Early introduction of cow’s milk formula associated with reduced risk of cow’s milk allergy

Published Online: May 2016

Cow’s milk allergy (CMA) is the second most common food allergy in the United States and Japan. Exclusive breastfeeding until 4 to 6 months of age has been recommended to prevent IgE-mediated cow’s milk allergy (IgE-CMA). In recent years, early introduction of food allergens has been suggested to prevent food allergies. A few studies have suggested that early introduction of cow’s milk (CM) formula might be protective against IgE-CMA. However, these studies have limited data about the factors affecting parental choice of feeding patterns.

In a study published by The Journal of Allergy and Clinical Immunology: In Practice, Onizawa and colleagues used a retrospective questionnaire to investigate the feeding patterns used in early infancy in patients with IgE-CMA, and the reasons the parents chose that feeding pattern. The authors compared the frequency of use of CM formula in IgE-CMA patients with that in age- and sex-matched healthy controls. By adjusting for patient background, family history of allergic diseases, and history of atopic dermatitis or bronchial asthma, the effect of timing of introduction of CM formula on the development of IgE-CMA was evaluated. The authors also compared IgE-CMA patients with IgE-mediated egg allergy patients to reduce confounding factors.

A total of 185 children were recruited in the study. Regular use (at least once daily) of CM formula in the first month of life was significantly less common in IgE-CMA patients than in other groups. The authors concluded that delayed or irregular use of CM formula increases the risk for IgE-CMA. Most parents of patients with IgE-CMA reported that they chose exclusive breastfeeding because they did not feel the need to use CM formula, not for the future prevention of allergic diseases.

This study supports the hypothesis that early exposure to CM formula may prevent IgE-CMA.  However, a large prospective study is required to confirm this possibility and to assess the benefits and adverse effects of the consumption of CM formula in infancy.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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