Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy

Article (PDF Available)inThe Journal of allergy and clinical immunology 126(1):77-82.e1 · July 2010with85 Reads
DOI: 10.1016/j.jaci.2010.04.020 · Source: PubMed
The diversity in the perceived prevalence, recovery, and risk factors for cow's milk allergy (CMA) necessitated a large-scale, population-based prospective study. We sought to determine the prevalence, cross-reactivity with soy allergy, and risk factors for the development of CMA. In a prospective study the feeding history of 13,019 infants was obtained by means of telephone interview (95.8%) or questionnaire (4.2%). Infants with probable adverse reactions to milk were examined, skin prick tested, and challenged orally. Ninety-eight percent of the cohort participated in the study. The cumulative incidence for IgE-mediated CMA was 0.5% (66/13,019 patients). The mean age of cow's milk protein (CMP) introduction was significantly different (P < .001) between the healthy infants (61.6 +/- 92.5 days) and those with IgE-mediated CMA (116.1 +/- 64.9 days). Only 0.05% of the infants who were started on regular CMP formula within the first 14 days versus 1.75% who were started on formula between the ages of 105 and 194 days had IgE-mediated CMA (P < .001). The odds ratio was 19.3 (95% CI, 6.0-62.1) for development of IgE-mediated CMA among infants with exposure to CMP at the age of 15 days or more (P < .001). Sixty-four patients with IgE-mediated CMA tolerated soy, and none had a proved allergy to soy. IgE-mediated CMA is much less common than generally reported. Early exposure to CMP as a supplement to breast-feeding might promote tolerance. Finally, soy is a reasonable feeding alternative in patients with IgE-mediated CMA.

Full-text (PDF)

Available from: Eli Eisenberg
    • "It presents in the first year of life, with an estimated population prevalence of between 2% and 3% [41], or as high as 7% [42]. However, the results from recent cohort studies and from a randomized trial of early introduction of allergenic foods in the diet of breast-fed infant have shown that the incidence for IgE-mediated cow milk allergy could be as low as 0.5% [43][44][45]. Because there is no definition for differentiating IgE-mediated and non-lgE-mediated cow milk allergy, and the clinical symptoms of both overlap significantly, it is possible that, at least, some non-IgE mediated allergy cases may have been included in IgE-mediated cow milk allergy in previous reports. "
    [Show abstract] [Hide abstract] ABSTRACT: Mothers’ own milk is the best source of nutrition for nearly all infants. Beyond somatic growth, breast milk as a biologic fluid has a variety of other benefits, including modulation of postnatal intestinal function, immune ontogeny, and brain development. Although breastfeeding is highly recommended, breastfeeding may not always be possible, suitable or solely adequate. Infant formula is an industrially produced substitute for infant consumption. Infant formula attempts to mimic the nutritional composition of breast milk as closely as possible, and is based on cow’s milk or soymilk. A number of alternatives to cow’s milk-based formula also exist. In this article, we review the nutritional information of breast milk and infant formulas for better understanding of the importance of breastfeeding and the uses of infant formula from birth to 12 months of age when a substitute form of nutrition is required.
    Full-text · Article · May 2016
    • "Similarly, authors of a large scale prospective study involving over 13,000 infants found that infants with IgE-mediated CMA were more likely to have had supplemental cow's milk protein (CMP)-based formulas introduced between 3.5– 6.5 months of age compared to non-allergic infants, who received supplemental CMP formula within the first 2 weeks of life. This suggests that early exposure to CMP as a supplement to breastfeeding may prevent development of CMA [36]. Studies also indicate that early peanut ingestion may protect against development of peanut allergy in high-risk children . "
    [Show abstract] [Hide abstract] ABSTRACT: Food allergy is defined as an IgE-mediated hypersensitivity response to ingested food with allergic symptoms ranging from urticaria to life-threatening anaphylaxis. Food allergy is thought to develop because of (1) failed induction of tolerance upon initial exposure to food antigen or (2) breakdown of established tolerance to food antigen. We review current understanding of the pathogenesis, epidemiology, and natural history of food allergy, including the unconventional IgE-mediated food allergy to mammalian meat known as alpha-gal food allergy. We highlight emerging data on food allergy treatment and prevention, emphasizing the growing appeal of manipulating the gut microenvironment using probiotics and helminth products to blunt systemic allergic responses to food.
    Article · May 2016
    • "Allergic rhinitis (AR) is triggered after allergen specific IgE and T helper cells recognize inhalant allergen in the environment. Some studies have shown that allergen exposure is protective against IgEmediated allergic disorders [1][2][3], while some strongly suggest that exposure to allergen increase the risk of developing allergy [4][5][6][7]. The divergence of views may be attributed to the variety of the intensity and persistence of allergen exposure in the environment. "
    Article · Jan 2016 · Current Allergy and Asthma Reports
Show more