Pediatr Allergy Respir Dis.  2011 Sep;21(3):207-214.

Comparison of the Effects of Breast Milk Feeding with Maternal Restriction and Hypoallergenic Milk Feeding on the Acquisition of Tolerance to Cow Milk

• Cho J
• Suh J
• Lee JH
• Han Y
• Ahn K
• Lee SI

Abstract

PURPOSE
The aim of this study was to compare the effects of breast milk (BM) feeding with those of maternal cow milk (CM) restriction and extensively hydrolyzed CM formula feeding on the duration of CM allergy as well as changes in specific immunoglobulin E (IgE) levels in infants with CM allergy.
METHODS
Children diagnosed with CM allergy before 12 months age and BM fed were included retrospectively. CM allergy was diagnosed by CM specific IgE over 0.35 kU/L and 1) obvious clinical symptoms, 2) a suspicious history with positive provocation test, or 3) CM specific IgE over the 95% positive predictive value and subsequent documented report of clinical symptoms. The patients were classified into three groups by feeding regimen: BM group, extensively hydrolyzed formula (eHF) group, or mixed feeding (MF) group. Analysis of the groups regarding the duration of food allergy and changes in CM specific IgE was then performed.
RESULTS
Forty-six children were included. Twenty-four children were in the BM group, 13 children were in the eHF group, and 9 children comprised the MF group. Thirteen patients reached tolerance. The means of the tolerance age were 69.7+/-5.4 months in the BM group, 36.6+/-4.6 months in the eHF group, and 38.2+/-7.9 months in the MF group. The survival curves of tolerance showed significant difference among the three groups (P=0.04). CM specific IgE levels measured at a second time period were 9.6 kU/L (interquartile range, 3.6-44.2) in the BM group, 2.0 kU/L (1.0-18.0) in the eHF group, and 4.8 kU/L (0.2-10.4) in the MF group (P=0.04).
CONCLUSION
Feeding regimen influences the duration of CM allergy. Exclusively BM-fed children achieved tolerance later than eHF-fed children. Prospective and randomized controlled studies are required.

Keyword

Food allergy; Cow milk; Breast milk feeding; Extensively hydrolyzed formula; Tolerance; Specific immunoglobulin E

MeSH Terms

Breast
Child
Food Hypersensitivity
Humans
Hypersensitivity
Immunoglobulin E
Immunoglobulins
Infant
Milk
Milk, Human
Retrospective Studies
Immunoglobulin E
Immunoglobulins

Figure

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  Fig. 1. Kaplan-Meier curve for persistence of cow's milk allergy (CMA) (n=46).

• 

  Fig. 2. Comparison of survival curve for persistence between breast milk, extensively hydrolyzed formula and mixed feeding groups. BM, breast milk; eHF, extensively hydrolyzed formula.

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  Fig. 3. Comparison of survival curve for persistence between (A) exclusive hydrolyzed formula (eHF) group and the other feeding groups (P =0.284), (B) exclusive breast milk group and the other feeding groups (P =0.020). BM, breast milk.

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  Fig. 4. The changes of specific immunoglobulin E (IgE) in each feeding groups. The levels of specific IgE are log transformed to show changes of means in each groups. BM, breast milk; eHF, extensively hydrolyzed formula; MF, mixed feeding.

Reference

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