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Objectives and Study Amino acid-based follow-on formulas (AAF) are designed for children over 1 year old for the management of severe cow’s milk protein allergy (CMA) or any other condition where an amino acid formula is indicated. Human Milk Oligosaccharides (HMOs) are the third-largest component in human breast milk, with proven benefits for immune development in infants and children. 1 This study aimed to assess the tolerance and palatability of a new AAF containing HMOs.Methods The study was a multicentre prospective study to assess the tolerance of an amino acid follow-on formula containing HMO. The study formula was SMA Alfamino Junior HMO (Nestlé Health Science). Arm A of the study assessed the efficacy and tolerance of a neutral variant flavour and Arm B assessed the palatability and tolerance of a vanilla flavour for at least 7 days. Ethical approval granted by the U.K. Research Ethics Committee (22/NE/0065 311790).Results 30 children consented to the study. 15 children were included in Arm A (neutral flavour) and another 15 children were recruited to Arm B (vanilla flavour). Of these, 13/30 children were females. Median age 2.8 years (IQR:1.2,3.8). 24/30 of children had a primary diagnosis of severe CMPA or multiple food allergies. 6/30 required an AAF for severe gastrointestinal intolerances such as pancolitis and gastrointestinal bleeding. 15/30 thought the formula tasted ‘good’ or ‘very good’. Smell & appearance were reported to be ‘good’ or ‘very good’ in 20/30. 16/30 thought the smell was ‘good’ or ‘very good’. 7/30 children reported significant improvement in GI symptoms.Conclusion Alfamino Junior HMO was well accepted for the dietary management of severe CMA, multiple food allergies and other conditions requiring an AAF. Additionally, the formula was well tolerated from a gastrointestinal perspective. Compliance was good and palatability data were positive.Acknowledgements for Funding or Support Research funding supported by Nestlé Health Science.Reference Wiciński M, Sawicka E, Gębalski J, Kubiak K, Malinowski B. Human milk oligosaccharides: health benefits, potential applications in infant formulas, and pharmacology. Nutrients 2020 Jan 20;12(1):266. doi: 10.3390/nu12010266. PMID: 31968617; PMCID: PMC7019891.