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Breastfeeding and risk of food allergy: A nationwide birth cohort in Japan.

Abstract

BACKGROUND

Although breastfeeding has been well-established as the preferred method for infant nutrition, its prophylactic effects on food allergy remain controversial. Infantile eczema has been linked to food allergy via percutaneous sensitization; however, this relationship has not been considered in previous studies. We aimed to uncover the prophylactic effects of breastfeeding on food allergy, focusing on eczema-mediated percutaneous sensitization.

METHODS

This retrospective cohort study was based on 46,616 children from the Longitudinal Survey of Newborns in the 21st Century in Japan, begun in 2001. We classified participants into three groups based on infant feeding practices (exclusive breastfeeding, partial breastfeeding including only colostrum, and formula feeding only) and used information from at least one outpatient visit for food allergy during two observation periods (age 6-18 months and age 6-66 months) as health outcomes. We performed log-binomial regression analysis adjusted for potential confounders and stratified analysis according to infantile eczema status.

RESULTS

Compared with formula feeding, partial breastfeeding including only colostrum reduced the risk of food allergy only in children with infantile eczema, (RR = 0.66, 95% CI: 0.46, 0.96 for age 6-66 months), whereas exclusive breastfeeding increased this risk in those without infantile eczema (RR = 2.41, 95% CI: 1.40, 4.15, age 6-66 months). The prophylactic effects of breastfeeding on food allergy in the infantile eczema group increased with shorter breastfeeding duration.

CONCLUSIONS

Our results showed that breastfeeding, especially colostrum, had prophylactic effects on food allergy only among high-risk children with infantile eczema whereas prolonged breastfeeding increased the risk of food allergy.

Authors+Show Affiliations

Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan. Electronic address: naomi.f@nifty.com.Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.Department of Pediatric Acute Medicine, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.Department of Pediatrics, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31540813

Citation

Matsumoto, Naomi, et al. "Breastfeeding and Risk of Food Allergy: a Nationwide Birth Cohort in Japan." Allergology International : Official Journal of the Japanese Society of Allergology, 2019.
Matsumoto N, Yorifuji T, Nakamura K, et al. Breastfeeding and risk of food allergy: A nationwide birth cohort in Japan. Allergol Int. 2019.
Matsumoto, N., Yorifuji, T., Nakamura, K., Ikeda, M., Tsukahara, H., & Doi, H. (2019). Breastfeeding and risk of food allergy: A nationwide birth cohort in Japan. Allergology International : Official Journal of the Japanese Society of Allergology, doi:10.1016/j.alit.2019.08.007.
Matsumoto N, et al. Breastfeeding and Risk of Food Allergy: a Nationwide Birth Cohort in Japan. Allergol Int. 2019 Sep 17; PubMed PMID: 31540813.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Breastfeeding and risk of food allergy: A nationwide birth cohort in Japan. AU - Matsumoto,Naomi, AU - Yorifuji,Takashi, AU - Nakamura,Kazue, AU - Ikeda,Masanori, AU - Tsukahara,Hirokazu, AU - Doi,Hiroyuki, Y1 - 2019/09/17/ PY - 2019/03/07/received PY - 2019/08/10/revised PY - 2019/08/21/accepted PY - 2019/9/22/entrez KW - Breastfeeding KW - Cohort KW - Colostrum KW - Eczema KW - Food allergy JF - Allergology international : official journal of the Japanese Society of Allergology JO - Allergol Int N2 - BACKGROUND: Although breastfeeding has been well-established as the preferred method for infant nutrition, its prophylactic effects on food allergy remain controversial. Infantile eczema has been linked to food allergy via percutaneous sensitization; however, this relationship has not been considered in previous studies. We aimed to uncover the prophylactic effects of breastfeeding on food allergy, focusing on eczema-mediated percutaneous sensitization. METHODS: This retrospective cohort study was based on 46,616 children from the Longitudinal Survey of Newborns in the 21st Century in Japan, begun in 2001. We classified participants into three groups based on infant feeding practices (exclusive breastfeeding, partial breastfeeding including only colostrum, and formula feeding only) and used information from at least one outpatient visit for food allergy during two observation periods (age 6-18 months and age 6-66 months) as health outcomes. We performed log-binomial regression analysis adjusted for potential confounders and stratified analysis according to infantile eczema status. RESULTS: Compared with formula feeding, partial breastfeeding including only colostrum reduced the risk of food allergy only in children with infantile eczema, (RR = 0.66, 95% CI: 0.46, 0.96 for age 6-66 months), whereas exclusive breastfeeding increased this risk in those without infantile eczema (RR = 2.41, 95% CI: 1.40, 4.15, age 6-66 months). The prophylactic effects of breastfeeding on food allergy in the infantile eczema group increased with shorter breastfeeding duration. CONCLUSIONS: Our results showed that breastfeeding, especially colostrum, had prophylactic effects on food allergy only among high-risk children with infantile eczema whereas prolonged breastfeeding increased the risk of food allergy. SN - 1440-1592 UR - https://www.unboundmedicine.com/medline/citation/31540813/Breastfeeding_and_risk_of_food_allergy:_A_nationwide_birth_cohort_in_Japan L2 - https://linkinghub.elsevier.com/retrieve/pii/S1323-8930(19)30136-4 DB - PRIME DP - Unbound Medicine ER -