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Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy.
J Allergy Clin Immunol. 2010 Jul; 126(1):77-82.e1.JA

Abstract

BACKGROUND

The diversity in the perceived prevalence, recovery, and risk factors for cow's milk allergy (CMA) necessitated a large-scale, population-based prospective study.

OBJECTIVE

We sought to determine the prevalence, cross-reactivity with soy allergy, and risk factors for the development of CMA.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

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Authors+Show Affiliations

Katz Y
Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Zerifin, Israel. ykatz49@gmail.com
Rajuan N
No affiliation info available
Goldberg MR
No affiliation info available
Eisenberg E
No affiliation info available
Heyman E
No affiliation info available
Cohen A
No affiliation info available
Leshno M
No affiliation info available

MeSH

AnimalsBreast FeedingCattleFemaleHumansImmunoglobulin EInfantInfant, NewbornMaleMilk HypersensitivityMilk ProteinsProspective StudiesRisk FactorsSoybeans

Pub Type(s)

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

Language

eng

PubMed ID

20541249

Citation

Katz, Yitzhak, et al. "Early Exposure to Cow's Milk Protein Is Protective Against IgE-mediated Cow's Milk Protein Allergy." The Journal of Allergy and Clinical Immunology, vol. 126, no. 1, 2010, pp. 77-82.e1.
Katz Y, Rajuan N, Goldberg MR, et al. Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy. J Allergy Clin Immunol. 2010;126(1):77-82.e1.
Katz, Y., Rajuan, N., Goldberg, M. R., Eisenberg, E., Heyman, E., Cohen, A., & Leshno, M. (2010). Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy. The Journal of Allergy and Clinical Immunology, 126(1), 77-e1. https://doi.org/10.1016/j.jaci.2010.04.020
Katz Y, et al. Early Exposure to Cow's Milk Protein Is Protective Against IgE-mediated Cow's Milk Protein Allergy. J Allergy Clin Immunol. 2010;126(1):77-82.e1. PubMed PMID: 20541249.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy. AU - Katz,Yitzhak, AU - Rajuan,Nelly, AU - Goldberg,Michael R, AU - Eisenberg,Eli, AU - Heyman,Eli, AU - Cohen,Adi, AU - Leshno,Moshe, Y1 - 2010/06/11/ PY - 2010/01/25/received PY - 2010/04/21/revised PY - 2010/04/21/accepted PY - 2010/6/15/entrez PY - 2010/6/15/pubmed PY - 2010/7/31/medline SP - 77 EP - 82.e1 JF - The Journal of allergy and clinical immunology JO - J Allergy Clin Immunol VL - 126 IS - 1 N2 - BACKGROUND: The diversity in the perceived prevalence, recovery, and risk factors for cow's milk allergy (CMA) necessitated a large-scale, population-based prospective study. OBJECTIVE: We sought to determine the prevalence, cross-reactivity with soy allergy, and risk factors for the development of CMA. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. SN - 1097-6825 UR - https://www.unboundmedicine.com/medline/citation/20541249/Early_exposure_to_cow's_milk_protein_is_protective_against_IgE_mediated_cow's_milk_protein_allergy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0091-6749(10)00688-3 DB - PRIME DP - Unbound Medicine ER -