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Formula and breast feeding in infant food allergy: A population-based study
Alice J Goldsmith1,2, Jennifer J Koplin2,3, Adrian J Lowe2,4
1School of Medicine, Sydney, University of Notre Dame, Sydney, New South Wales, Australia.
Insights
Exclusive breastfeeding duration and partially hydrolyzed formula use do not affect infant food allergy risk. This large study found no link between these feeding practices and allergy development at one year of age.
Area of Science:
- Pediatric Allergy and Immunology
- Nutritional Epidemiology
- Public Health Nutrition
Background:
- Infant feeding practices are critical for immune development.
- The role of breastfeeding and specialized formulas in preventing food allergies remains debated.
- Understanding these associations is crucial for evidence-based infant feeding guidelines.
Purpose of the Study:
- To investigate the association between exclusive breastfeeding duration and infant food allergy.
- To determine if partially hydrolyzed formula use modifies the risk of developing food allergy.
- To inform public health recommendations on infant feeding for allergy prevention.
Main Methods:
- Observational, population-based study of 5276 infants in Melbourne, Australia.
- Data collected on infant feeding practices and confounders.
- Food allergy status determined by skin prick testing and oral food challenges.
Main Results:
- No association found between exclusive breastfeeding duration and food allergy at 1 year.
- Partially hydrolyzed formula use did not reduce food allergy risk compared to cow's milk formula.
- 11.3% of infants studied were diagnosed with food allergy.
Conclusions:
- Exclusive breastfeeding duration and partially hydrolyzed formula are not associated with food allergy at one year.
- Findings do not support the use of partially hydrolyzed formula for food allergy prevention.
- Results have implications for population-based infant feeding guidelines.
Aim:
To determine whether infant-feeding practices, including duration of exclusive breastfeeding and use of partially hydrolysed formula, modify the risk of developing infant food allergy.
Methods:
In an observational population-based study, 1 year olds were recruited from community immunisation clinics in Melbourne, Australia. Parent-reported data on infant-feeding practices and potential confounders were collected prior to infant skin prick testing for four food allergens. Sensitised infants attended hospital-based oral food challenges to establish food allergy status. Multiple logistic regression was used to investigate associations between breastfeeding and formula-feeding and infant food allergy adjusting for possible confounding variables.
Results:
A total of 5276 (74% response) infants participated. Of the 4537 for whom food allergy status was determined, 515 (11.3%) were food allergic (challenge-proven in the context of skin prick testing positive (≥2 mm)). After adjusting for confounding variables, there was no association between duration of exclusive breastfeeding and food allergy. Use of partially hydrolysed formula did not reduce the risk of food allergy compared with cow's milk formula in the general population (adjusted odds ratios 1.03 (confidence interval 0.67-1.50)).
Conclusion:
Duration of exclusive breastfeeding and use of partially hydrolysed formula were not associated with food allergy at 1 year of age in this large population-based study. These findings have implications for population-based infant-feeding guidelines and do not support the use of partially hydrolysed formula for food allergy prevention.
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