Infant milk-feeding practices and food allergies, allergic rhinitis, atopic dermatitis, and asthma throughout the life span: a systematic review

Abstract

Background During the Pregnancy and Birth to 24 Months Project, the USDA and Department of Health and Human Services initiated a review of evidence on diet and health in these populations. Objectives The aim of these systematic reviews was to examine the relation of 1) never versus ever feeding human milk, 2) shorter versus longer durations of any human milk feeding, 3) shorter versus longer durations of exclusive human milk feeding prior to infant formula introduction, 4) feeding a lower versus higher intensity of human milk to mixed-fed infants, and 5) feeding a higher intensity of human milk by bottle versus breast with food allergies, allergic rhinitis, atopic dermatitis, and asthma. Methods The Nutrition Evidence Systematic Review team conducted systematic reviews with external experts. We searched CINAHL, Cochrane, Embase, and PubMed for articles published between January 1980 and March 2016, dual-screened the results according to predetermined criteria, extracted data from and assessed the risk of bias for each included study, qualitatively synthesized the evidence, developed conclusion statements, and graded the strength of the evidence. Results The systematic reviews numbered 1–5 above included 44, 35, 1, 0, and 0 articles, respectively. Moderate, mostly observational, evidence suggests that 1) never versus ever being fed human milk is associated with higher risk of childhood asthma, and 2) among children and adolescents who were fed human milk as infants, shorter versus longer durations of any human milk feeding are associated with higher risk of asthma. Limited evidence does not suggest associations between 1) never versus ever being fed human milk and atopic dermatitis in childhood or 2) the duration of any human milk feeding and allergic rhinitis and atopic dermatitis in childhood. Conclusions Moderate evidence suggests that feeding human milk for short durations or not at all is associated with higher childhood asthma risk. Evidence on food allergies, allergic rhinitis, and atopic dermatitis is limited.

Infant Feeding, Vitamin D and IgE Sensitization to Food Allergens at 6 Years in a Longitudinal Icelandic Cohort

“…A Cochrane review from 2016 found no evidence to disagree with recommendations for healthy infants of exclusive breastfeeding for the first 6 months [68]. A more recent systematic review found moderate evidence suggesting that a short breastfeeding duration, or no breastfeeding, was associated with a higher risk of childhood asthma [11]. The same review found limited evidence for the effect of either a short breastfeeding duration or no breastfeeding on food allergies, allergic rhinitis and atopic dermatitis [11].…”

“…The systematic literature review on breastfeeding prepared for the Nordic Nutrition Recommendations gave the lowest grade of evidence for any preventive effects of breastfeeding on the risk of atopic diseases in children, so no conclusions were drawn, while for most other undesirable outcomes there was convincing or probable evidence for the protective effects of breastfeeding [4]. Similarly, recent systematic literature reviews found the data inconclusive regarding the effect of breastfeeding on the risk of atopic diseases [11,12].…”

The Role of Early Programming and Early Nutrition on the Development and Progression of Celiac Disease: a review.

“…A meta-analysis by the PREVENTCD Study Group [130] determined in 2015 that there is no relationship between BF and the development of CD, nor between its duration and the appearance of disease, these recommendations being identical to those of ESPGHAN in 2016 [77]. These data have been corroborated more recently in a systematic review [131], in which the expert committee determines a very weak level of evidence for the claim that drinking breast milk at some point compared to artificial milk protects against development of CD. Likewise, it concludes with respect to the duration of breastfeeding that the evidence is insufficient to draw conclusions, because in many of the studies the disease developed before the lactation period had ended, and a clear causal relationship could not be established.…”

Timing of Food Introduction and the Risk of Food Allergy

“…However, a firm conclusion about the role of breast-feeding in preventing or delaying the onset of atopic diseases is not possible at this time, mainly because truly randomized breastfeeding goes beyond the limits of what is ethical and correct [23,24]. A recent systematic review reports that there is insufficient evidence to determine whether never vs. ever being fed human milk, or whether the duration of any human milk feeding, are associated with FA development [42].…”