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Systematic review: Early infant feeding practices and the risk of wheat allergy
Author(s) -
Chmielewska Anna,
PieścikLech Małgorzata,
Shamir Raanan,
Szajewska Hania
Publication year - 2017
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13562
Subject(s) - breastfeeding , medicine , observational study , randomized controlled trial , allergy , gluten , wheat allergy , food allergy , asthma , breast feeding , pediatrics , environmental health , immunology , pathology
Aim Wheat is a common allergen. Early feeding practices (breastfeeding, potentially allergenic foods) might affect the risk of allergy. To systematically evaluate the association between early feeding practices and the risk of wheat allergy and sensitisation. Methods Five databases were searched for studies of any design up to July 2015. Results We included seven studies (five observational, low to moderate quality, two randomised controlled trials ( RCTs ), high quality). The results come from observational studies unless stated otherwise. Longer breastfeeding was associated with wheat allergy (two studies, n = 1847) and sensitisation (one study, n = 3781). Evidence for exclusive breastfeeding was contradictory; longer exclusive breastfeeding was associated with either lower (one study, n = 408) or higher (one study, n = 3781) risk of wheat sensitisation. Breastfeeding at gluten introduction did not affect the risk of wheat allergy (two studies, n = 2581). Introducing cereal ≥7 months of age increased the risk of wheat allergy (one study, n = 1612), but results from an RCT ( n = 1303) showed no effect. Early introduction of gluten was associated with a reduced risk of wheat sensitisation up to 5 years in one observational study ( n = 3781) but not in RCT s ( n = 1303). Conclusions Based on limited evidence, the influence of breastfeeding and an early exposure to gluten on the risk of wheat allergy remain uncertain. There is no evidence supporting breastfeeding at gluten introduction as modifying the risk. Early introduction of gluten might reduce the risk of sensitisation, but currently, no evidence exists that it affects the risk of wheat allergy.