Infant feeding, wheezing, and allergy: a prospective study

Area of Science:

• Pediatrics
• Allergy and Immunology
• Epidemiology

Background:

• Investigating early life factors influencing childhood allergy and wheezing is crucial for prevention strategies.
• A family history of allergic disease is a significant risk factor for developing allergies in children.

Purpose of the Study:

• To examine the impact of withholding cow's milk protein in early infancy on the development of allergy and wheezing.
• To assess the long-term effects of breastfeeding on wheezing and allergic disease up to age 7.
• To identify other environmental or familial determinants of wheezing and allergy.

Main Methods:

• A randomized controlled trial involving 453 children with a family history of allergic disease.
• Intervention group: cows' milk protein avoidance for the first three months, replaced with soy milk.
• Follow-up to age 7, assessing allergy and wheezing incidence, with data on breastfeeding, environmental exposures, and demographics.

Main Results:

• Withholding cows' milk protein did not significantly reduce the incidence of allergy or wheezing.
• Children who were ever breastfed had a lower incidence of wheeze (59%) compared to those never breastfed (74%).
• This protective effect of breastfeeding on wheeze persisted to age 7 in non-atopic children, halving the risk after adjusting for covariates. Allergic disease showed no association with tobacco smoke, dust mite, or cat exposure.

Conclusions:

• Early avoidance of cow's milk protein is not effective in preventing childhood allergy or wheezing.
• Breastfeeding appears to offer long-term protection against wheezing, particularly in non-atopic children.
• Breastfeeding may also confer protection against respiratory infections, suggesting broader health benefits.