Breastfeeding increases the risk of food sensitization but not affect food allergy symptoms in young children with atopic dermatitis

Purpose: Breast-feeding is recommended to prevent allergies, particularly in high-risk infants, but the evidence of protective effects that breast-feeding has on food allergy (FA) remains elusive. The aim of this study was to investigate risk factors of FA and the association between breast-feeding and FA symptoms/food sensitization (FS) in children with atopic dermatitis under 2 years of age. 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. Symptoms of FA, feeding type, and family history of allergic disease were assessed. 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 3 groups based on FA symptoms and evidence of sensitization: The FA symptom group (n= 240), no symptom group (n= 53) and no FS group (n= 91). The 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 the no FA symptom group. In multivariate analysis, breast-feeding was associated with FS (adjusted odds ratio [aOR], 2.43; 95% confidence intervals [CI], 1.03-5.74) but was not associated with FA symptoms (aOR, 0.65; 95% CI, 0.23-1.83). Conclusion: Breast-feeding may increase the risk of FS, but not immediate-type FA symptoms in children with atopic dermatitis.