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Early introduction of cow's milk protein protects against milk allergy in childhood: Study
Boston, MA: New research in The Journal of Allergy and Clinical Immunology has shown that early and consistent exposure to cow's milk in children appears protective against adverse reactions to cow milk.
This prompted researchers to suggest that mothers intending to exclusively breastfeed might avoid cow's milk-based formula supplements post-birth. "When deciding the timing of cow's milk introduction to the diet, parents might consider whether an infant was given supplemental formula after birth." the researchers wrote.
Current guidelines have suggested early introduction to potentially allergenic foods, but there is no clear establishment of the optimal timing, amount, and exposure routes for foods other than peanuts. Often, cow's milk is the first allergic food introduced through infant formulas.
Considering the above, Karen M. Switkowski, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, and colleagues aimed to examine the timing of cow's milk protein introduction (CMPI), including interaction with formula supplementation after delivery, in relation to reported cow's milk adverse reactions (CMARs), throughout childhood.
For this purpose, the researchers assessed the timing of CMPI (<2wks, 2wks-<6mos, ≥6mos) among children in the Boston, MA-area Project Viva cohort with questionnaires administered in infancy. Outcomes included 1) parent-reported CMAR via annual questionnaires from 2-13yrs (n=1298); and 2) milk sensitization (n=505) and IgE-mediated milk allergy (n=491) at ∼8yrs.
Multivariable logistic regression models were used after adjusting for parental atopy history, delivery mode, gestational age at delivery, child race, and census tract median household income. Effect modification was investigated by ever/never breastfed status and formula supplementation in the delivery hospital.
Key findings of the study include:
· 32% were introduced to cow's milk protein at <2wks, 38% at 2wks-<6mos, and 30% at ≥6mos.
· Compared to children with CMPI <2wks, children with CMPI ≥6mos had a higher risk of CMAR at 2-5yrs (OR: 2.4).
· Children who were given formula after delivery + CMPI <2wks had the lowest risk overall.
· Among children not given formula after delivery, CMPI 2wks-6mos appeared most protective. Results were similar among ever-breastfed children.
· Timing of CMPI was not associated with milk sensitization or IgE-mediated milk allergy in mid-childhood.
The researchers conclude, "early, consistent cow's milk exposure appears protective against adverse reactions to cow's milk."
Reference:
Switkowski KM, Oken E, Rifas-Shiman SL, Camargo CA Jr, Gold DR, Sordillo JE, Lightdale JR. Timing of Cow's Milk Protein Introduction and Childhood Adverse Reactions to Cow's Milk. J Allergy Clin Immunol Pract. 2022 Jun 29:S2213-2198(22)00644-4. doi: 10.1016/j.jaip.2022.06.022. Epub ahead of print. PMID: 35779778.
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751