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. 2022 Aug 7;18(1):71.
doi: 10.1186/s13223-022-00712-z.

The association between early formula and reduced risk of cow's milk allergy during the first three year of life: a Japanese cohort study

Kota Ikari #  1 , Junichiro Tezuka #  1 , Masafumi Sanefuji  2   3 , Jiro Nakayama  4 , Daisuke Nishima  5 , Yuri Sonoda  5   6 , Masanobu Ogawa  7 , Masayuki Shimono  8   9 , Reiko Suga  9 , Satoshi Honjo  10 , Koichi Kusuhara  8   9 , Shouichi Ohga  5   6 ; Japan Environment and Children’s Study (JECS) Group
Collaborators, Affiliations

The association between early formula and reduced risk of cow's milk allergy during the first three year of life: a Japanese cohort study

Kota Ikari et al. Allergy Asthma Clin Immunol. .

Abstract

Background: Our recent observational study showed that regular consumption of cow's milk (CM) formula during early infancy (3-6 months old) was associated with a reduced risk of CM allergy (CMA) at 12 months old. However, the long-term association is unclear. The present study was aimed to examine how long this inverse association persists after 12 months old.

Methods: This study used the dataset of an ongoing nationwide prospective cohort, the Japan Environment and Children's Study, in which participants were registered between January 2011 and March 2014. We analyzed 65,568 children followed-up until 36 months old. The exposure factors were the consumption statuses of formula milk from 0-3, 3-6, and 6-12 months old. The primary outcome was the prevalence of CMA at 6, 12, 18, 24 and 36 months old. CMA was defined as an allergic reaction and sensitization to CM protein in an individual with no or limited intake of this protein at the evaluation time, combined with physician-diagnosed food allergy. Multivariable regression models were used to estimate the association between the periods of formula consumption and the prevalence of CMA.

Results: The prevalence of CMA increased with a peak of 1.51% at 18 months old and then declined to 0.79% at 36 months old. Formula milk from 3-6 months old was associated with a reduced risk of CMA throughout the first 3 years of life, although the extent of the reduction was mitigated with age (adjusted relative risk: [95% confidence interval]: 0.19 [0.10-0.34] at 12 months old, 0.23 [0.16-0.33] at 18 months old, 0.41 [0.26-0.64] at 24 months old, and 0.47 [0.26-0.80] at 36 months old). The association between early formula and CMA were observed in both children with and without eczema, but more prominent and long-lasting in the former than the latter.

Conclusions: Regular exposure to CM protein during infancy was associated with a reduced prevalence of CMA during early childhood. At present, however, this observational study does not necessarily encourage formula feeding, and randomized controlled trials are warranted to confirm the findings and their significance.

Keywords: Child; Cow’s milk; Food allergy; Observational study; Questionnaire survey.

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Conflict of interest statement

M. Sanefuji and SO report the receipt of a grant and director’s fees, respectively, from Morinaga Houshikai, independent of this work. The other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart for participant selection. CM, cow’s milk
Fig. 2
Fig. 2
Patterns of formula feeding and the prevalence of cow’s milk allergy (CMA). Gray and white boxes denote consumption and non-consumption, respectively, of formula milk. The number in the gray boxes represents the percentage of subjects with concurrent use of breastmilk among formula-fed children. For each pattern, the prevalences of CMA are provided. The prevalence in the grayed areas is zero or nearly zero, as expected from the definition of CMA, which required no consumption of CM products including formula at the evaluation times
See this image and copyright information in PMC

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References

    1. Yamamoto-Hanada K, Pak K, Saito-Abe M, Yang L, Sato M, Irahara M, et al. Allergy and immunology in young children of Japan: the JECS cohort. World Allergy Organ J. 2020;13:100479. doi: 10.1016/j.waojou.2020.100479. - DOI - PMC - PubMed
    1. Katz Y, Rajuan N, Goldberg MR, Eisenberg E, Heyman E, Cohen A, et al. Early exposure to cow's milk protein is protective against IgE-mediated cow's milk protein allergy. J Allergy Clin Immunol. 2010;126(77–82):e1. - PubMed
    1. Onizawa Y, Noguchi E, Okada M, Sumazaki R, Hayashi D. The association of the delayed introduction of cow's milk with IgE-mediated cow's milk allergies. J Allergy Clin Immunol Pract. 2016;4(481–8):e2. - PubMed
    1. Saarinen KM, Savilahti E. Infant feeding patterns affect the subsequent immunological features in cow's milk allergy. Clin Exp Allergy. 2000;30:400–406. doi: 10.1046/j.1365-2222.2000.00732.x. - DOI - PubMed
    1. Peters RL, Koplin JJ, Dharmage SC, Tang MLK, McWilliam VL, Gurrin LC, et al. Early exposure to cow's milk protein is associated with a reduced risk of cow's milk allergic outcomes. J Allergy Clin Immunol Pract. 2019;7(462–70):e1. - PubMed

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