Cow’s milk formula: milk sensitization, allergy risk declines with early avoidance

  • Urashima M & al.
  • JAMA Pediatr
  • 21 oct. 2019

  • de Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Avoiding infant exposure to cow’s milk formula in the first 3 days of life is linked to reduced risk for sensitization and allergy to cow’s milk in children with increased risk for atopy.

Why this matters

  • These authors say that their findings suggest that this allergy and sensitization are largely avoidable with this approach.
  • Editorial: the results add valuable information to aid in identifying the right window of avoidance.

Key results

  • In avoidance group, 16.8% had sensitization by their second birthday compared with 32.2% in the nonavoidance group: risk ratio (RR), 0.52; 95% CI, 0.34-0.81.
  • Immediate food allergy at the second birthday was also lower in the avoidance group (2.6%) compared with the nonavoidance group (13.2%): RR, 0.20; 95% CI, 0.07-0.57.
  • Anaphylactic allergy was also lower at 0.7% with avoidance group vs 8.6% with nonavoidance group: RR, 0.08; 95% CI, 0.01-0.58.

Study design

  • Randomized, nonblinded clinical trial in Japan, with 312 infants randomly allocated 1:1 to breastfeeding with cow’s milk formula supplementation or with elemental formula supplementation.
  • Primary outcome: sensitization by the second birthday.
  • Funding: Ministry of Education, Culture, Sports, Science, and Technology of Japan; others.

Limitations

  • Not double-blinded, small numbers with allergy, sensitization.