Best Allergy Articles 2021-Cow’s Milk Allergy

In Pediatrics, supplement 3 summarizes 76 articles: Synopsis Book: Best Articles Relevant to Pediatric Allergy, Asthma and Immunology

Some of the studies that are most relevant to pediatric GI doctors I am reviewing for this blog over the next few days.

T Sakihara et al. J Allergy Clin Immunol 2021; 147: 224-232.e8. Randomized trial of early infant formula introduction to prevent cow’s milk allergy

In this randomized trial, infants (n=491 enrolled) in Japan were randomly allocated to ingest at least 10 mL of CMF (cow’s milk formula) daily (ingestion group) or avoid CMF (avoidance group) between 1 and 2 months of age. In the avoidance group breast-feeding was supplemented with soy formula as needed. Oral food challenge was performed at 6 months of age to assess CMA development. Continuous breast-feeding was recommended for both groups until 6 months of age.

Key findings:

  • There were 2 CMA cases (0.8%) among the 242 members of the CMF ingestion group and 17 CMA cases (6.8%) among the 249 participants in the avoidance group (risk ratio = 0.12; 95% CI = 0.01-0.50; P < .001).
  • Approximately 70% of the participants in both groups were still being breast-fed at 6 months of age.

My take: This study adds to the growing body of evidence that early introduction of allergenic foods lowers the likelihood of developing food allergies.

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