1. Influence of Breastfeeding on Infant Allergy Development
Anya Guy, Anna King, and Marissa Uhlhorn
Food Science and Human Nutrition
Fall 2015
Abstract
Breastfeeding influences allergy development among infants. Specifically,
duration of exclusive breastfeeding, maternal nutrition, and environmental
factors can impact the capacity for the breastmilk to affect the infant’s
immune system. Various studies suggest that exclusive breastfeeding for 6
months and any breastfeeding for 1 year is the most beneficial for
decreasing food allergy risk. The purpose of this poster is to educate
nutrition professionals and pregnant or breastfeeding mothers on the
current research about infant allergy development in regards to
breastfeeding. Beneficial components in the mother’s breast milk include
food antigens, antimicrobial peptides, and cytokines. These provide the
immunoprotective effect the infant needs to digest potentially allergenic
nutrients. Protective effects increase with the duration of breastfeeding.
Background
• Research suggests a correlation between duration of exclusive
breastfeeding and infant allergy development.1 The mother’s diet,
family history, and environmental factors can also impact breast milk’s
influence on immune response to allergens. 2
• The American Academy of Pediatrics has a firm stance on breastfeeding
infants. They state that infants should be exclusively breastfed for 6
months. As complementary foods are introduced from six months to
one year of age, the infant should be continually breastfed as tolerated
by the mother and infant. 3
Objectives
• To reach Nutrition Professionals and impact their future interactions
with pregnant or breastfeeding mothers they counsel.
• To urge pregnant or breastfeeding mothers to exclusively breastfeed
for at least six months in hopes of decreasing their infants’ allergy
development.
Physiological Aspects
• Infant allergy development is influenced by family history of allergies,
duration of breastfeeding, when the mother introduces solid foods, the
mother’s diet, and the gastrointestinal maturity of the infant.5
• Adult immune systems begin to fight antigens as they are introduced,
but infants need the maternal milk growth factor, (TGF)-B, to initiate an
immune tolerance to an allergen.2, 6
Related Nutrition
There is an immunoprotective component of breastfeeding that is proven
to strengthen the infant’s gastrointestinal tract maturation. There is no
conclusive evidence that eliminating highly allergenic foods in the mother’s
diet decreases infant allergy development.5 Unless there is a large family
history of food allergies or if the infant shows atopic symptoms, the
mother should include allergen-containing foods in her diet.8
Depending on the mother’s diet, the amount of antigens in the breast milk
from common allergenic foods (peanut, wheat, and egg) can be transferred
to the infant in nanogram per milliliter (n/mL) amounts.9 The components
of the mother’s breast milk that are shown to have positive effects on the
infant are IgA, antimicrobial peptides, cytokines, growth factors, and
essential nutrients. These are found in colostrum and breastmilk and
provide the immunoprotective effect the infant needs to digest potentially
allergenic foods.9
Applications/Conclusions
References/Acknowledgements
1. Grimshaw K, Maskell J, Oliver E, et al. Introduction of Complementary Foods and the Relationship to Food Allergy. Pediatrics. 2013;
132(6): e1529-e1538.
2. American Academy of Pediatrics. Breastfeeding and the Use of Human Milk. Pediatrics. 2012; 129(1): e847-e841.
3. Borres M, Brandtzaeg P, Edberg U, Hanson L, Host A, Kull I, Odijk J, Olsen S, Skerfving S, Sundell J, Wille S. Breastfeeding and allergic
disease: a multidisciplinary review of the literature (1966-2001) on the mode of early feeding in infancy and its impact on later atopic
manifestations. Allergy. April 2003; 58(1): 833-843.
4. Maternal, Infant, and Child Health. Healthy People 2020 Website. http://www.healthypeople.gov/2020/topics-
objectives/topic/maternal-infant-and-child-health/objectives. Published 2014. Updated November 3, 2015. Accessed Novmber 3, 2015.
5. Kewgyir-Afful E, Luccioli S, Ramos-Valle M, Verril L, Zhang Y. Infant Feeding Practices and Reported Food Allergies at 6 Years of Age.
Pediatrics. 2014; 134(1): s21-s28.
6. Matheson M, et al. Breastfeeding and atopic disease: a cohort study from childhood to middle age. J Allergy Clin Immunol. November 2007;
120(1): 1051-1057.
7. Verhasselt, V. Is Infant Immunization by Breastfeeding Possible?. Phil. Trans. R. Soc B. 2015; 370(1): 1-6.
8. Odijk J, et al. Breastfeeding and allergic disease: a multidisciplinary review of the literature (1966–2001) on the mode of early feeding in
infancy and its impact on later atopic manifestations. Allergy. 2003; 58(1): 833-843.
9. Boyle R, Munblit D, Warner J. Factors affecting breast milk composition and potential consequences for development of the allergic
phenotype. Clinical & Experimental Allergy. 2014; 45(1):583-601.
10. Wyness L. Nutrition in early life and the risk of asthma and allergic disease. Nutrition. 2014; Br J Community Nurs. 2014; 19(7): S28-S32.
11. Greer F R, Sicherer S H, Burks A W, and the Committee on Nutrition and Section on Allergy and Immunology. Effects on Early Nutritional
Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding,
Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. Pediatrics. 2008; 121(1): 183-191.
12. Boulay A, Gancheva V, Houghton J, et al. Peanut exposure during pregnancy, breastfeeding and complementary feeding: perceptions of
practices in four countries. Int J Consum Stud. 2015; 39(1): 51-59.
Duration of
Breastfeeding
Healthy People 2011
Rate
Healthy People 2020
Goal
Ever breastfed 79.2% 81.9%
Breastfed at 6 months 49.4% 60.6%
Breastfed at 1 year 26.7% 34.1%
Exclusively breastfed
through 3 months
40.7% 46.2%
Exclusively breastfed
through 6 months
18.8% 25.5%
Table 1: Maternal, Infant, and Child Health. Healthy People 2020 Website. http://www.healthypeople.gov/2020/topics-
objectives/topic/maternal-infant-and-child-health/objectives. Published 2014. Updated November 3, 2015. Accessed November 3,
2015.
This chart explains the most current data available compared to the Healthy People 2020
Goals. If these goals were met, less infants would develop food allergies.4
Figure 1: Factors affecting infant’s immune strength7
This picture displays the environmental and maternal factors that could affect the
infant’s response to antigens.7
• It is not necessary for breastfeeding mothers to delay or avoid potential
food allergens in their own diets to prevent their infants from developing
food allergies.10, 11
• Protective effects increase with the duration of breastfeeding up to at
least six months and persist up to the first decade of life.3
• Breastfeeding mothers should consume a varied diet to expose the
infant to a wide range of food profiles through breastmilk.12
• Components found in colostrum have immunoprotective properties and
can aid in the infant’s digestion of allergenic foods.9
• Several studies support the Academy of Pediatrics stance on exclusively
breastfeeding for six months without solid food introduction until after
six months.
• In children with a family history of allergies, it is even more crucial to
provide the protective benefits of breastfeeding to the infant.10
Figure 2: Transfer of food
antigens from mother to
infant.
Any nutrient the mother
consumes will be digested
and directly transferred to
the infant through
breastmilk. This is carried
along with a variety of other
immunologic components.
When the antigen is
absorbed in the infant’s gut,
it initiates immunity to the
food in the gastrointestinal
tract.9