Early complementary feeding and risk of food sensitization in a birth cohort

Christine L.M. Joseph, Dennis Randall Ownby, Suzanne L. Havstad, Kimberly J. Woodcroft, Ganesa Wegienka, Hugh MacKechnie, Edward Zoratti, Edward L. Peterson, Christine C. Johnson

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Abstract

Background: Exposure to solid food or cow's milk (complementary food) before age 4 months may confer immune protection (tolerance) or detriment (allergy). Objective: We explored the relationship between introduction of complementary food <4 months and IgE to egg, milk, and peanut allergen at 2 years in the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study birth cohort of Detroit, Mich. Methods: At infant ages 1, 6, and 12 months, mothers were interviewed about feeding practices. Blood samples were collected at age 2 to 3 years to assess sensitization (IgE ≥ 0.35 IU/mL) to egg, milk, or peanut. Results: For the 594 maternal-infant pairs analyzed, maternal mean age was 29.7 years, and 60.6% self-reported as African American or black. Infant exposure to complementary food <4 months was reported by 39.7% of mothers. IgE ≥0.35 IU/mL for egg, milk, or peanut allergen at age 2 years was observed in 23.9% (95% CI, 20.5% to 27.6%), 30.6% (26.9% to 34.5%), and 11.4% (8.9% to 14.3%) of children, respectively. The association between early feeding and sensitization was modified by parental history of asthma or allergy. In multivariable analysis, early feeding reduced the risk of peanut sensitization among children with a parental history (adjusted odds ratio, 0.2 [95% CI, 0.1-0.7]; P = .007). The relationship also became significant for egg when a cutoff for IgE of ≥0.70 IU/mL was used (adjusted odds ratio, 0.5 [95% CI, 0.3-0.9]; P = .022). Conclusion: In this cohort, complementary food introduced <4 months was associated with a reduced risk of peanut (and perhaps egg) sensitization by age 2 to 3 years, but only for children with a parental history of asthma or allergy.

Original languageEnglish (US)
Pages (from-to)1203-1210.e5
JournalJournal of Allergy and Clinical Immunology
Volume127
Issue number5
DOIs
StatePublished - Jan 1 2011

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Infant Nutritional Physiological Phenomena
Ovum
Immunoglobulin E
Parturition
Hypersensitivity
Milk
Food
Asthma
Mothers
Allergens
Odds Ratio
Immune Tolerance
Maternal Age
African Americans
Longitudinal Studies
Arachis
Health

Keywords

  • Food allergy
  • birth cohort
  • food sensitization
  • infant feeding

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Joseph, C. L. M., Ownby, D. R., Havstad, S. L., Woodcroft, K. J., Wegienka, G., MacKechnie, H., ... Johnson, C. C. (2011). Early complementary feeding and risk of food sensitization in a birth cohort. Journal of Allergy and Clinical Immunology, 127(5), 1203-1210.e5. https://doi.org/10.1016/j.jaci.2011.02.018

Early complementary feeding and risk of food sensitization in a birth cohort. / Joseph, Christine L.M.; Ownby, Dennis Randall; Havstad, Suzanne L.; Woodcroft, Kimberly J.; Wegienka, Ganesa; MacKechnie, Hugh; Zoratti, Edward; Peterson, Edward L.; Johnson, Christine C.

In: Journal of Allergy and Clinical Immunology, Vol. 127, No. 5, 01.01.2011, p. 1203-1210.e5.

Research output: Contribution to journalArticle

Joseph, CLM, Ownby, DR, Havstad, SL, Woodcroft, KJ, Wegienka, G, MacKechnie, H, Zoratti, E, Peterson, EL & Johnson, CC 2011, 'Early complementary feeding and risk of food sensitization in a birth cohort', Journal of Allergy and Clinical Immunology, vol. 127, no. 5, pp. 1203-1210.e5. https://doi.org/10.1016/j.jaci.2011.02.018
Joseph, Christine L.M. ; Ownby, Dennis Randall ; Havstad, Suzanne L. ; Woodcroft, Kimberly J. ; Wegienka, Ganesa ; MacKechnie, Hugh ; Zoratti, Edward ; Peterson, Edward L. ; Johnson, Christine C. / Early complementary feeding and risk of food sensitization in a birth cohort. In: Journal of Allergy and Clinical Immunology. 2011 ; Vol. 127, No. 5. pp. 1203-1210.e5.
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N2 - Background: Exposure to solid food or cow's milk (complementary food) before age 4 months may confer immune protection (tolerance) or detriment (allergy). Objective: We explored the relationship between introduction of complementary food <4 months and IgE to egg, milk, and peanut allergen at 2 years in the Wayne County Health, Environment, Allergy and Asthma Longitudinal Study birth cohort of Detroit, Mich. Methods: At infant ages 1, 6, and 12 months, mothers were interviewed about feeding practices. Blood samples were collected at age 2 to 3 years to assess sensitization (IgE ≥ 0.35 IU/mL) to egg, milk, or peanut. Results: For the 594 maternal-infant pairs analyzed, maternal mean age was 29.7 years, and 60.6% self-reported as African American or black. Infant exposure to complementary food <4 months was reported by 39.7% of mothers. IgE ≥0.35 IU/mL for egg, milk, or peanut allergen at age 2 years was observed in 23.9% (95% CI, 20.5% to 27.6%), 30.6% (26.9% to 34.5%), and 11.4% (8.9% to 14.3%) of children, respectively. The association between early feeding and sensitization was modified by parental history of asthma or allergy. In multivariable analysis, early feeding reduced the risk of peanut sensitization among children with a parental history (adjusted odds ratio, 0.2 [95% CI, 0.1-0.7]; P = .007). The relationship also became significant for egg when a cutoff for IgE of ≥0.70 IU/mL was used (adjusted odds ratio, 0.5 [95% CI, 0.3-0.9]; P = .022). Conclusion: In this cohort, complementary food introduced <4 months was associated with a reduced risk of peanut (and perhaps egg) sensitization by age 2 to 3 years, but only for children with a parental history of asthma or allergy.

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