Food Allergy Risk: A Comprehensive Review of Maternal Interventions for Food Allergy Prevention

Background: There is a lack of data regarding the early introduction of the consumption of allergenic food among Asian infants. Methods: We examined infants who had early-onset eczema before 6 months of age and received instructions from certified allergists for the early introduction of hen’s eggs, milk, wheat, peanuts, and tree nuts. Results: The consumption rates of hen’s eggs were 100% at 24 months. For peanuts and walnuts, the consumption rate was moderate at 12 months (48.5% and 30.3%, respectively), but by 24 months, it had progressed to 78.8% and 81.3%, respectively. In contrast, cashews remained at lower levels than other allergens at 20.7% at 12 months and 41.4% at 24 months. No adverse events related to early introductions occurred. Conclusions: In infants with eczema, allergenic foods could be introduced early and well tolerated in Asian infants. However, having eczema may indicate a predisposition to food allergies, so caution is necessary when introducing allergenic foods. The early introduction of peanuts and tree nuts was still more challenging in real-world practice in Asia as well as in Western countries.

Section: Discussionmentioning

confidence: 99%

Feasibility and Safety of the Early Introduction of Allergenic Foods in Asian Infants with Eczema

Harama,

Saito-Abe,

Hamaguchi

et al. 2024

Correlation of Maternal Vitamin D Status in Early Pregnancy and Vitamin D Supplementation during Pregnancy with Atopic Dermatitis in Infants: A Prospective Birth Cohort Study

Zhang,

Yang,

Shen

et al. 2024

Objective: This study aimed to investigate the association of maternal first-trimester vitamin D levels and vitamin D supplementation during pregnancy with infant atopic dermatitis (AD) and to determine the effect of variables such as mode of conception on the association. Methods: This study was based on the Shanghai sub-cohort of the International Birth Cohort of China. A total of 4051 woman–infant pairs with singleton pregnancies were recruited. Vitamin D deficiency and insufficiency were defined as serum 25-hydroxyvitamin D concentrations of 25 and 50 nmol/L, respectively. AD in infants was assessed during the first six months using a standardized questionnaire based on the British Working Party criteria. Modified Poisson regression estimated the association between maternal vitamin D status and infant AD. Results: The risk of AD in infants was higher in women with deficient 25-hydroxyvitamin D levels in the first trimester (RR: 1.77, 95% CI: 1.41–2.23). This increased risk was seen in naturally conceived pregnancies, but not in those conceived using assisted reproductive technology (ART). The incidence of AD decreased in infants of mothers who took multi-vitamin (RR: 0.79, 95% CI: 0.67–1.98) and vitamin D supplements (RR: 0.51, 95% CI: 0.37–0.71) compared to those whose mothers did not take any supplements. Maternal vitamin D deficiency had varying effects on AD risk based on passive smoking exposure and breastfeeding patterns. Conclusions: Our findings highlight the importance of monitoring and supplementing vitamin D during pregnancy, especially in specific maternal populations, to reduce the risk of AD in offspring.

Goat Milk Allergy and a Potential Role for Goat Milk in Cow’s Milk Allergy

Benjamin-van Aalst,

Dupont,

van der Zee

et al. 2024

In many parts of the world, goat milk has been part of the human diet for millennia. Allergy to goat’s milk, not associated with allergy to cow’s milk, is a rare disorder, although some cases have been described. Goat milk proteins have substantial homology with cow’s milk proteins and even show cross-reactivity; therefore, they are not advised as an alternative to cow’s milk for infants with IgE-mediated cow’s milk allergies. However, there are indications that, due to the composition of the goat milk proteins, goat milk proteins show lower allergenicity than cow’s milk due to a lower αS1-casein content. For this reason, goat milk might be a better choice over cow’s milk as a first source of protein when breastfeeding is not possible or after the breastfeeding period. Additionally, some studies show that goat milk could play a role in specific types of non-IgE-mediated cow milk allergy or even in the prevention of sensitization to cow’s milk proteins. This review discusses a possible role of goat milk in non-IgE mediated allergy and the prevention or oral tolerance induction of milk allergy.