Why is there still confusion about the impact of breast-feeding on the risk of allergy development?

Wold, Agnes E.

doi:10.1080/11026480600617774

Cited by 4 publications

(3 citation statements)

References 33 publications

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“…Previous studies have been criticised for evaluating allergic outcomes before breastfeeding termination and too early in childhood, when allergy-related disorders are harder to distinguish from infectious diseases [ 27 ]. By two years, almost all the children in the current study were weaned from breast milk and a persisting effect should be possible to detect.…”

Section: Discussionmentioning

confidence: 99%

Duration of breastfeeding, age at introduction of complementary foods and allergy-related diseases: a prospective cohort study

et al. 2021

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Background The influences of breastfeeding and infant diet in the prevention of allergy-related diseases are uncertain and many of the studies conducted on the topic are limited by methodological challenges. Our aim was to assess whether the duration of breastfeeding and age at complementary food introduction affected the prevalence of asthma, wheeze, allergic rhinoconjunctivitis (ARC) and eczema at two and six years of age. Methods We used information gathered between 2000 and 2014 through questionnaires in the Prevention of Allergy among Children in Trondheim (PACT) study, a prospective cohort study in Trondheim, Norway. The current study includes 6802 children who submitted questionnaires detailing breastfeeding duration and or age at introduction to complementary foods, as well as at least one of the child health questionnaires completed at two and six years of age. Adjusted odds ratios (aORs) were calculated for each combination of exposure and outcomes and sensitivity analyses were performed to assess the possible influence of recall bias and reverse causality. Results The mean duration of breastfeeding was 11 months (SD 5.6) in this study population and 5695 of 6796 (84%) infants had been breastfed for at least 6 months. We did not find any conclusive preventative effect of longer breastfeeding on parental reported doctor-diagnosed asthma, aOR 0.79 (95% CI 0.51, 1.21). However, at 6 years of age we observed a reduction in the less strictly defined outcome wheeze, aOR 0.71 (95% CI 0.53, 0.95). Longer breastfeeding was associated with a reduced risk of ARC at 2 years, aOR 0.65 (95% CI 0.49, 0.86), with a continued protective trend at 6 years, aOR 0.77 (95% CI 0.58, 1.04). Conclusions Longer breastfeeding resulted in a reduced risk of wheeze and a trend towards a protective effect on ARC up until school age. No conclusive associations were seen between the duration of breastfeeding or age at introduction to complementary foods and prevention of asthma, wheeze, ARC and eczema. Trial registration The trial is registered in Current Controlled Trials as ISRCTN28090297.

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Section: Discussionmentioning

confidence: 99%

Duration of breastfeeding, age at introduction of complementary foods and allergy-related diseases: a prospective cohort study

et al. 2021

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“…The association between being breastfed for 4 months or more and increased IgE was unexpected as it has not been reported previously. There have been many studies of the impact of breastfeeding on the subsequent development of allergic disease and despite the undoubted health benefits of breastfeeding on child health, the impact on allergic disease is not fully understood (Wold ; Revalas & Katasos ). One of the well‐recognised benefits of breastfeeding is the transfer of maternal immunity in the form of immunoglobulin A (IgA) to the infant (Hanson & Korotkova ) and protection against infection (AAP ), and breastfed infants have lower mortality attributable to infections than those who are not breastfed (Arifeen et al .…”

Section: Discussionmentioning

confidence: 99%

What are the main environmental exposures associated with elevated IgE in Cuban infants? A population‐based study

Fundora-Hernández

Venero-Fernández

Suárez-Medina

et al. 2014

Tropical Med Int Health

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ObjectiveImmunoglobulin E (IgE) plays a key role in allergy disease pathogenesis, but little is known about the environmental factors associated with higher IgE levels in infants. The aim of this study was to determine the risk factors for elevated serum total IgE infants living in Havana.MethodsEight hundred and seventy-seven infants provided blood samples. Data on allergic disease symptoms and a wide range of exposures were collected.ResultsThe median IgE was 35IU/ml (interquartile range 13–96). The risk of having an IgE level above the median was higher for children who had been breastfed for 4 months or more (adjusted odds ratio (OR) 1.28; 95% confidence interval (CI): 1.02–1.61) and for children who reported cockroaches in their home (OR 1.30; 95% CI: 1.03–1.63). The risk was lower for children whose mother was in paid employment (OR 0.73; 95% CI: 0.54–0.97 compared with those who did not), for children living in homes where gas and electricity were used for cooking (OR 0.45; 95% CI: 0.32–0.62 compared with electricity only) and for children with domestic pets at birth (OR 0.83; 95% CI: 0.70-1.00). There was no association between paracetamol use and serum IgE levels.ConclusionsAssociations between gas fuel use and maternal employment indicate that IgE levels in early life are lower in children who may be living in relative affluence. The discrepancy in the effect of early exposure to pets or cockroaches may reflect differences in these allergens, or be confounded by relative affluence. Further investigation of this cohort will determine how these effects translate into the expression of allergic disease in later life.ObjectifLes immunoglobulines E (IgE) jouent un rôle clé dans la pathogenèse de la maladie allergique, mais on sait peu sur les facteurs environnementaux associés à des taux plus élevés d'IgE chez les nourrissons. Le but de cette étude était de déterminer les facteurs de risque pour un taux élevé d'IgE sériques totales chez les nourrissons vivant à La Havane.MéthodesDes échantillons de sang ont été collectés chez 877 nourrissons. Les données sur les symptômes de la maladie allergique et sur une large gamme d'expositions ont été recueillies.RésultatsLa médiane des IgE était de 35 UI/ml (gamme interquartile: 13 à 96). Le risque d'avoir un taux d'IgE au-dessus de la médiane était plus élevé pour les enfants qui avaient été allaités pendant au moins quatre mois (odds ratio ajusté (OR): 1,28; intervalle de confiance (IC) à 95%: 1,02 à 1,61) et pour les enfants pour qui des cafards ont été signalés dans la maison (OR: 1,30; IC 95%: 1,03 à 1,63). Le risque était plus faible pour les enfants dont la mère possédait un emploi rémunéré (OR: 0,73; IC 95%: 0,54 à 0,97 par rapport à ceux dont les mères n'avaient pas cet emploi, pour les enfants vivant dans des foyers où le gaz et l’électricité étaient utilisés pour la cuisson (OR: 0,45; IC 95%: 0,32 à 0,62 par rapport à l'utilisation de l’électricité seule) et pour les enfants ayant des animaux domestiques à la naissance (OR: 0,83; IC 95%: 0,70 à 1,00). Il n'...

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“…An example of conflicting evidence related to breastfeeding is its effects on infant infections and allergies [ 198 , 199 ]. As an evolutionary benefit, breastfeeding may protect against infections, while effects against allergic diseases are more questionable, or at least depend on many factors, including hygiene standards.…”

Section: Science Faith and Breastfeedingmentioning

confidence: 99%

Science and Faith to Understand Milk Bioactivity for Infants

Sangild

2024

Nutrients

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Milk bioactivity refers to the specific health effects of milk components beyond nutrition. The science of milk bioactivity involves the systematic study of these components and their health effects, as verified by empirical data, controlled experiments, and logical arguments. Conversely, ’faith in milk bioactivity’ can be defined as personal opinion, meaning, value, trust, and hope for health effects that are beyond investigation by natural, social, or human sciences. Faith can be strictly secular, but also influenced by spirituality or religion. The aim of this paper is to show that scientific knowledge is frequently supplemented with faith convictions to establish personal and public understanding of milk bioactivity. Mammalian milk is an immensely complex fluid containing myriad proteins, carbohydrates, lipids, and micronutrients with multiple functions across species, genetics, ages, environments, and cultures. Human health includes not only physical health, but also social, mental, and spiritual health, requiring widely different fields of science to prove the relevance, safety, and efficacy of milk interventions. These complex relationships between milk feeding and health outcomes prevent firm conclusions based on science and logic alone. Current beliefs in and understanding of the value of breast milk, colostrum, infant formula, or isolated milk proteins (e.g., immunoglobulins, α-lactalbumin, lactoferrin, and growth factors) show that both science and faith contribute to understand, stimulate, or restrict the use of milk bioactivity. The benefits of breastfeeding for infants are beyond doubt, but the strong beliefs in its health effects rely not only on science, and mechanisms are unclear. Likewise, fear of, or trust in, infant formula may rely on both science and faith. Knowledge from science safeguards individuals and society against ‘milk bioactivity superstition’. Conversely, wisdom from faith-based convictions may protect science from unrealistic ‘milk bioactivity scientism’. Honesty and transparency about the potentials and limitations of both scientific knowledge and faith convictions are important when informing individuals and society about the nutritious and bioactive qualities of milk.

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Why is there still confusion about the impact of breast-feeding on the risk of allergy development?

Cited by 4 publications

References 33 publications

Duration of breastfeeding, age at introduction of complementary foods and allergy-related diseases: a prospective cohort study

Duration of breastfeeding, age at introduction of complementary foods and allergy-related diseases: a prospective cohort study

What are the main environmental exposures associated with elevated IgE in Cuban infants? A population‐based study

Science and Faith to Understand Milk Bioactivity for Infants

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