Supplementary feeding in maternity hospitals and the risk of cow’s milk allergy: A prospective study of 6209 infants☆☆☆★

Saarinen, Kimmo; Juntunen‐Backman, Kaisu; Järvenpää, Anna‐Liisa; Kuitunen, P; Lope, Leena; Renlund, Martin; Siivola, Matti; Savilahti, Erkki

doi:10.1016/s0091-6749(99)70393-3

Cited by 256 publications

(193 citation statements)

References 23 publications

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“…The present study used the findings of our previous study (5), which collected four groups of 4-y-old children from an unselected birth cohort of 4674 infants born between August 1994 and November 1995. The children had been followed prospectively during their first year of life for the appearance of CMA (23). Groups were selected based on presence or absence of family history of atopy and the early milk-feeding pattern of each child.…”

Section: Methodsmentioning

confidence: 99%

IgA Antibodies, TGF-β1 and -β2, and Soluble CD14 in the Colostrum and Development of Atopy by Age 4

et al. 2005

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Specific defense factors in breast milk together with length of breast-feeding and genetic predisposition may modulate the development of allergy. We studied whether IgA, soluble CD14 (sCD14), or transforming growth factor (TGF)-␤ in colostrum could affect the development of atopy in children up to age 4. From a cohort of 4676, we selected four groups of children with either long or short exclusive breast-feeding (Ͼ3.5 or Ͻ0.5 mo); these groups further differed in the presence or absence of atopic heredity. In colostrum from mothers, we measured total IgA, IgA antibodies to cow's milk (CM) and casein, sCD14, and TGF-␤1 and -␤2. The children were divided into three groups: those with no atopic symptoms or IgE, those with allergic symptoms, and those with both outcomes. Mothers of infants later showing atopic symptoms or, in addition, having IgE sensitization (verified atopy) had a lower concentration of IgA casein antibodies in their colostrum than did mothers of infants with no indication of atopy at age 4. Low concentration of IgA casein antibodies was a significant risk for verified atopy. sCD14 levels were lower in colostrum of mothers with infants developing atopic symptoms and IgE sensitization than of those of infants with no atopy. Specific IgA antibodies to CM antigens and sCD14 in colostrum significantly associated with the appearance of both symptomatic and verified atopy by age 4. Interaction between early infant feeding and subsequent development of allergies has been debated for decades (1-5). Human breast milk contains antibodies to antigens the mother has come into contact with, particularly against food antigens and enteral microbes (6 -10). These antibodies, together with a small amount of food antigens in the milk, may direct the immune response of the infant to develop tolerance or hypersensitivity to those antigens. Breast milk also contains a number of nonspecific anti-infectious substances such as iron-binding lactoferrin, bacteriocidic lysozyme, and the oligosaccharides inhibiting microbial attachment to epithelial cells. It therefore effectively reduces infections of the newborn infant and has an impact on infants' indigenous bacterial flora (8 -10). Human milk, furthermore, contains a number of cytokines (11-16) and other immunomodulatory (17) agents as well as living cells (18), which in the immature intestine of the newborn may modulate the development of local immune responses.We recently showed that the effect of breast-feeding on the appearance of allergic diseases at age 4 y depended on heredity: if the infant has the genetic component for allergy, long breast-feeding seems to protect against allergies; if the heredity is negative, long breast-feeding promotes emergence of allergies (5). Because of such interactions and the fact that maternal heredity has a stronger impact on the appearance of allergies than does paternal allergy (19), breast milk of mothers with allergy has been speculated to differ from that of nonallergic mothers and, in fact, some differences have emerged (20,2...

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Section: Methodsmentioning

confidence: 99%

IgA Antibodies, TGF-β1 and -β2, and Soluble CD14 in the Colostrum and Development of Atopy by Age 4

et al. 2005

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“…Sample size was calculated based on the primary outcome. The mean percentage of at-risk children who effectively develop allergic manifestations is fairly imprecise, between 6 and 20%, the risk being approximately divided by two by probiotics (Saarinen et al, 1999;Exl and Fritsche, 2001;Kalliomaki et al, 2001). Based on these data, for rejection of two-sided null hypothesis with a type I error of 5% and a type II error of 30%, at least 62 children had to be included per group, for a total of 124 children.…”

Section: Subjectsmentioning

confidence: 99%

A non-hydrolyzed, fermented milk formula reduces digestive and respiratory events in infants at high risk of allergy

et al. 2010

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Background/Objectives: To determine the impact of a not hydrolyzed fermented infant formula containing heat-killed Bifidobacterium breve C50 and Streptococcus thermophilus 065 (HKBBST) on the incidence of allergy-like events during the first 2 years of life in children at high risk of atopy. Subjects/Methods: This multicenter, randomized, double-blind, controlled study included infants at high risk of atopy. Infants used HKBBST or a standard infant formula (SIF) since birth until 1 year of age, and were followed at 4, 12 and 24 months after birth. Skin prick tests (SPTs) for six foods and six aeroallergens were systematically performed and adverse events (AEs) were recorded. In case of potentially allergic AE (PAAE), allergy could be further tested by SPT, patch tests and quantification of specific IgEs. If cow's milk allergy (CMA) was suspected, an oral challenge could also be performed. Results: The study included 129 children, 63 were randomized to SIF, 66 to HKBBST. The use of HKBBST milk did not alter the proportion of CMA but decreased the proportion of positive SPT to cow's milk (1.7 vs 12.5%, P ¼ 0.03), and the incidence of digestive (39 vs 63%, P ¼ 0.01) and respiratory potentially allergic AEs (7 vs 21%, P ¼ 0.03) at 12 months, and that of respiratory PAAEs at 24 months (13 vs 35%, P ¼ 0.01). Conclusions: HKBBST decreased the incidence of PAAEs in children with family history of atopy, during the first months of life and after the formula was stopped. Oral tolerance to cow's milk in infants at high risk of atopy may therefore be improved using not hydrolyzed fermented formulae.

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“…56 Both hydrolyzed formula and breastmilk have been reported to protect against cow's milk allergy, compared to the use of routine, cow's milk-based infant formula. 61 excluded. At 12 months, the incidence of allergic manifestations was significantly lower with the caseinbased eHPF than with the conventional formula (9 vs. 16%).…”

Section: Intervention Strategy In Formula-fed Infantsmentioning

confidence: 99%

Alergia alimentar: atualização prática do ponto de vista gastroenterológico

Ferreira¹,

Seidman²

2007

J. Pediatr. (Rio J.)

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Objective: To present an up-to-date and critical review regarding food allergies, focusing mainly on treatment and prevention. Sources:Review of published literature searched on MEDLINE database; those data which were the most up-to-date and representative were selected (2000)(2001)(2002)(2003)(2004)(2005)(2006). The search included the European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the American Academy of Pediatrics (AAP). Summary of the findings:The prevalence of allergic diseases has increased over the last decades, and food allergy seems to be part of this increase. Food allergy is much more common in pediatrics and has a significant medical, financial and social impact on young children and their families. Treatment and prevention of food allergy is a major challenge for public health, scientific and medical communities. There is a lot of misinformation and the medical management of this condition is still discussable. We present and discuss the guidelines regarding criteria for the prevention of food allergy and atopic diseases published by the Nutrition Committees of ESPGHAN jointly with the European Society for Pediatric Allergy and Clinical Immunology (ESPACI) and AAP. Conclusion:The overdiagnosis of food allergy is quite prevalent. There is a need for standardization of definitions and diagnostic procedures. The primary goal of therapy should be to first establish effective means of preventing food allergies. There is a need for accurate diagnostic methods to confirm or rule out the diagnosis. Patients need appropriate treatment by eliminating foods that cause symptoms, while avoiding the nutritional side effects and the cost of inappropriate diets.J Pediatr (Rio J). 2007;83(1):7-20: Food allergy, IgE-mediated allergy, non-IgE-mediated allergy, cell-mediated allergy, prevention, treatment.

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Supplementary feeding in maternity hospitals and the risk of cow’s milk allergy: A prospective study of 6209 infants☆☆☆★

Cited by 256 publications

References 23 publications

IgA Antibodies, TGF-β1 and -β2, and Soluble CD14 in the Colostrum and Development of Atopy by Age 4

IgA Antibodies, TGF-β1 and -β2, and Soluble CD14 in the Colostrum and Development of Atopy by Age 4

A non-hydrolyzed, fermented milk formula reduces digestive and respiratory events in infants at high risk of allergy

Alergia alimentar: atualização prática do ponto de vista gastroenterológico

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