Effects of Breastfeeding on the Development of Allergies

Ha-Baik Lee

doi:10.7599/hmr.2010.30.1.49

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Lee: Effects of Breastfeeding on the Development of Allergies

Review Article

Hanyang Medical Reviews

Hanyang Medical Reviews 2010; 30(1): 49-59.

Published online: 28 February 2010

DOI: https://doi.org/10.7599/hmr.2010.30.1.49

Effects of Breastfeeding on the Development of Allergies

Ha-Baik Lee, M.D., Ph.D.

Department of Pediatrics, Hanyang University School of Medicine, Seoul, Korea.

Corresponding author (hablee@hanyang.ac.kr)

Received 20 January 2010 Accepted 10 February 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Breastfeeding has many positive nutritional and other benefits that influence the maturation of the gastrointestinal mucosa and microflora of the newborn infants. Furthermore, there is evidence that exclusive breastfeeding in the first 4 months protects against atopic dermatitis and early wheezing in infancy, and immunomodulatory reactions of human milk contributes to the reduction of allergic diseases. Some conflicting reports suggest that breastfeeding provides risk for asthma development if there is a positive family history of allergy. Nevertheless breastfeeding is thought to be associated with a lower asthma risk in young children. Consequently exclusive breastfeeding is highly recommended for all infants at both high and low risk of atopy and irrespective of atopic maternal history for at least 4 to 6 months. For the prevention of allergies, however, exclusion of highly allergenic foods such as peanut and eggs from the maternal diet in the sensitized atopic mother during lactation and supply of extensively hydrolyzed food for the high risk infants is necessary.

Keywords: Breastfeeding, Allergy, Atopic disease, Infants

Figures and Tables

Fig. 1

Several factors modify the primary immune response encountered early in life involving the T cell response.(From Friedman NJ and Zeiger RZ: Prevention and natural history of food allergy. In: Leung DYM, Sampson HA, Geha RS, Szefler SJ, eds. Pediatric allergy, principles and practice, Mosby, Inc. St. Louis 2003. p. 496).

Fig. 2

Adjusted associations between breast feeding (>16 weeks vs no breast feeding) and asthma at 3-8 years of age in the total population (n=3115). (From Scholtens S, Wijga AH, Brunekreef B, et al. Breast feeding, parental allergy and asthma in children followed for 8 years. The PIAMA birth cohort study. Thorax 2009;64:604-9).

Fig. 3

Adjusted associations between breast feeding (>16 weeks vs no breast feeding) and asthma at 3-8 years of age in children of (A) non-allergic mothers (n=2238) and (B) allergic mothers (n=877).(From Scholtens S, Wijga AH, Brunekreef B, et al. Breast feeding, parental allergy and asthma in children followed for 8 years. The PIAMA birth cohort study. Thorax 2009;64:604-9).

Table 1

Factors in Breast Milk that are Currently being Evaluated as Either Inducing or Protecting Against Food Allergies

(From Friedman NJ and Zeiger RZ: Prevention and natural history of food allergy. In: Leung DYM, Sampson HA, Geha RS, Szefler SJ, ed. Pediatric allergy, principles and practice, Mosby, Inc. St Louis 2003:p. 496)

Table 2

Risk Factors for Sensitization in the Child

(From Pali-Scholl I, Renz H, Jensen-Jarolim E. Update on allergies in pregnancy, lactation, and early childhood. J Allergy Clin Immunol 2009;123:1012-21)

Table 3

Dietary Prevention Recommendations/Comments from Several Professional Organizations

(From Sicherer SH, Burks AW. Maternal and infant diets for prevention of allergic diseases: understanding menu changes in 2008. J Allergy Clin Immunol 2008;122:29-33)

^*Advice that is the same for those not "high risk"

Abbreviations : ESPACI, European Society for Pediatric Allergology and Clinical Immunology; ESPGHAN, European Society for Pediatric Gastroenterology, Hepatology and Nutrition; SP-EAACI, Section on Pediatrics, European Academy of Allergology and Clinical Immunology

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