The association of infant feeding patterns with food allergy symptoms and food allergy in early childhood

Abstract

Background: The role of infant feeding for food allergy in children is unclear and studies have not addressed simultaneous exposures to different foods. The goal of this study was to analyze existing data on feeding practices that represent realistic exposure and assess the risk of food allergy symptoms and food allergy in children. Methods: The Infant Feeding Practices Study II conducted by the CDC and US-FDA enrolled pregnant women and collected infant feeding information using nine repeated surveys. Participants were re-contacted after 6 years. Food allergy data were collected at 4, 9, 12, and 72 months. In total, 1387 participants had complete infant feeding pattern data for 6 months and information on food allergy symptoms and doctors' diagnosed food allergy. Feeding patterns constituted six groups: 3-months of feeding at breast followed by mixed feeding, 3-months of breast milk and bottled milk followed by mixed feeding, 1-month of feeding at breast followed by mixed feeding, 6-months of mixed feeding i.e., concurrent feeding of breast milk, bottled milk and formula, 2-3 months of formula followed by formula and solid food, and formula and solid food since the first month. To estimate risks of food allergy, we used linear mixed models, controlling for potential confounders.Results: Of the 328 children with food allergy symptoms in infancy and at 6 years, 52 had persistent symptoms from infancy. Children exposed to mixed feeding had a higher risk of food allergy symptoms (Risk Ratio [RR] 1.54; 95% Confidence Interval [CI] 1.04, 2.29) compared to 3-months of feeding at breast adjusted for confounding. No statistically significant risk of infant feeding patterns was found for doctors' diagnosed food allergy. Paternal allergy posed a higher risk for food allergy symptoms (RR 1.36; 95% CI 1.01, 1.83). Prenatal maternal smoking increased the risk for doctors' diagnosed food allergy (RR 2.97; 95% CI 1.53, 5.79).Conclusions: Analysis of this prospective birth cohort suggest that introduction of multiple feeding source may lead to food allergy symptoms. Future efforts are needed to determine acceptable approaches to improve the ascertainment of food allergy in children and the role of infant feeding.

Epigenome-Wide Association of Infant Feeding and Changes in DNA Methylation from Birth to 10 Years

“…This is essential as it not only takes out the confounding effects of other infant feeding modes on breastfeeding while studying its association with DNAm, but also allows us to compare the effects of exclusive formula feeding and mixed feedings with recommended exclusive breastfeeding. Also, the use of these feeding modes is consistent with other association studies of infant feeding and adverse health outcomes such as obesity [57], gastroesophageal reflux [58], asthma [59], and food allergy [33]. About 18% of the infants in our cohort were exclusively breastfed for 13 weeks, 8.9% received formula exclusively for 13 weeks, and 73% received formula or solids (along with breastfeeding) before 13 weeks.…”

“…However, recent investigations on infant feeding and gene expression showed that infants' current weight, height, and head circumference and expression of obesity-predisposing genes (FTO and CPT1A) are significantly higher in infants that were formula or mixed fed in comparison to exclusive breastfed [32]. Moreover, a mixed feeding mode (direct feeding at the breast, pumping and feeding, and formula feeding) was associated with a higher risk of food allergy symptoms than a single infant feeding source such as direct feeding at the breast and formula feeding [33].…”

Knowledge, attitude and practices regarding breastfeeding and infant milk substitutes among mothers of upper middle-class society in a baby friendly hospital initiative accredited hospital of New Delhi, India

“…1,2 The benefits of breastfeeding are innumerable and it is vital for overall growth and development of a child. 3,4 The benefits of breastfeeding are not only limited to the baby, but also in many ways positively affect mothers. 5 Despite establishment of all these facts, exclusive breastfeeding has remained low in prevalence.…”

Regulation of oral antigen delivery early in life: Implications for oral tolerance and food allergy

“…Risk factors for food allergy can be described by alterations in this window of tolerance: missing this window, as in the case of delayed allergen exposure, disrupting this window, as in the case of formula feeding, 9,104,105…”