Age at First Introduction of Cow Milk Products and Other Food Products in Relation to Infant Atopic Manifestations in the First 2 Years of Life: The KOALA Birth Cohort Study

Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, PO Box 616, 6200 MD Maastricht, Netherlands.
PEDIATRICS (Impact Factor: 5.47). 08/2008; 122(1):e115-22. DOI: 10.1542/peds.2007-1651
Source: PubMed


Scientific evidence is scarce about timing of solid-food introduction and its association with the development of atopy. We aimed to evaluate any associations between the introduction of cow milk products/other solid food products and infant atopic manifestations in the second year of life, taking into account reverse causation.
Data from 2558 infants in an ongoing prospective birth cohort study in the Netherlands were analyzed. Data on the main determinants (introduction of cow milk products and other food products), outcomes (eczema; atopic dermatitis [United Kingdom Working Party criteria]; recurrent wheeze; any sensitization; sensitization against cow milk, hen egg, peanut, and at least 1 inhalant allergen), and confounders were collected by repeated questionnaires at 34 weeks of gestation and 3, 7, 12, and 24 months postpartum. Information on sensitization was gathered by venous blood collections performed during home visits at age 2. Analyses were performed by multiple logistic regression analyses.
More delay in introduction of cow milk products was associated with a higher risk for eczema. In addition, a delayed introduction of other food products was associated with an increased risk for atopy development at the age of 2 years. Exclusion of infants with early symptoms of eczema and recurrent wheeze (to avoid reverse causation) did not essentially change our results.
Delaying the introduction of cow milk or other food products may not be favorable in preventing the development of atopy.

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Available from: Bianca Snijders, May 26, 2014
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    • "Maternal milk cytokines, such as TGF-β2 and interleukin (IL-10) have the potential to regulate immune responses to food antigens and promote tolerance [17] [18] [19] [20] [21] [22] [23]. Although the relationship between breastfeeding and allergy prevention is controversial [24] [25] [26], there has recently been a growing interest in the role of breast milk in regulating immune response development to food antigens as new foods are introduced into the diet [16] [27]. "
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    ABSTRACT: There are conflicting data to support the practice of delaying the introduction of allergenic foods into the infant diet to prevent allergy development. This study investigated immune response development after early oral egg antigen (Ovalbumin; OVA) exposure in a rat pup model. Brown Norway (BN) rat pups were randomly allocated into groups: dam reared (DR), DR pups challenged daily (days 4-13) with oral OVA (DR + OVAc), DR pups challenged intermittently (on day 4, 10, 12, and 13) with oral OVA (DR + OVAi), formula-fed pups (FF), and FF pups challenged daily with oral OVA (FF + OVA). Immune parameters assessed included OVA-specific serum IgE, IgG1, and IgA. Ileal and splenic messenger ribonucleic acid (mRNA) expression of transforming growth factor-beta (TGF-β1), mothers against decapentaplegic (Smad) 2/4/7, and forkhead box P3 (Foxp3) were determined. Ileum was stained for TGF-β1 and Smad4. Results. Feeding OVA daily to DR pups maintained systemic and local gut antibody and immunoregulatory marker mRNA responses. Systemic TGF-β1 was lower in DR + OVAi pups compared to DR and DR + OVAc pups. Feeding OVA to FF pups resulted in significantly greater OVA-specific IgE and IgG1, and lower IgA and TGF-β1 and Smad expression compared to DR pups. Conclusions. Early daily OVA exposure in the presence of maternal milk maintains immune markers associated with a regulated immune response, preventing early allergic sensitization.
    Clinical and Developmental Immunology 01/2012; 2012(12):396232. DOI:10.1155/2012/396232 · 2.93 Impact Factor
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    • "There is also significant data showing that dietary restrictions may actually increase the risk of atopic disease[18,19]. A major difference of this report versus previous versions is that it does not make recommendations. Instead, statements about possible dietary changes are made along with the presence or absence of its effectiveness. "
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    ABSTRACT: Food allergy poses a significant burden on patients, families, health care providers, and the medical system. The increased prevalence of food allergy has brought about investigation as to its cause and new treatments. Currently, the only treatment available is to avoid the food and symptomatically treat any reactions. There are multiple clinical and murine models of food allergy treatment that use allergen specific and nonspecific pathways. Allergen specific treatments use mucosal antigen exposure as a method of inducing desensitization and tolerance. Allergen nonspecific methods act via a more global TH2 suppressive mechanism and may be useful for those patients with multiple food allergies.
    World Allergy Organization Journal 12/2009; 2(12):282-8. DOI:10.1097/WOX.0b013e3181c81fed
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