title: Does concurrent breastfeeding alongside the introduction of solid food prevent the development of food allergy?
abstract: The timing of introduction of solid food on the subsequent development of food allergy is under debate and the role of concurrent breastfeeding is unclear. The aim of the present study was to investigate the role of solid food introduction whilst concurrently breastfeeding on food allergy outcome, with a specific focus on cows' milk allergy. Prospectively collected infant feeding data from a birth cohort were analysed. Participants with histories suggestive of food allergy underwent diagnostic food challenges. Children with food allergy were matched to control participants for age and sex. Mann-WhitneyUtests, χ2, Fisher exact tests and logistic regression calculations were undertaken. A total of thirty-nine food-allergic children and seventy-eight matched controls were identified, including twenty-two cows' milk-allergic children and forty-four matched controls. The control group introduced solid food earlier than the food-allergic group (P< 0·05). There was no effect of concurrent breastfeeding alongside cows' milk introduction or other food allergens on the development of food allergy. Due to small numbers, it was not possible to explore differences for food allergy phenotype. We have therefore found no evidence that introducing solids, or food allergens, whilst breastfeeding has an allergy-preventative effect; however, the results should be interpreted with caution due to sample size. Recommendations regarding infant feeding and food allergy should be carefully considered. Although breastfeeding should be promoted for many health reasons, larger studies looking at the introduction of food allergens on the development of food allergy are needed to make a final conclusion.
authors.affiliation: School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK; David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK.
authors.forename: Carina
authors.initials: C
authors.lastname: Venter
authors.affiliation: School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK; David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Maslin
authors.affiliation: School of Health Sciences and Social Work, University of Portsmouth, Portsmouth, UK; David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK.
authors.forename: Taraneh
authors.initials: T
authors.lastname: Dean
authors.affiliation: David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, UK; Clinical and Experimental Sciences, University of Southampton, Southampton, UK.
authors.forename: Syed Hasan
authors.initials: SH
authors.lastname: Arshad
keywords: Breastfeeding; CMA, cows’ milk allergy; Complementary feeding; EAT, Enquiring About Tolerance; ESPGHAN, European Society of Paediatric Gastroenterology, Hepatology and Nutrition; FAIR, Food Allergy and Intolerance Research; Food allergies; Infant feeding; LEAP, Learning Early About Peanut Allergy