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Reduced peanut sensitization with maternal peanut consumption and early peanut introduction while breastfeeding

Published online by Cambridge University Press:  09 December 2020

Meghan B. Azad
Affiliation:
Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB, Canada
Christoffer Dharma
Affiliation:
Department of Medicine, McMaster University, Hamilton, ON, Canada
Elinor Simons
Affiliation:
Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
Maxwell Tran
Affiliation:
Department of Medicine, McMaster University, Hamilton, ON, Canada
Myrtha E. Reyna
Affiliation:
Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Ruixue Dai
Affiliation:
Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Allan B. Becker
Affiliation:
Section of Allergy and Immunology, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB, Canada Developmental Origins of Chronic Diseases in Children Network (DEVOTION), Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
Jean Marshall
Affiliation:
Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
Piushkumar J. Mandhane
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
Stuart E. Turvey
Affiliation:
Department of Pediatrics, BC Children’s Hospital, University of British Columbia, Vancouver, BC, Canada
Theo J. Moraes
Affiliation:
Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Diana L. Lefebvre
Affiliation:
Department of Medicine, McMaster University, Hamilton, ON, Canada
Padmaja Subbarao
Affiliation:
Division of Respiratory Medicine, Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
Malcolm R. Sears
Affiliation:
Department of Medicine, McMaster University, Hamilton, ON, Canada
Corresponding
E-mail address:

Abstract

New guidelines for peanut allergy prevention in high-risk infants recommend introducing peanut during infancy but do not address breastfeeding or maternal peanut consumption. We assessed the independent and combined association of these factors with peanut sensitization in the general population CHILD birth cohort (N = 2759 mother–child dyads). Mothers reported peanut consumption during pregnancy, timing of first infant peanut consumption, and length of breastfeeding duration. Child peanut sensitization was determined by skin prick testing at 1, 3, and 5 years. Overall, 69% of mothers regularly consumed peanuts and 36% of infants were fed peanut in the first year (20% while breastfeeding and 16% after breastfeeding cessation). Infants who were introduced to peanut early (before 1 year) after breastfeeding cessation had a 66% reduced risk of sensitization at 5 years compared to those who were not (1.9% vs. 5.8% sensitization; aOR 0.34, 95% CI 0.14–0.68). This risk was further reduced if mothers introduced peanut early while breastfeeding and regularly consumed peanut themselves (0.3% sensitization; aOR 0.07, 0.01–0.25). In longitudinal analyses, these associations were driven by a higher odds of outgrowing early sensitization and a lower odds of late-onset sensitization. There was no apparent benefit (or harm) from maternal peanut consumption without breastfeeding. Taken together, these results suggest the combination of maternal peanut consumption and breastfeeding at the time of peanut introduction during infancy may help to decrease the risk of peanut sensitization. Mechanistic and clinical intervention studies are needed to confirm and understand this “triple exposure” hypothesis.

Type
Original Article
Copyright
© The Author(s), 2020. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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References

Soller, L, Ben-Shoshan, M, Harrington, DW, et al. Overall prevalence of self-reported food allergy in Canada. J Allergy Clin Immunol. 2012; 130(4), 986988.CrossRefGoogle ScholarPubMed
Gupta, RS, Warren, CM, Smith, BM, et al. The public health impact of parent-reported childhood food allergies in the United States. Pediatrics. 2018; 142(6), e20181235.CrossRefGoogle ScholarPubMed
Dyer, AA, Rivkina, V, Perumal, D, et al. Epidemiology of childhood peanut allergy. Allergy Asthma Proc. 2015; 36(1), 5864.CrossRefGoogle ScholarPubMed
Bock, SA, Muoz-Furlong, A, Sampson, HA. Fatalities due to anaphylactic reactions to foods. J Allergy Clin Immunol. 2001; 107(1), 191193.CrossRefGoogle ScholarPubMed
Du, Toit G, Sayre, PH, Roberts, G, et al. Effect of avoidance on peanut allergy after early peanut consumption. N Engl J Med. 2016; 374(15), 14351443.Google Scholar
Togias, A, Cooper, SF, Acebal, ML, et al. Addendum guidelines for the prevention of peanut allergy in the United States: report of the national institute of allergy and infectious diseases–sponsored expert panel. J Allergy Clin Immunol. 2017; 139(1), 2944.CrossRefGoogle ScholarPubMed
Fleischer, DM, Sicherer, S, Greenhawt, M, et al. Consensus communication on early peanut introduction and the prevention of peanut allergy in high-risk infants. J Allergy Clin Immunol. 2015; 136(2), 258261.CrossRefGoogle ScholarPubMed
Tran, MM, Lefebvre, DL, Dai, D, et al. Timing of food introduction and development of food sensitization in a prospective birth cohort. Pediatr Allergy Immunol. 2017; 28(5), 471477.CrossRefGoogle Scholar
Chan, ES, Cummings, C, Atkinson, A, et al. Dietary exposures and allergy prevention in high-risk infants: A joint position statement of the Canadian society of allergy and clinical immunology and the Canadian paediatric society. Allergy, Asthma Clin Immunol. 2014; 10, 45.CrossRefGoogle ScholarPubMed
Abrams, EM, Sicherer, SH. Maternal peanut consumption and risk of peanut allergy in childhood. CMAJ. 2018; 190(27), E814E815.CrossRefGoogle ScholarPubMed
Fleischer, DM, Spergel, JM, Assa’ad, AH, Pongracic, JA. Primary prevention of allergic disease through nutritional interventions. J Allergy Clin Immunol Pract. 2013; 1(1), 2936.CrossRefGoogle ScholarPubMed
Lodge, CJ, Tan, DJ, Lau, MX, et al. Breastfeeding and asthma and allergies: a systematic review and meta-analysis. Acta Paediatr Int J Paediatr. 2015; 104(467), 3853.CrossRefGoogle ScholarPubMed
Järvinen, KM, Martin, H, Oyoshi, MK. Immunomodulatory effects of breast milk on food allergy. Ann. Allergy, Asthma, Immunol. 2019; 123(2), 133143.CrossRefGoogle ScholarPubMed
Bernard, H, Ah-Leung, S, Drumare, MF, et al. Peanut allergens are rapidly transferred in human breast milk and can prevent sensitization in mice. Allergy. 2014; 69(7), 888897.CrossRefGoogle ScholarPubMed
Vadas, P, Wai, Y, Burks, W, Perelman, B. Detection of peanut allergens in breast milk of lactating women. J. Am. Med. Assoc. 2001; 285(13), 17461748.CrossRefGoogle ScholarPubMed
Schocker, F, Baumert, J, Kull, S, et al. Prospective investigation on the transfer of Ara h 2, the most potent peanut allergen, in human breast milk. Pediatr Allergy Immunol. 2016; 27(4), 348355.CrossRefGoogle ScholarPubMed
Munblit, D, Peroni, DG, Boix-Amoros, A, et al. Human milk and allergic diseases : an unsolved puzzle. Nutrients. 2017; 9(8), 894.CrossRefGoogle ScholarPubMed
Dawod, B, Marshall, JS. Cytokines and soluble receptors in breast milk as enhancers of oral tolerance development. Front Immunol. 2019; 10, 16.CrossRefGoogle ScholarPubMed
Persson, LA, Ivarsson, A Hernell, O. Breast-feeding protects against celiac disease in childhood--epidemiological evidence. Adv Exp Med Biol. 2002; 503, 115123.CrossRefGoogle Scholar
Ivarsson, A, Hernell, O, Stenlund, H, Persson, L. Breast-feeding protects against celiac disease. Am J Clin Nutr. 2002; 75(5), 914921.CrossRefGoogle ScholarPubMed
Grimshaw, KEC, Maskell, J, Oliver, EM, et al. Introduction of complementary foods and the relationship to food allergy. Pediatrics. 2013; 132(6), 15291538.CrossRefGoogle ScholarPubMed
Venter, C, Maslin, K, Dean, T, Arshad, SH. Does concurrent breastfeeding alongside the introduction of solid food prevent the development of food allergy? J Nutr Sci. 2016; 5, 18.CrossRefGoogle ScholarPubMed
Pitt, TJ, Becker, AB, Chan-Yeung, M, et al. Reduced risk of peanut sensitization following exposure through breast-feeding and early peanut introduction. J Allergy Clin Immunol. 2018; 141(2), 620625.CrossRefGoogle ScholarPubMed
Subbarao, P, Anand, SS, Becker, AB, et al. The Canadian healthy infant longitudinal development (CHILD) study: examining developmental origins of allergy and asthma. Thorax. 2015; 70(10), 9981000.CrossRefGoogle ScholarPubMed
Azad, MB, Vehling, L, Chan, D, et al. Infant feeding and weight gain: separating breast milk from breastfeeding and formula from food abstract. Pediatrics. 2018; 142(4), e20181092.CrossRefGoogle Scholar
Frazier, AL, Camargo, CA, Malspeis, S, Willett, WC, Young, MC. Prospective study of peripregnancy consumption of peanuts or tree nuts by mothers and the risk of peanut or tree nut allergy in their offspring. JAMA Pediatr. 2014; 168(2), 156162.CrossRefGoogle ScholarPubMed
Simons, E, Balshaw, R, Lefebvre, DL, et al. Timing of introduction, sensitization, and allergy to highly allergenic foods at age 3 years in a general-population Canadian cohort. J Allergy Clin Immunol Pract. 2019; 8(1), 166175.CrossRefGoogle Scholar
Desroches, A, Infante-Rivard, C, Paradis, L, Paradis, J, Haddad, E. Peanut allergy: is maternal transmission of antigens during pregnancy and breastfeeding a risk factor? J Invest Allergol Clin Immunol. 2010; 20(4), 289294.Google ScholarPubMed
Sicherer, SH, Wood, RA, Stablein, D, et al. Maternal consumption. J Allergy Clin Immunol. 2011; 126(6), 11911197.CrossRefGoogle Scholar
Lack, G, Fox, D, Northstone, K, Golding, J. Factors associated with the development of peanut allergy in childhood. N Engl J Med. 2003; 348(11), 997–985.CrossRefGoogle ScholarPubMed
Verhasselt, V, Genuneit, J, Metcalfe, JR, et al. Ovalbumin in breastmilk is associated with a decreased risk of IgE-mediated egg allergy in children. Allergy. 2020; 75(6), 14631466.CrossRefGoogle ScholarPubMed
Brockow, I, Zutavern, A, Hoffmann, U, et al. Early allergic sensitizations and their relevance to atopic diseases in children aged 6 years: Results of the GINI study. J Invest Allergol Clin Immunol. 2009; 19(3), 180187.Google ScholarPubMed
Gustafsson, D, Sjoberg, O, Foucard, T. Development of allergies and asthma in infants and young children with atopic dermatitis--a prospective follow-up to 7 years of age. Allergy. 2000; 55(3), 240245.CrossRefGoogle ScholarPubMed
Illi, S, von Mutius, E, Lau, S, et al. The pattern of atopic sensitization is associated with the development of asthma in childhood. J Allergy Clin Immunol. 2001; 108(5), 709714.CrossRefGoogle ScholarPubMed
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