Early Cow's Milk Formula Tied to Subsequent Allergies in Infants
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Avoiding infants' exposure to cow's milk for at least the first 3 days of life appears to decrease the risk for cow's milk sensitization and clinical food allergies, a randomized study found. In the Atopy Induced by Breastfeeding or Cow's Milk Formula (ABC) trial, cow's milk sensitization was present in 32.2% of 2-year-olds in the group exposed to cow's milk formula right after birth compared with 16.8% of their counterparts who were not, for a relative risk (RR) of 0.52 (95% confidence interval [CI], 0.34 - 0.81). Food allergy was significantly less prevalent in unexposed 2-year-olds for both immediate and anaphylactic types: 2.6% vs 13.2% (RR, 0.20; 95% CI, 0.07 - 0.57) and 0.7% vs 8.6% (RR, 0.08; 95% CI, 0.01 - 0.58), respectively. "This prevention is easily and immediately applicable to clinical practice throughout the world without the cost and time of therapy," write Mitsuyoshi Urashima, MD, MPH, PhD, a professor of molecular epidemiology at Jikei School of Medicine in Tokyo, Japan, and colleagues.
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@aparajita The newborns were all at risk for atopy, having at least one parent or sibling with current and/or past atopic diseases such as asthma. They were randomly assigned in a 1:1 ratio immediately after birth to breastfeeding with or without amino acid-based elemental formula (BF/EF) for at least the first 3 days of life or to breastfeeding supplemented with cow's milk formula at ≥ 5 mL/d (BF/CMF) from the first day of life to age 5 months. The primary outcome was sensitization to cow's milk protein defined by a cow's milk immunoglobulin E (IgE) level of ≥ 0.35 allergen units (UA)/mL) at 24 months. Secondary outcomes were immediate and anaphylactic types of food allergy, including cow's milk, egg, wheat, and others, as diagnosed by oral food challenge test or triggered by food ingestion, with food-specific IgE levels of ≥0.35 UA/mL.