Breastfeeding May Increase the Risk of Food Sensitization but Not Affect Food Allergy Symptoms in Young Children with Atopic Dermatitis

Rationale: Breastfeeding is recommended to prevent allergies, particularly in high risk infants, but evidence of protective effects that breastfeeding may have against food allergy (FA) remains elusive. The aim of this study is to investigate risk factors of FA and the association between breastfeeding and FA symptoms and food sensitization (FS) in children under 2 years of age with atopic dermatitis.

Methods: We reviewed the medical records of 384 children with atopic dermatitis under 2 years of age who visited our pediatric allergy clinic from March 1, 2009 through December 31, 2014. We assessed symptoms of FA, feeding type, and family history of allergic diseases. Laboratory tests were conducted, including serum total IgE, eosinophil (%), serum 25-hydroxyvitamin D and specific IgE to egg white, milk, soy, peanut, and wheat.

Results: Subjects were divided into three groups based on FA symptom and evidence of sensitization: positive FA symptom group (n = 240), positive FS with no symptom group (n = 53) and no FS group (n = 91). Positive FA symptom group had a higher log total IgE level (2.0 vs. 1.3, P < 0.001) and eosinophil (%) (7.0% vs. 4.7%, P = 0.001) than no FA symptom group. In multivariate analysis, breastfeeding was associated with FS (adjusted odds ratio [OR], 2.43; 95% confidence interval [CI], 1.03-5.74) but was not associated with FA symptom (aOR, 0.65; 95% CI, 0.23-1.83).  

Conclusions: Breastfeeding may increase the risk of food sensitization but not affect FA symptoms in children with atopic dermatitis.