Association between Caesarean Delivery and Isolated Doses of Formula Feeding in Cow Milk Allergy

Abstract

Background: Cow milk allergy (CMA) is the most common food allergy in breastfed infants. The aim of this study is to verify whether certain perinatal factors may influence the development of CMA immunoglobulin E (IgE)+. Methods: A retrospective, observational study of case and control groups was carried out. Information was collected of patients with CMA IgE+ from our department during the years 1990-2013. Patients of the same age and sex were recruited for the control group. Information on the following variables was collected: sex, age, pregnancy tolerance, duration of pregnancy, type of delivery, isolated doses of formula feeding in hospital (FFH), duration of breastfeeding, and family history of allergy (defined as ≥1 first-degree family member with allergic disease). Statistical analysis was performed using multivariate logistic regression techniques. Results: A total of 211 cases were included in this study. Multivariate analysis showed an influence of duration of breastfeeding, FFH to be a risk factor (OR 4.94; 95% CI 2.68-9.08), especially in caesarean delivery (OR 11.82; 95% CI 2.64-47.50), and prematurity (OR 0.29; 95% CI 0.09-0.92) to be a protective factor. Conclusions: Perinatal factors play a key role in the development of CMA IgE+, with an influence of breastfeeding duration, FFH and caesarean delivery as risk factors and prematurity as a protective factor. While family history had no important role, environmental factors were more decisive.

Factors Associated with the Development of Immune Tolerance in Children with Cow’s Milk Allergy

“…We believe that the intake of isolated cow’s milk formula during the first hours of life, together with the effect caesarean sections have on intestinal bifidogenic flora, may be associated with IgE-mediated CMA, the former being a predisposing factor and the latter a triggering one [25]. Our results show that caesarean sections could be associated with delayed acquisition of tolerance in patients affected with CMA.…”

The gut microbiota, environmental factors, and links to the development of food allergy

“…Consequently, breastfed infants are colonized with Bifidobacteria and Lactobacilli compared with formula fed infants [74]. Additionally, the breastfeeding duration also has an influence on the development of food allergy as infants with a very brief breastfeeding duration have a higher risk of developing cow's milk allergy [75].…”

Recent Advances in Experimental Allergy

“…A common allergy amongst infants is that of cow’s milk. An association between Caesarean births and instances of formula feeding in hospitals was recently reported to have a positive association with cow milk allergy [68]. This work highlights the importance of food intake during early life with respect to the development of food allergy.…”