by Anne Eglash MD, IBCLC, FABM
Does breastfeeding protect from allergies? According to authors of a 2017 review article entitled ‘Human Milk and Allergic Disease: An Unsolved Puzzle’, childhood allergies to foods and other environmental agents have steadily increased in the last 20 years. The relationship between breastfeeding and childhood allergies is very complicated, which is why we have seen a dizzying volley of research articles flowing through the media over several years. Some research indicates that breastfeeding is protective of childhood allergies, asthma, and eczema, and other research has not found any protection from breastfeeding.
The complexity comes from all of the other factors that play a role in allergies, including factors in the environment, maternal diet during pregnancy and lactation, timing of introduction and quality of solid food, and the balance of certain immunologic factors in breastmilk. For example, the ‘hygiene hypothesis’ links immune response to infection with risk of allergies. In other words, less exposure to germs such as from farm animals, unpasteurized milk, house pets, siblings, and daycare increases the risk of childhood allergies. These other factors make it difficult to tease out the role of breastfeeding in allergy protection.
According to this article, what are accurate statements regarding childhood allergies and infant feeding? Choose 1 or more:
- Breastfeeding appears to protect against asthma by reducing the risk of respiratory infections, rather than reducing the risk of allergy.
- A most recent meta-analysis shows no statistically-significant association between breastfeeding and risk of food allergies.
- Exclusive breastfeeding for 3-4 months is associated with less eczema for children under age 2.
- Maternal diet can modify the immunologic properties in breastmilk, and play a role in childhood allergies.
- The composition of the infant gut microbiome differs significantly between infants with allergies and those without.
See the Answer
Answers- all of the above
Human Milk and Allergic Diseases: An Unsolved Puzzle
Munblit D ,Peroni DG ,Boix-Amorós A ,Hsu PS, Van't Land B, Gay MCL, Kolotilina A, Skevaki C, Boyle RJ, Collado MC, Garssen J, Geddes DT, Nanan R, Slupsky C, Wegienka G, Kozyrskyj AL, Warner JO
There is conflicting evidence on the protective role of breastfeeding in relation to the development of allergic sensitisation and allergic disease. Studies vary in methodology and definition of outcomes, which lead to considerable heterogeneity. Human milk composition varies both within and between individuals, which may partially explain conflicting data. It is known that human milk composition is very complex and contains variable levels of immune active molecules, oligosaccharides, metabolites, vitamins and other nutrients and microbial content. Existing evidence suggests that modulation of human breast milk composition has potential for preventing allergic diseases in early life. In this review, we discuss associations between breastfeeding/human milk composition and allergy development.
Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
This article is detailed and rich in its explanations of the role of various immunologic factors, vitamins, and other nutrients in allergic disease. For example, do you know lactose’s role in protecting the infant’s gut against pathogens? What about the importance of supplementing a pregnant or lactating mother with probiotics and fish oil? I highly suggest reading this article to develop an appreciation of the role of many human milk bioactive factors and other nutrients in infant immune system development. The authors also discuss where we have holes in the research.
It seems to me that protection from allergic disease has to be a multipronged approach, starting with environmental and dietary considerations for the mother pre-conception and during pregnancy. Breastfeeding certainly plays a role in allergy prevention, as do other infant dietary and environmental and health care factors. Perhaps someday we will have comprehensive recommendations for families on how to prevent childhood allergies, asthma, and eczema.