273:
Continuous Cow’s Milk Protein Consumption from Birth and a Decrease in Milk Allergy: a Prospective Cohort Study Related to the PETIT Study
Saturday, March 3, 2018: 2:15 PM
S320CD (Convention Center)
Osamu Natsume, MD, PhD, , , , , , , , , , ,
RATIONALE:

A meta-analysis of randomized, controlled studies showed that early introduction of hen’s egg and peanut in infancy prevents each food allergy. However, cow’s milk allergy (CMA) remains controversial. We investigated whether continuous cow’s milk protein (CMP) consumption from birth decreases CMA.

METHODS:

Participants in this study belonged to the same cohort of the Prevention of Egg allergy with Tiny amount InTake (PETIT) study (Lancet 2017; 389: 276-86). They were enrolled at 4–5 months old, and their atopic dermatitis was extensively treated with topical corticosteroids. Participants were followed up until 18 months old. CMP consumption was determined by questionnaire at 4–6, 9, 12, and 18 months old. The continuous group was defined as participants who continuously consumed CMP from birth to 18 months old and the discontinuous group was defined as participants who did not consume CMP for longer than 1 month until 18 months old. Immediate CMA was diagnosed by allergists based on the history of immediate allergic reaction.

RESULTS:

The number of included participants was 114 (continuous group, n=25; discontinuous group, n=89). The prevalence of CMA was 4% (1/25) in the continuous group and 20% (18/89) in the discontinuous group (p=0.069). Serum milk-specific IgE was not different between the groups. Serum milk-specific IgG1, IgG4, and IgA were significantly higher in the continuous group than in the discontinuous group at 9 and 12 months old.

CONCLUSIONS:

Continuous CMP consumption from birth to 18 months old increases milk-specific IgG4 and IgA, and might decrease CMA.