title: Effects of maternal dietary egg intake during early lactation on human milk ovalbumin concentration: a randomized controlled trial.
abstract: There is limited understanding of how maternal diet affects breastmilk food allergen concentrations, and whether exposure to allergens through this route influences the development of infant oral tolerance or sensitization.
  
  
  
  To investigate how maternal dietary egg ingestion during early lactation influences egg protein (ovalbumin) levels detected in human breastmilk.
  
  
  
  In a randomized controlled trial, women were allocated to a dietary group for the first six weeks of lactation: high-egg diet (> 4 eggs per week), low-egg diet (one-three eggs per week) or an egg-free diet. Breastmilk samples were collected at 2, 4 and 6 weeks of lactation for the measurement of ovalbumin. The permeability of the mammary epithelium was assessed by measuring the breastmilk sodium : potassium ratio. Egg-specific IgE and IgG4 were measured in infant plasma at 6 weeks, and prior to the introduction of egg in solids at 16 weeks.
  
  
  
  Average maternal egg ingestion was associated with breastmilk ovalbumin concentration. Specifically, for each additional egg ingested per week, there was an average 25% increase in ovalbumin concentration (95% CI: 5-48%, P = 0.01). Breastmilk ovalbumin concentrations were significantly higher in the 'high-egg' group (> 4 eggs per week) compared with the 'egg-free' group (P = 0.04). However, one-third of women had no breastmilk ovalbumin detected. No detectable associations were found between mammary epithelium permeability and breastmilk ovalbumin concentrations. Infant plasma egg-specific IgG4 levels were also positively associated with maternal egg ingestion, with an average 22% (95% CI: 3-45%) increase in infant egg-specific IgG4 levels per additional egg consumed per week (P = 0.02).
  
  
  
  Increased maternal egg ingestion is associated with increased breastmilk ovalbumin, and markers of immune tolerance in infants. These results highlight the potential for maternal diet to benefit infant oral tolerance development during lactation.
authors: School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.
authors: J R
authors: JR
authors: Metcalfe
authors: Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.|School of Mathematics & Statistics, The University of Western Australia, Perth, WA, Australia.
authors: J A
authors: JA
authors: Marsh
authors: Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
authors: N
authors: N
authors: D'Vaz
authors: School of Chemistry and Biochemistry, The University of Western Australia, Perth, WA, Australia.
authors: D T
authors: DT
authors: Geddes
authors: School of Chemistry and Biochemistry, The University of Western Australia, Perth, WA, Australia.
authors: C T
authors: CT
authors: Lai
authors: School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.|Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia.
authors: S L
authors: SL
authors: Prescott
authors: School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.
authors: D J
authors: DJ
authors: Palmer
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology*; D000818:Animals; D000918:Antibody Specificity; D001942:Breast Feeding / Q000009:adverse effects; D004032:Diet / Q000009:adverse effects; D004531:Eggs / Q000009:adverse effects; D005260:Female; D005512:Food Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology; D007074:Immunoglobulin G / Q000097:blood / Q000276:immunology; D007223:Infant; D007231:Infant, Newborn; D007774:Lactation; D008297:Male; D008895:Milk, Human / Q000276:immunology*; D010047:Ovalbumin / Q000276:immunology*; D011247:Pregnancy; D012307:Risk Factors
chemical_list: D000485:Allergens; D007074:Immunoglobulin G; D007073:Immunoglobulin E; D010047:Ovalbumin
keywords: allergens and epitopes; clinical immunology; food allergy; pediatrics; prevention