The Effect of Breastfeeding on Food Allergies in Newborns and Infants

Abstract

Breastfeeding is the preferred method of infant feeding and its establishment is one of the primary goals for the infant. Allergic diseases are common in childhood, with increased morbidity. Food allergies are also associated with a strong negative impact on health-related quality of life and is a major public health problem. In addition, maternal exclusion of common allergens during pregnancy and/or lactation suggests that supplementation with regular cow’s milk formula during the first week of life should be avoided. Breast milk contains many active immune factors, such as cytokines, inflammatory mediators, signaling molecules and soluble receptors, which may also reduce the risk of allergic disease. The prophylactic effects of breastfeeding have been the subject of many studies, some with weak evidence. In this narrative review, we aim to provide an up-to-date account of the effects of prophylactic breastfeeding on food allergy and other common allergies in infants and children up to 5 years of age. Colostrum in particular has been shown to be prophylactic against food allergy. The American Academy of Pediatrics cautions that the relationship between duration of breastfeeding and incidence of food allergy in early childhood is unclear. The protective role of breastfeeding has a positive effect on allergy prevention, which is opposed by the early introduction of solid foods, but larger studies are needed to confirm the evidence. There is evidence that breastfeeding is effective in providing partial protection to infants.

Metabolomics in Children Cow’s Milk Protein Allergy: Possible Contribution from a System Biology Approach?

“…A very recent literature review that addressed the potential prophylactic effects of breastfeeding on FA made it clear that breast milk is definitely effective in providing partial protection to infants [39]. In fact, breast milk, especially colostrum, given its content in active immune factors, such as antibodies, cytokines, inflammatory mediators, signaling molecules, and soluble receptors, can reduce the risk of allergic diseases and promote tolerance [1,39]. There is also the contribution of HMOs, especially for their probiotic action, given the key role of the gut microbiota in tolerance induction [1].…”

“…Indeed, a recent systematic review of the literature found that low concentrations of lacto-N-fucopentaose III (LNFP-III) would appear to be associated with the onset of CMA [40]. However, the relationship between the duration of breastfeeding and the incidence of FA in early childhood remains unclear, although the contribution of prolonged maternal breastfeeding seems to be evidenced not only in promoting tolerance during complementary feeding but also in counteracting the early introduction of solid foods [39,41,42].…”

“…In this regard, the importance of proper timing of complementary feeding's initiation, certainly after 17 weeks, preferably around 6 months of age, and exposure of the child to all potentially allergenic foods, without delayed introductions of allergens, is recognized to date to promote the acquisition of tolerance precisely through early oral exposure [20,30,39,41,42]. The importance of this mechanism and the difference from skin sensitization was proposed by recent work on the correlation between AD and FA conducted by Eigemann et al [17].…”

The Role of Diet and Nutritional Interventions for the Infant Gut Microbiome

“…A study by Bäckhed et al [169] suggests that the delayed introduction of solid food could cause a lag in microbial maturation and increase susceptibility to allergies and obesity. On the other hand, an earlier introduction could expose infants to potential pathogens and allergens [170][171][172]. Hence, the timing of solid food introduction should balance between these risks and benefits.…”