Hydrolyzed rice protein formulas for cow's milk allergy in infants
What it found
In infants with cow's milk protein allergy, hydrolyzed rice protein formulas were well tolerated by at least 90% of children and supported normal growth.
The evidence comes from a small number of clinical studies, mostly short and in small groups.
What they found
Studies in people
Tolerance in allergic children
In studies that included children with cow's milk protein allergy, the hydrolyzed rice protein formulas were well tolerated by at least 90% of the children. Two studies included both IgE-mediated and non-IgE-mediated allergy.
Growth in infants
Seven studies looked at growth in infants fed hydrolyzed rice protein formulas. Overall, healthy children grew appropriately, and those with cow's milk protein allergy showed catch-up growth. The studies were small and relatively short.
Digestive tolerance
In healthy infants, digestive tolerance was good and similar to a standard cow's milk formula. Infants fed the rice formula tended to have less regurgitation and vomiting. In infants with cow's milk protein allergy, one study found no adverse effects, and stool normalization improved over three months, though that was an observational study.
Bone mineralization markers
Two studies found similar plasma levels of calcium, magnesium, and alkaline phosphatase in healthy children receiving either the rice formula or a standard formula. These are only indirect markers of bone health, and no study has looked at fracture rates or bone density.
Animal and lab studies
Allergenicity in animals
In 130 young guinea pigs fed either a hydrolyzed rice formula or a standard cow's milk formula for 37 days, those fed the rice formula had significantly fewer reactions after injection with cow's milk proteins. No reaction occurred after injection with the rice formula itself, and only two benign reactions occurred with rice protein.
Studies in people and animals
Acceptability and palatability
Overall acceptance was good in several studies. In one study, 18.8% of parents felt their infant did not like the formula, leading 3 of 40 infants to drop out. A double-blind study in 50 adults found rice and soy formulas tasted better than several cow's milk hydrolysates, and in children rice formula was preferred over cow's milk hydrolysate.
What the authors conclude
“Based on the current evidence, they seem appropriate to restore a normal growth and may be used as a first choice during CMPA.”
Also in their conclusions
- They conclude that hydrolyzed rice protein formulas are a valuable option for feeding infants with cow's milk protein allergy in some countries.
- They state that based on current evidence, these formulas seem appropriate to restore normal growth and may be used as a first choice during cow's milk protein allergy.
- They note that evidence is lacking on long-term use, especially for bone mineralization, on the acquisition of tolerance, and on their place in complex conditions such as allergy to hydrolysates and multiple food allergy.
How it was done
The authors wanted to better understand hydrolyzed rice protein formulas, including how rice proteins are made, whether they suit children with cow's milk protein allergy, and whether they support normal growth. Their goal was to help health care professionals advise on using these formulas.
They reviewed published studies on hydrolyzed rice protein formulas, including clinical trials in infants and children with cow's milk protein allergy, studies in healthy infants, and one animal study in guinea pigs. The number of studies was limited, and most were small and of short duration.
What it can’t tell you
- The studies in children were small and of short duration, so they cannot show what happens over the long term.
- No study has looked at bone density, fracture rates, or mineral absorption from these formulas.
- The animal study in guinea pigs cannot show what happens in infants.
Who paid
- Conflicts
- All authors, except Anna Essex (Sodilac employee) received honoraria for a Scientific Advisory Board, held on 15 February 2020.
- Authors work at
- Paris-Descartes University, France; APHP Necker-Enfants Malades Hospital, France; Franche-Comté University, France
The paper
- Title
- Hydrolyzed Rice Protein-Based Formulas, a Vegetal Alternative in Cow's Milk Allergy
- Type
- ReviewThe authors read earlier studies and describe what they found. It isn’t a new study.
- Evidence
- Studies in people · animals · lab
- Summarised from
- Full text
- Cite
- Dupont C, Bocquet A, Tomé D, et al (2020). Hydrolyzed Rice Protein-Based Formulas, a Vegetal Alternative in Cow's Milk Allergy. Nutrients. doi:10.3390/nu12092654Free full textPubMed 32878135DOI
Summary written 26 Sep 2026. Check it against the paper before it changes what you eat. How we summarise papers · Report an error