Alternative Milk Options for Infants with Cow's Milk Allergy: A Systematic Review of Goat's Milk, Plant-Based Milk, and Partially Hydrolyzed Protein

Wija, Ida Bagus Eka Utama and Angelica, Chatrine and Hardiyani, Kartika and Felicia, Mildi and Sirait, Gogma Firmansyah and Nandya, Galuh and Tampubolon, Christine Handayani (2025) Alternative Milk Options for Infants with Cow's Milk Allergy: A Systematic Review of Goat's Milk, Plant-Based Milk, and Partially Hydrolyzed Protein. KESANS: International Journal of Health and Science, 4 (12). pp. 1081-1089. ISSN 2808-7178

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Abstract

Cow's milk allergy (CMA) is the most common food allergy occurring in the first year of life. Restriction of cow's milk and dairy products results in decreased macro- and micronutrient intake, especially in infants who are not breastfed. Therefore, alternative milk supplements for supplemental nutrition in CMA must be considered. Methods: This systematic review used PRISMA guidelines with the PICO search strategy, focusing on RCTs, clinical trials, and observational studies. A comprehensive search was conducted to obtain articles published in English between 2010 and 2025 using ScienceDirect, PubMed, SagePub, and Scopus. Result and Discission: Results A total of 2010 publications were retrieved using relevant search terms. After a rigorous three-stage review, nine studies were selected based on inclusion criteria and deemed suitable for in-depth analysis. These studies addressed tolerance and allergic reactions or cross-reactivity following administration of goat's milk, soy isolate, rice isolate, and partially hydrolyzed formula. Conclusion: In infants with CMA, goat's milk can trigger cross-reactivity. Partially hydrolyzed formulas can be an option for oral food challenges to assess tolerance. Plant-based formulas, particularly rice isolate, are the best choice, especially for those with non-severe CMA and CMA who cannot tolerate extensively hydrolyzed and amino acid-containing formulas

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