Breast feeding is recommended for the prevention of allergic diseases, particularly in high risk infants, but the evidence of a protective effect on food sensitization and food allergy(FA) remains elusive. The aim of this study is to investigate the association between breast feeding and food sensitization and FA in children under 2 years with atopic dermatitis
We reviewed the medical records of 384 children with atopic dermatitis under 2 years old who visited our pediatric allergic clinic between March 1, 2009 and December 31, 2014. We assessed symptoms of FA, duration of breast feeding, history of parental allergic diseases, and other concomitant allergic diseases. Laboratory tests including serum total IgE, eosinophil(%), and specific IgE to egg white, milk, soy, wheat, and peanut were measured. On the basis of sensitization (IgE ≥ 0.35 KU/L) and clinical history, children were as having FA and having no FA. Having no FA group was divided with sensitized but tolerant, or not allergic/not sensitized.
Two hundred-forty (150 male, 62.5%) were included in the FA group, while one hundred forty-four (92 male, 63.9%) were included in the non-FA group. Children with having FA had a higher blood total IgE levels(238.7±414.6 IU/mL vs. 50.7±96.0 IU/mL, P=0.001) and eosinophil(%)(7.0% ± 5.0% vs. 4.7% ±3.4%, P=0.001), and more frequent parental allergic history(70% vs. 59%, P=0.025). The frequency of breast feeding were relatively higher in FA group than in non-FA group.(77.9% vs. 61.8%, P= 0.001) Subanalysis between children with FA(n=240) and children with food sensitization but tolerant group(n=53) were not showing significant difference in frequency of breast feeding(77.9% vs. 75.5%, P=0.700).
Adjusting for reverse causation by excluding children of age over 6 months or with parental allergic diseases or without parental allergic diseases did not alter these results.
Breast feeding increases the risk of food sensitization but does not affect FA in children with atopic dermatitis.