Food Proteins in Human Breast Milk and Probability of IgE-Mediated Allergic Reaction in Children During Breastfeeding: A Systematic Review

Gamirova, Aysylu; Berbenyuk, Anna; Levina, D. M.; Peshko, Dmitrii; Simpson, Melanie Rae; Azad, Meghan B.; Järvinen, Kirsi M.; Brough, Helen A.; Genuneit, Jon; Greenhawt, Matthew; Verhasselt, Valérie; Peroni, Diego; Perkin, Michael R.; Warner, John O.; Palmer, Debra J.; Boyle, Robert; Munblit, Daniel

doi:10.1016/j.jaip.2022.01.028

Cited by 33 publications

(23 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As to whether these dietary allergens ingested by lactating women are indeed found in breast milk at levels that exceed thresholds of reactivity to induce an allergic response, only a few samples from three studies [ 24 , 25 , 27 ] reached a level of β-LG ≥ED01 (eliciting dose for 1% of allergic individuals), and in no case did the samples contain β-LG in concentrations ≥ED05 [ 65 ]. The probability of having enough β-LG in breast milk to trigger an allergic reaction in a susceptible child has been estimated at 1:2893 [ 8 ]. However, in the previous systematic review, only immunochemical methods were used (ELISA and radioimmunoassays).…”

Section: Discussionmentioning

confidence: 99%

“…Aside from the above, formula-fed infants receive high amounts of antigens from bovine milk, which is the basis for most infant formula, while for breastfed babies, the first exposure to food allergens is breast milk, in which the antigens from the maternal diet and presumably also those inhaled by the mother will be found in much smaller amounts than in infant formula [ 8 ]. The presence of food antigens in breast milk will depend on factors such as maternal digestion and transfer rate to the mammary gland.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cow’s Milk Antigens Content in Human Milk: A Scoping Review

Franco

Fente

Sánchez

et al. 2022

Foods

View full text Add to dashboard Cite

The functionality of breast milk in terms of immunity is well-known. Despite this, a significant proportion of breastfed infants exhibit sensitization to different potentially allergenic proteins and clinical reactivity (including anaphylaxis) early in life and before the introduction of complementary feeding for the first time. The potential induction of early oral tolerance to overcome early allergic sensitization through exposure to allergens in breast milk also remains controversial and not yet well-established. The objective of this scoping review is to provide a critical appraisal of knowledge about the content of cow’s milk antigens in human milk. The amount of dietary derived milk antigens found in human milk and the analytical methodologies used to detect and quantify these antigens, the allergic status of the mother, the stage of lactation, the time of sampling (before or after ingestion of food), and the impact of human milk allergen on the infant were the outcomes that were assessed. Allergy risk was explored in all reviewed studies and could help to better elucidate its role in the context of allergic disease development. According to the included literature, we can conclude that there are mainly fragments derived from bovine proteins in human milk, and the presence of potentially allergenic molecules is greater in the milk of mothers with an allergic tendency. A clear relationship between maternal diet and allergen content in breast milk could not be firmly concluded though. Also, infants receiving milk from human milk banks, where donor milk is pasteurized for preservation, may be subject to greater risk of allergy development, especially for β-lactoglobulin.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cow’s Milk Antigens Content in Human Milk: A Scoping Review

Franco

Fente

Sánchez

et al. 2022

Foods

View full text Add to dashboard Cite

show abstract

“…For chronic symptoms without any obvious temporal relationship to milk protein ingestion, recommendations highlighted the distinction between children directly ingesting milk protein and those who were exclusively breastfed (Table S3; Figure 3). 22 Consensus was reached that milk allergy does not need to be considered for changes to colour, frequency or consistency of stool, aversive feeding, occasional spots of blood in stool, nasal or respiratory symptoms, in the absence of a temporal relationship with milk protein ingestion. Exceptions to this were biopsy-proven eosinophilic gastrointestinal disorders or protein-losing enteropathy or, in a child ingesting milk protein, faltering growth or daily visible blood in stools.…”

Section: Milk Allergy Detectionmentioning

confidence: 99%

Detection and management of milk allergy: Delphi consensus study

Allen

Pendower

Santer

et al. 2022

Clin Experimental Allergy

Self Cite

View full text Add to dashboard Cite

Background: There is significant overdiagnosis of milk allergy in young children in some countries, leading to unnecessary use of specialized formula. This guidance, developed by experts without commercial ties to the formula industry, aims to reduce milk allergy overdiagnosis and support carers of children with suspected milk allergy. Methods: Delphi study involving two rounds of anonymous consensus building and anopen meeting between January and July 2021. Seventeen experts in general practice, nutrition, midwifery, health visiting, lactation support and relevant areas of paediatrics participated, located in Europe,

show abstract

“…Parallels can be drawn with pharmaceutical companies, which have been criticised for drug advertising in medical journals, influencing readers’ understanding, and resulting in some “mythical associations” between medical conditions and branded drugs. 33 34 35 Overall, private sector activities impacting public health, either positively or negatively, and the enabling political economic systems and norms are referred to as commercial determinants of health. 36 Unethical marketing strategies and political activities, including misinformation, lobbying, and donations are well documented features of the current interplay between corporations and public wellbeing.…”

Section: Discussionmentioning

confidence: 99%

Health and nutrition claims for infant formula: international cross sectional survey

Cheung

Petrou

Helfer

et al. 2023

BMJ

Self Cite

View full text Add to dashboard Cite

ObjectivesTo review available health and nutrition claims for infant formula products in multiple countries and to evaluate the validity of the evidence used for substantiation of claims.DesignInternational cross sectional survey.SettingPublic facing and healthcare professional facing company owned or company managed formula industry websites providing information about products marketed for healthy infants delivered at full term in 15 countries: Australia, Canada, Germany, India, Italy, Japan, Nigeria, Norway, Pakistan, Russia, Saudi Arabia, South Africa, Spain, the United Kingdom, and the United States in 2020-22.Main outcome measuresNumber and type of claims made for each product and ingredient. References cited were reviewed and risk of bias was assessed for registered clinical trials using the Cochrane risk of bias tool, and for systematic reviews using the Risk Of Bias in Systematic reviews tool.Results757 infant formula products were identified, each with a median of two claims (range from 1 (Australia) to 4 (US)), and 31 types of claims across all products. Of 608 products with ≥1 claims, the most common claim types were “helps/supports development of brain and/or eyes and/or nervous system” (323 (53%) products, 13 ingredients), “strengthens/supports a healthy immune system” (239 (39%) products, 12 ingredients), and “helps/supports growth and development” (224 (37%) products, 20 ingredients). 41 groups of ingredients were associated with ≥1claims, but many claims were made without reference to a specific ingredient (307 (50%) products). The most common groups of ingredients cited in claims were long chain polyunsaturated fatty acids (278 (46%) products, 9 different claims); prebiotics, probiotics, or synbiotics (225 (37%) products, 19 claims); and hydrolysed protein (120 (20%) products, 9 claims). 161/608 (26%) products with ≥1 claims provided a scientific reference to support the claim—266 unique references were cited for 24 different claim types for 161 products. The reference types most frequently cited were clinical trials (50%, 134/266) and reviews (20%, 52/266). 28% (38/134) of referenced clinical trials were registered, 14% (19/134) prospectively. 58 claims referred to 32 registered clinical trials, of which 51 claims (27 trials) related to a randomised comparison. 46 of 51 claims (90%) referenced registered clinical trial outcomes at high risk of bias, and all cited systematic reviews and pooled analyses, carried a high risk of bias.ConclusionsMost infant formula products had at least one health and nutrition claim. Multiple ingredients were claimed to achieve similar health or nutrition effects, multiple claims were made for the same ingredient type, most products did not provide scientific references to support claims, and referenced claims were not supported by robust clinical trial evidence.

show abstract

Food Proteins in Human Breast Milk and Probability of IgE-Mediated Allergic Reaction in Children During Breastfeeding: A Systematic Review

Cited by 33 publications

References 49 publications

Cow’s Milk Antigens Content in Human Milk: A Scoping Review

Cow’s Milk Antigens Content in Human Milk: A Scoping Review

Detection and management of milk allergy: Delphi consensus study

Health and nutrition claims for infant formula: international cross sectional survey

Contact Info

Product

Resources

About