for infants cost US$117 (103 euro) per birth in England, US$93 (82 euro) in Norway and US$27 (23 euro) in Australia. Soya formula prescriptions exceeded expected volumes 5.5- to 6.4-fold in England in 1994 and subsequently declined, co-incident with public health concerns regarding soya formula safety. In 2020, 30%-50% of prescribed specialized formula across the three countries was AAF.
CONCLUSIONS
In England, Norway and Australia, specialized formula prescriptions increased in the early 21st century and exceeded expected levels. Unnecessary specialized formula use may make a significant contribution to free sugars consumption in young children.
背景
据报道，英国过度使用了针对牛奶过敏的特殊配方，但尚未进行全面分析，且其他国家的趋势尚不清楚。一些特殊配方产品，特别是氨基酸配方（AAF），含有较高的游离糖。我们评估了有国家处方数据库记录国家处方率的国家的特殊配方趋势。
方法
对英国、挪威和澳大利亚的国家处方数据库进行横断面分析。结果为特殊配方的数量和成本，以及有和无牛奶过敏的婴儿服用特殊配方的比例。预期数量假设 1%的牛奶过敏发生率和有和无牛奶过敏的婴儿之间类似的配方喂养率。
结果
英格兰的婴儿特殊配方的处方量从 2007 年到 2018 年增加了 2.8 倍，英国其他地区也呈现出类似的趋势。2009 年至 2020 年，挪威的处方量增加了 2.2 倍，2001 年至 2012 年，澳大利亚的处方量增加了 3.2 倍。2020 年，英格兰的实际处方量比预期高出 9.7 至 12.6 倍，挪威的实际处方量比预期高出 8.3 至 15.6 倍，澳大利亚的实际处方量比预期高出 3.3 至 4.5 倍，而澳大利亚于 2012 年引入了处方限制。在挪威，2009 年有 2.2%的婴儿被处方特殊配方，到 2020 年增至 6.9%，即比预期高出 11.2 至 13.3 倍。2020 年，英格兰每出生一名婴儿的婴儿特殊配方费用为 117 美元（103 欧元），挪威为 93 美元（82 欧元），澳大利亚为 27 美元（23 欧元）。1994 年，英国的大豆配方处方量超过预期的 5.5 至 6.4 倍，此后下降，恰逢公众对大豆配方安全性的担忧。2020 年，三个国家有 30%至 50%的处方特殊配方为 AAF。
结论
在英国、挪威和澳大利亚，21 世纪初特殊配方的处方量增加，并超过了预期水平。不必要的特殊配方使用可能会使幼儿的游离糖摄入量显著增加。
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