Royal Prince Alfred Hospital Royal Prince Alfred Hospital
Allergy Unit

Student research

Outcome of Maternal Modification Intervention and the Role of Breastfeeding in Allergy Prevention in Children

Hayley Gilbert
Master of Science (Nutrition and Dietetics), University of Wollongong
Supervisors: Velencia Soutter, Robert Loblay, Anne Swain
October 2007

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Introduction: Food allergy in children is a major health risk with the possibility of life threatening anaphylaxis. To lessen this burden, the causes of allergy and possible means for allergy prevention need to be assessed. This study aimed to evaluate the effectiveness of maternal avoidance of highly allergenic foods and assess the benefit of breastfeeding for allergy prevention in high risk children.

Methods: Subjects were selected from an initial cohort of 2114 patients between 0 and 18 years who were seen by Dr. Velencia Soutter at the Royal Prince Alfred Hospital Allergy Consulting Rooms from 1992 to 2005. Information on breastfeeding duration, any maternal modification, Skin Prick Tests (SPT), eczema and asthma were acquired from patient family records.

Results: Siblings to a child with a food allergy whose mother had followed a modified diet (Modified group) showed less eczema (p< .005) and asthma (p< .001) than siblings whose mother had not (Non modified group). Differences in food sensitisation were not significant between groups. Breastfeeding duration had no effect on asthma or eczema. There was a significant increase in subjects with any food sensitisation before the age of one for both Modified (p< .05) and Non modified groups (p< .05) breastfed for 6 months or longer but not after this age. Breastfeeding for 6 months or longer did not significantly increase the mean number of sensitisations to food before the age of one in the Modified group (p >.05) as it did in the Non modified group (p< .005).

Conclusion: A maternal modified diet can be recommended in the second half of pregnancy and during lactation to help prevent a child developing eczema and asthma. Extended breastfeeding cannot be recommended as a means to prevent allergy. An extended breastfeeding duration of 6 months and longer may be a risk factor for food sensitisation before the age of one in high risk children, especially when no dietary avoidance measures are taken.