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From:
Lucy Towbin <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 26 Apr 2011 10:01:42 -0500
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Both my son and I (I was breastfed a year, he was breastfed way beyond infancy) have been diagnosed with multiple food allergies. So I am on various food allergy/sensitivity groups and doing a lot of reading about it these days.  There are some interesting discussions going on about food allergies and some research that is saying that in cultures where foods are introduced EARLY and frequently, there are fewer allergies.  Like one comparing Ashkenazi Jews in Israel to Ashkenazi Jews in England. In Israel, children eat a type of peanut product from an early age and there are fewer peanut allergies there.  It was in a recent interview on NPR here: http://www.npr.org/2011/02/07/133568684/new-guidelines-for-handling-food-allergies


This is a description of another study:

There actually have been a few studies recently, not double blinded, but pretty good, that found similar results as the Israeli peanut correlation.  One was in Australia, and they recruited several thousand infants at immunization clinics.  Parents were given questionaires about egg and egg containing products and the ages at which they were introduced into the diet.  The parents also answered questions about breast feeding, age of introduction of solids, and a whole host of confounding variables (ex: excema, family history of allergy, maternal smoking during pregnancy, etc).
While this was going on, a study nurse gave the baby a skin prick test to 4 food, a positive and negative control.  If they had a reaction to egg, they were invited to participate in a follow up clinic for a formal food challenge.
After the food challenge, the babies who were able to tolerate a whole raw egg white at the challenge were give a whole raw egg white daily at home for a week and kept a symptom diary as well.

They found that introducing cooked (rather than baked- like egg in a muffin) egg into the diet at 4-6 months substantially lowered the risk of egg allergy than later introduction even after controlling for family history of allergy or infant allergy symptoms.
They also found NO association between age at introduction of solids or duration of breast feeding when they controlled for confounding variables.
There is definitely the risk of recall bias, but I think this study is on the right track!  Especially since current recommendations are to wait until age 2 to introduce egg.
Here's the citation for the study if anyone is interested: -Koplin et al. (2010). Can
early introduction of egg prevent egg allergy in infants? A population-based
study. Journal Allergy Clinical Immunology,
126(4), 807-813.



There seems to be a problem to me with this one in that the children given the frequent eggs were the ones who did NOT respond to the initial tests. But still, I guess they reacted less than the non-responders NOT given the frequent eggs.

So is this contradicting what I was taught in studying for my IBCLC about early introduction of foreign proteins being problematic?  Or is there some window of opportunity where it is not too early or not too late?  Or maybe introduction of the proteins through mom's milk has some positive effect that is absent if a formula baby is exposed later?  I'd be interested in hearing people's thoughts and any other studies you are aware of.

Lucy Towbin, MSW, LCSW, IBCLC

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