Food allergy and breast-feeding

Abstract

Breast-feeding is currently recommended as the optimal source of nutrition for infants; however, it is known that some individuals can excrete enough food antigens in breast milk to result in allergic reactions in infants, especially those already highly sensitized. These reactions can include non‐immunoglobulin E (IgE) mediated reactions, such as atopic dermatitis or gastrointestinal symptoms, and IgE-mediated reactions, such as anaphylaxis, although rare. Food reactions in infants who are breast-fed is a unique challenge because identifying the culprit foods may be more difficult and special consideration must be taken in ensuring proper nutrition during periods of food avoidance for both the infant and mother. This article reviews what is currently known about food allergy in infants who are breast-fed as well as offers insights into a proposed evaluation.

Maternal dietary allergen restriction while breast-feeding: Pediatric resident knowledge and practices

“…Pediatricians are uniquely positioned to influence maternal dietary decision-making while the mother is breast-feeding, and confident guidance and understanding of this topic are important in fostering appropriate maternal nutrition and potentially improving allergic outcomes in infants. 10 Given an evolving understanding of this topic and variability in medical guidance, the development of robust educational resources with regard to this topic is needed.…”

“… 9 Maternal dietary restriction can be recommended in breast-fed infants with food-protein proctocolitis, yet evidence in individuals with other symptoms or mild atopic dermatitis is less clear. 5 , 7 , 8 , 10 Results of research have also downplayed the role of maternal allergen ingestion on infantile colic. 11 , 12 Also, although the World Allergy Organization conditionally recommends probiotics in breast-fed infants to prevent eczema, this guidance is not universally accepted, and no clear prevention guidelines exist for other supplements ( e.g ., vitamin D, fish oil).…”

Food allergy prevention, including early food introduction

“…Changing breast-feeding recommendations and trends as well as confounding factors, such as families at high risk and who may lean toward breast-feeding longer, may be masking a discernable effect of breast-feeding on food allergy. 22 For more on the association between breastfeeding and food allergy see the article by Pier and Jarvinen 23 in this Food Allergy Primer.…”