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

Abstract

Exposure to solid food or cow's milk (complementary food) before age 4 months may confer immune protection (tolerance) or detriment (allergy). 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. 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. 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). 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.