Prenatal and/or Breastfeeding Food Exposures and Risk of Food Allergies in the Offspring
The prevalence of food allergies is increasing in westernized societies. Allergen sensitization has been shown to occur very early in childhood, although the exact timing of sensitization is still under investigation. In recent years, studies have shown that the effect of consumption of peanuts during pregnancy could vary depending on mothers’ allergic status. For example, in high-risk mothers (with a background of atopy/food allergies), peanut consumption likely increases peanut allergy risk in offspring. Although several clinical studies have suggested that breastfeeding reduces food allergy, recent studies have shown no preventive benefit of breastfeeding on food allergy development in such high-risk populations. Also, epigenetic phenomena likely play an important role when evaluating the effect of prenatal exposure and breastfeeding on the risk of food allergies.
KeywordsFood allergy Breastfeeding Prevention Pregnancy Peanut Milk Egg Atopic dermatitis Tolerance Sensitization Allergen Exposure Introduction Microbiota Epigenetics Epidemiology Risk factors Prenatal
Compliance with Ethics Guidelines
Conflict of Interest
François Graham, Philippe Bégin, Louis Paradis, and Anne Des Roches declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 10.••Palmer DJ, Metcalfe J, Makrides M, et al. Early regular egg exposure in infants with eczema: a randomized controlled trial. J Allergy Clin Immunol. 2013;132(2):387–92 e1. Describes very early sensitization to egg allergy in infants with moderate to severe atopic dermatitis.PubMedCrossRefGoogle Scholar
- 29.•Atarashi K, Tanoue T, Oshima K, et al. Treg induction by a rationally selected mixture of Clostridia strains from the human microbiota. Nature. 2013;500(7461):232–6. Presents murine model that underline the importance of commensal bacteria in the establishment of oral tolerance.PubMedCrossRefGoogle Scholar
- 33.•Bartnikas LM, Gurish MF, Burton OT, et al. Epicutaneous sensitization results in IgE-dependent intestinal mast cell expansion and food-induced anaphylaxis. J Allergy Clin Immunol. 2013;131(2):451–60 e1-6. Present murine model that underline the role of the skin as an important route for allergic sensitization.PubMedCentralPubMedCrossRefGoogle Scholar
- 48.••McGowan EC, Bloomberg GR, Gergen PJ, et al. Influence of early-life exposures on food sensitization and food allergy in an inner-city birth cohort. J Allergy Clin Immunol. 2015;135(1):171–8. Well-performed study on early diagnosis of food allergy which underlines the importance of specific IgE levels and clinical evolution to establish prevalence.PubMedCrossRefGoogle Scholar
- 56.••Jelding-Dannemand E, Malby Schoos AM, Bisgaard H. Breast-feeding does not protect against allergic sensitization in early childhood and allergy-associated disease at age 7 years. J Allergy Clin Immunol. 2015;In press. Well-conducted study on risk of food allergy from breastfeeding in high-risk population. Google Scholar
- 57.••Hong X, Wang G, Liu X, et al. Gene polymorphisms, breast-feeding, and development of food sensitization in early childhood. J Allergy Clin Immunol. 2011;128(2):374–81 e2. Highlight the underlying genetic predisposition on the food allergy risk from breastfeeding.PubMedCentralPubMedCrossRefGoogle Scholar
- 59.••Brough HA, Simpson A, Makinson K, et al. Peanut allergy: effect of environmental peanut exposure in children with filaggrin loss-of-function mutations. J Allergy Clin Immunol. 2014;134(4):867–75. Provides human epidemiologic evidence for eczematous skin as an important route for food allergy sensitization. PubMedCentralPubMedCrossRefGoogle Scholar
- 74.Kim JY, Kwon JH, Ahn SH, et al. Effect of probiotic mix (Bifidobacterium bifidum, Bifidobacterium lactis, Lactobacillus acidophilus) in the primary prevention of eczema: a double-blind, randomized, placebo-controlled trial. Pediatr Allergy Immunol. 2010;21(2 Pt 2):e386–93.PubMedCrossRefGoogle Scholar
- 90.Grunewald SM, Werthmann A, Schnarr B, et al. An antagonistic IL-4 mutant prevents type I allergy in the mouse: inhibition of the IL-4/IL-13 receptor system completely abrogates humoral immune response to allergen and development of allergic symptoms in vivo. J Immunol. 1998;160(8):4004–9.PubMedGoogle Scholar