Main Article Content
Breastfeeding, Cow’s milk, Risk factors, Egg sensitization
Background: Both breastfeeding and the moment at which introduction to solid food occurs have been associated with food allergy.
Objective: To evaluate whether prolonged breastfeeding and the delayed introduction of whole cow’s milk into an infant’s diet are factors that can be associated with egg sensitization.
Methods: This was a hospital-based case-control study, matched by age and sex: each study group comprised 97 atopic children. Additionally, logistic regression was used to identify the factors associated with egg protein sensitization.
Results: The most common type of allergic disease among both groups was allergic rhinitis. After adjusting for possible confounding variables, a delayed introduction to whole cow’s milk decreased the odds of egg protein sensitization; OR = 0.16 (95% CI: 0.07-0.36, p < 0.0001). Notably, breastfeeding during the first six months of life, regardless of whether it was the only milk an infant drank, increased the risk for sensitization to chicken eggs; OR = 5.54 (95% CI: 2.41-12.7, p < 0.0001).
Conclusion: Prolonged breastfeeding, regardless of whether it was the only milk an infant drank, greatly increased the risk of egg sensitization. Interestingly, a delayed introduction to whole cow’s milk was associated with a reduced possibility of becoming sensitized to eggs. Further studies are required to elucidate these findings.
2. Chang ML, Shao B, Liu YH, Li LL, Pei LC, Wang BY. Analysis of allergens in 5473 patients with allergic diseases in Harbin, China. Biomed Environ Sci. 2013;26:886-93.
3. Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007;120:638-46.
4. Clark AT, Skypala I, Leech SC, Ewan PW, Dugué P, Brathwaite N, et al. British society for Allergy and Clinical Immunology. British Society for Allergy and Clinical Immunology guidelines for the management of egg allergy. Clin Exp Allergy. 2010;40: 1116-29.
5. Shakoor Z, Almogren A, Mohammed R, Hasanato W, Zahid B. Screening for hen’s egg and chicken meat specific IgE antibodies in Saudi patients with allergic disorders. Afr Health Sci. 2014;14:634-40.
6. Fiocchi A, Pecora V, Petersson CJ, Dahdah L, Borres MP, Amengual MJ, et al. Sensitization pattern to inhalant and food allergens in symptomatic children at first evaluation. Ital J Pediatr. 2015;41:96.
7. Alduraywish SA, Lodge CJ, Vicendese D, Lowe AJ, Erbas B, Matheson MC, et al. Sensitization to milk, egg and peanut from birth to 18 years: a longitudinal study of a cohort at risk of allergic disease. Pediatr Allergy Immunol. 2016;27:83-91.
8. Koplin JJ, Dharmage SC, Ponsonby AL, Tang ML, Lowe AJ, Gurrin LC, et al. HealthNuts Investigators. Environmental and demographic risk factors for egg allergy in a population-based study of infants. Allergy. 2012;67:1415-22.
9. Pelucchi C, Galeone C, Bach JF, La Vecchia C, Chatenoud L. Pet exposure and risk of atopic dermatitis at the pediatric age: a meta-analysis of birth cohort studies. J Allergy Clin Immunol. 2013;132:616-22.
10. Nwaru BI, Takkinen HM, Niemelä O, Kaila M, Erkkola M, Ahonen S, et al. Introduction of complementary foods in infancy and atopic sensitization at the age of 5 years: timing and food diversity in a Finnish birth cohort. Allergy. 2013;68:507-16.
11. van Kampen V, de Blay F, Folletti I, Kobierski P, Moscato G, Olivieri M, et al. EAACI position paper: skin prick test-ing in the diagnosis of occupational type I allergies. Allergy. 2013;68:580-4.
12. Vásquez-Garibay EM. First year of life. Human milk and human milk substitutes. Gac Med Mex. 2016;152 Suppl. 1:13-21. Spanish.
13. Agostoni C, Decsi T, Fewtrell M, Goulet O, Kolacek S, Koletzko B, et al. ESPGHAN Committee on Nutrition. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2008;46: 99-110.
14. Sears MR, Greene JM, Willan AR, Taylor DR, Flannery EM, Cowan JO, et al. Long-term relation between breastfeeding and development of atopy and asthma in children and young adults: a longitudinal study. Lancet. 2002;360:901-7.
15. Matheson MC, Erbas B, Balasuriya A, Jenkins MA, Wharton CL, Tang ML, et al. Breast-feeding and atopic disease: a cohort study from childhood to middle age. J Allergy Clin Immunol. 2007;120:1051-7.
16. Lowe AJ, Carlin JB, Bennett CM, Abramson MJ, Hosking CS, Hill DJ, et al. Atopic disease and breast-feeding - cause or consequence? J Allergy Clin Immunol. 2006;117:682-7.
17. Nwaru BI, Erkkola M, Ahonen S, Kaila M, Haapala AM, KronbergKippilä C, et al. Age at the introduction of solid foods during the first year and allergic sensitization at age 5 years. Pediatrics. 2010;125:50-9.
18. Koplin JJ, Osborne NJ, Wake M, Martin PE, Gurrin LC, Robinson MN, et al. Can early introduction of egg prevent egg allergy in infants? A population-based study. J Allergy Clin Immunol. 2010;126:807-13.
19. Katz Y, Rajuan N, Goldberg MR, Eisenberg E, Heyman E, Cohen A, et al. Early exposure to cow’s milk protein is protective against IgE-mediated cow’s milk protein allergy. J Allergy Clin Immunol. 2010;126:77-82.
20. Onizawa Y, Noguchi E, Okada M, Sumazaki R, Hayashi D. The association of the delayed introduction of cow’s milk with IgE mediated cow’s milk allergies. J Allergy Clin Immunol Pract. 2016;4:481-8.
21. Kull I, Bergström A, Lilja G, Pershagen G, Wickman M. Fish consumption during the first year of life and development of allergic diseases during childhood. Allergy. 2006;61:1009-15.
22. Nwaru BI, Takkinen HM, Niemelä O, Kaila M, Erkkola M, Ahonen S, et al. Introduction of complementary foods in infancy and atopic sensitization at the age of 5 years: timing and food diversity in a Finnish birth cohort. Allergy. 2013; 68:507-16.
23. Joseph CL, Ownby DR, Havstad SL, Woodcroft KJ, Wegienka G, MacKechnie H, et al. Early complementary feeding and risk of food sensitization in a birth cohort. J Allergy Clin Immunol. 2011;127:1203-10.e5.
24. Boyano-Martínez T, García-Ara C, Díaz-Pena JM, Martín-Esteban M. Prediction of tolerance on the basis of quantification of egg white-specific IgE antibodies in children with egg allergy. J Allergy Clin Immunol. 2002;110:304-9.
25. Kim J, Chung Y, Han Y, Ahn K, Lee SI. The natural history and prognostic factors of egg allergy in Korean infants with atopic dermatitis. Asian Pac J Allergy Immunol. 2009;27:107-14.
26. Sicherer SH, Sampson HA. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014;133:291-307.
27. Peters RL, Dharmage SC, Gurrin LC, Koplin JJ, Ponsonby AL, Lowe AJ, et al. HealthNuts study. The natural history and clinical predictors of egg allergy in the first 2 years of life: a prospective, population-based cohort study. J Allergy Clin Immunol. 2014;133:485-91.
28. Dong GH, Ding HL, Ma YN, Jin J, Cao Y, Zhao YD, et al. Asthma and asthma-related symptoms in 16 789 Chinese children in relation to pet keeping and parental atopy. J Investig Allergol Clin Immunol. 2008;18:207-13.
29. Min KB, Min JY. Exposure to household endotoxin and total and allergen-specific IgE in the US population. Environ Pollut. 2015;199:148-54.
30. Kettleson EM, Adhikari A, Vesper S, Coombs K, Indugula R, Reponen T. Key determinants of the fungal and bacterial microbiomes in homes. Environ Res. 2015;138:130-5.