Background: IgE-mediated food allergy is a major global health concern. While early introduction of allergenic foods and breastfeeding are potential preventive strategies, the role of breast milk in reducing food allergy incidence remains inconclusive.
Objective: We aimed to investigate the impact of exclusive breastfeeding for the first four months compared to partial breastfeeding or cow's milk formula (CMF) on the development of IgE-mediated food allergies (FAs) in an Israeli cohort.
Methods: A cross-sectional online survey of 3,030 mothers with infants aged 6-24 months collected data on early feeding practices, allergen introduction, atopic conditions, and family history. It documented suspected allergic reactions, symptoms, and diagnostic procedures.
Results: Of 3,030 surveyed mothers, 2,920 provided complete feeding data for the first 4 months. Among these, 39.0% exclusively breastfed, 12.1% used CMF, and 48.9% partially breastfed. There were 392 infants with FAs, totaling 480 cases involving cow's milk, sesame, egg, or peanut. Of these cases, 122 (25.4%) were in the breastfeeding group, and 358 (74.6%) were in the other groups. Exclusively breastfed infants had lower odds of egg (OR=0.53), sesame (OR=0.58), and peanut (OR=0.53) allergies compared to others. The interaction between feeding patterns and atopic dermatitis (AD) related to these FAs was insignificant. Exposure to CMF in the nursery and exclusively breastfed was associated with higher odds of developing cow's milk allergy. Delayed exposure to sesame in infants with AD was linked to increased odds of developing sesame allergy.
Conclusion: Exclusive breastfeeding may reduce the odds of developing IgE-mediated FA, regardless of AD status.
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