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Infant feeding patterns affect the subsequent immunological features in cow's milk allergy.

Abstract

BACKGROUND

The first exposure to food antigens provokes an immune reaction in an infant, its type depending on the quantity and frequency of doses and the age at introduction, and also being influenced by genetic factors. Most infants develop tolerance to food antigens, but in a small minority they provoke adverse symptoms.

OBJECTIVE

To study the effects of breast and formula feeding and other environmental and genetic factors on the subsequent type of cow's milk allergy classified by the presence or absence of immunoglobulin (Ig) E antibodies to cow's milk.

METHODS

A cohort of 6209 infants was followed prospectively from birth for symptoms of cow's milk allergy. The infant-feeding regimen was recorded at the maternity hospital and at home. At a mean age of 6.7 months, a total of 118 infants (1.9%) reacted adversely to a challenge with cow's milk. Before the challenge, the response to a skin-prick test with cow's milk and serum IgE cow's milk antibodies was measured.

RESULTS

At challenge, 75 (64%) infants showed IgE-positive reactions to cow's milk, their most common symptom being acute-onset urticaria. Significant risk factors for the presence of IgE cow's milk antibodies in allergic infants were long breast-feeding (odds ratio [OR] 3.9, 95% confidence interval [CI] 1.6-9.8), exposure to cow's milk at the maternity hospital (OR 3.5, 95% CI 1.2-10.1) and breast-feeding during the first 2 months at home either exclusively (OR 5.1, 95% CI 1.6-16.4) or combined with infrequent exposure to small amounts of cow's milk (OR 5.7, 95% CI 1.5-21.6). Fifty infants had their first adverse symptoms during exclusive breast-feeding, and 32 infants were sensitized during exclusive breast-feeding. Most of the infants in both cases were IgE-positive: 37 and 23, respectively.

CONCLUSIONS

In infants who are prone to developing cow's milk allergy, prolonged breast-feeding exclusively or combined with infrequent exposure to small amounts of cow's milk during the first 2 months of life induces development of IgE-mediated response to cow's milk.

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  • Authors+Show Affiliations

    ,

    Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.

    Source

    MeSH

    Animals
    Bottle Feeding
    Breast Feeding
    Feeding Behavior
    Humans
    Immunoglobulin E
    Infant
    Infant Food
    Infant, Newborn
    Intradermal Tests
    Milk
    Milk Hypersensitivity
    Prospective Studies

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    10691899

    Citation

    Saarinen, K M., and E Savilahti. "Infant Feeding Patterns Affect the Subsequent Immunological Features in Cow's Milk Allergy." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 30, no. 3, 2000, pp. 400-6.
    Saarinen KM, Savilahti E. Infant feeding patterns affect the subsequent immunological features in cow's milk allergy. Clin Exp Allergy. 2000;30(3):400-6.
    Saarinen, K. M., & Savilahti, E. (2000). Infant feeding patterns affect the subsequent immunological features in cow's milk allergy. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 30(3), pp. 400-6.
    Saarinen KM, Savilahti E. Infant Feeding Patterns Affect the Subsequent Immunological Features in Cow's Milk Allergy. Clin Exp Allergy. 2000;30(3):400-6. PubMed PMID: 10691899.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Infant feeding patterns affect the subsequent immunological features in cow's milk allergy. AU - Saarinen,K M, AU - Savilahti,E, PY - 2000/2/26/pubmed PY - 2000/5/16/medline PY - 2000/2/26/entrez SP - 400 EP - 6 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 30 IS - 3 N2 - BACKGROUND: The first exposure to food antigens provokes an immune reaction in an infant, its type depending on the quantity and frequency of doses and the age at introduction, and also being influenced by genetic factors. Most infants develop tolerance to food antigens, but in a small minority they provoke adverse symptoms. OBJECTIVE: To study the effects of breast and formula feeding and other environmental and genetic factors on the subsequent type of cow's milk allergy classified by the presence or absence of immunoglobulin (Ig) E antibodies to cow's milk. METHODS: A cohort of 6209 infants was followed prospectively from birth for symptoms of cow's milk allergy. The infant-feeding regimen was recorded at the maternity hospital and at home. At a mean age of 6.7 months, a total of 118 infants (1.9%) reacted adversely to a challenge with cow's milk. Before the challenge, the response to a skin-prick test with cow's milk and serum IgE cow's milk antibodies was measured. RESULTS: At challenge, 75 (64%) infants showed IgE-positive reactions to cow's milk, their most common symptom being acute-onset urticaria. Significant risk factors for the presence of IgE cow's milk antibodies in allergic infants were long breast-feeding (odds ratio [OR] 3.9, 95% confidence interval [CI] 1.6-9.8), exposure to cow's milk at the maternity hospital (OR 3.5, 95% CI 1.2-10.1) and breast-feeding during the first 2 months at home either exclusively (OR 5.1, 95% CI 1.6-16.4) or combined with infrequent exposure to small amounts of cow's milk (OR 5.7, 95% CI 1.5-21.6). Fifty infants had their first adverse symptoms during exclusive breast-feeding, and 32 infants were sensitized during exclusive breast-feeding. Most of the infants in both cases were IgE-positive: 37 and 23, respectively. CONCLUSIONS: In infants who are prone to developing cow's milk allergy, prolonged breast-feeding exclusively or combined with infrequent exposure to small amounts of cow's milk during the first 2 months of life induces development of IgE-mediated response to cow's milk. SN - 0954-7894 UR - https://www.unboundmedicine.com/medline/citation/10691899/Infant_feeding_patterns_affect_the_subsequent_immunological_features_in_cow's_milk_allergy_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0954-7894&date=2000&volume=30&issue=3&spage=400 DB - PRIME DP - Unbound Medicine ER -