A significant position paper was published today (Sunday) by the Israeli Association of Allergy and Clinical Immunology - warning that temporary feeding with cow's milk-based infant formula (IMF) in the first few days of life may increase the risk of developing a milk allergy.

The position paper is based on several  medical studies published in recent years, and the recommendations of the European Academy of Allergy and Clinical Immunology (EAACI). the paper is directed at medical teams in neonatal units, new mothers, expectant parents, the medical community, and the general public, focusing on the feeding of newborns in the first days after birth.

Cow's milk protein allergy (CMPA) is one of the most common food allergies in infancy. Over the past few decades, the incidence of food allergies in general, and CMPA specifically, has increased. The data is clear: the prevalence of CMPA among young children in Israel at the beginning of the 2000s was between 0.3% to 0.5%, but it is now estimated to be between 0.85% and 1% - more than a twofold increase, in just two decades.

While CMPA often resolves in early childhood (in 60%-70% of cases), its health implications are significant, even in cases that resolve early, and especially for those who remain allergic into adolescence and adulthood. CMPA can lead to nutritional deficiencies during growth and development, which may impact height potential in adulthood and reduce bone density. Additionally, CMPA is responsible for the majority of life-threatening allergic reactions in Israel. Given these health implications, the risk of severe allergic reactions, and the impact on quality of life, primary prevention of CMPA is critically important.

The World Health Organization (WHO) recommends that infants be exclusively breastfed from the first hour of life and continue breastfeeding exclusively (without additional foods or fluids, including water) for at least six months. However, a recent study conducted in Israel found that while the majority of new mothers (96%) believed their infants were exclusively breastfed from birth, the majority of infants (55%) actually received additional cow's milk-based formula during this period - while in the hospital.

Furthermore, several studies published in recent years have demonstrated that infants who were fed cow's milk-based formula in the first days of life, even in small amounts, and were then exclusively breastfed, developed milk allergies at a higher rate than infants who were exclusively breastfed from birth or who were consistently fed a combination of breastfeeding and formula.

The 2021 guidelines from the European Academy of Allergy and Clinical Immunology, along with accompanying clarifications, suggest avoiding the temporary addition of cow's milk-based formula in the first week after birth to prevent the development of milk allergies. Recent studies in Israel have confirmed these findings and support the recommendations of the European Academy. The accumulated conclusions indicate that temporary feeding of infants with cow's milk-based formula in the first days of life, even in small amounts, followed by exclusive breastfeeding, may increase the risk of developing a milk allergy.

In light of this, to reduce the risk of infants developing CMPA, the Israeli Association of Allergy and Clinical Immunology recommends:

1. Mothers who intend to exclusively breastfeed should avoid giving their infants cow's milk-based formula in the first days of life.
2. If the infant received small amounts of cow's milk-based formula in the first days of life, regular supplementation with the formula a few times a week, in parallel with breastfeeding, may reduce the risk of developing a milk allergy.

The position paper is endorsed by members of the Israeli Association of Allergy and Clinical Immunology: Chairman, Prof. Arnon Elitzur (Shamir Medical Center - Assaf Harofeh), former Chairman Prof. Alon Hershko (Hadassah Medical Center), Secretary of the Association Prof. Yuval Tal (Hadassah Medical Center), Prof. Ilan Dalal (Wolfson Medical Center), Prof. Avraham Beigelman (Schneider Children's Medical Center), Dr. Idit Lahover Roth (Meir Medical Center), Dr. Ramit Maoz-Segal (Sheba Medical Center), and Prof. Aharon Kesel (Bnei Zion Medical Center).

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Food allergies affect approximately 8% of children who, together with their families, struggle not only with uncomfortable symptoms, but often with social and lifestyle difficulties in accommodating the allergies, as well.

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Now Israeli Medtech startup MYOR plans to launch its solution to identify high-allergy risk infants and provide guidelines for prevention and care in the US in conjunction with a Denver-based healthcare provider.

MYOR's NURTURE Precision Infant Care platform harnesses newborns' data and use it as the basis of a highly accurate allergy-prediction tool. According to the company, this technology, combined with NURTURE's comprehensive web-based preventive care plan, allows caregivers and health professionals in their battle to help alleviate the burdens of childhood allergies.

According to MYOR CEO Idan Katz, "Caregivers across the country will be able to take control of the future of their children's allergies and sleep better at night. MYOR is proud to help bring together families, healthcare providers, and technology in order to achieve this."

MYOR is launching its NURTURE Precision Infant Care platform in conjunction with Horizon Pediatrics and Primary Care in Denver, but a growing number of participating clinics across the US will soon be offering the platform to parents when the bring their babies in for their first well-baby visits.

Parents and guardians wishing to participate fill out a short questionnaire while their baby undergoes a painless, fast non-invasive skin test.

Parents of children identified as "at-risk" will then be invited to join The NURTURE Program, which uses artificial intelligence (AI) to generate a personalized care plan. Caregivers then gain access to the platform, which offers them customized advice on managing their newborn's risk and well as recipes and other guidance. Their NUTURE membership will also offer them specifically formulated nutritional and dermatological products.

Dr. Isaac Melamed, an allergy specialist and the medical director of Horizon Pediatrics, said,  "NURTURE is an ideal offering for our patients and complements our vision to provide the best healthcare service available today. We have long understood that allergic conditions should be addressed before they emerge. Finally, we have a product that helps us to do so."

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Hezbollah leader Sheikh Hassan Nasrallah is scheduled to give a speech Tuesday afternoon, the Hezbollah-affiliated TV station Al Manar reported Thursday.

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The official reason for Nasrallah's scheduled appearance is to mark 30 years since the station was founded, but it appears likely that the speech is really intended to put to rest rumors that his health is poor, which have been circulating since a previous speech was interrupted by his own coughing.

In a speech last week marking the anniversary of the IDF's withdrawal from the security zone in southern Lebanon, Nasrallah appeared weak and was having difficulty breathing. He told viewers that "enemies of Hezbollah" would use the appearance of illness against him.

A few social media users shared reported that Nasrallah's health was deteriorating, and some even shared one report that he was in a coma. These rumors met with denials from Hezbollah. Nasrallah's deputy, Naim Qassem, stressed that Nasrallah was in good condition and needed only a day or two to recover from a minor illness. Another Hezbollah official who spoke to the Lebanese newspaper An-Nahar also claimed that Nasrallah was in good health.

Last week, Israel Hayom reported that journalists and media figures from Lebanon and the rest of the Arab world who follow Hezbollah were insisting that Nasrallah's apparent ill health was the result of seasonal allergies. They said that the Hezbollah leader always suffers from allergies in April and May, and his symptoms have nothing to do with a chronic disease he reportedly has, or with the COVID virus.

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