Human Milk and Atopic Disease

Abstract The prevalence of allergy is increasing across the world, and asthma is the most common chronic disease in children. Exclusive breastfeeding does decrease the occurrence of eczema in the first 2 years of life, and a longer duration of breastfeeding decreases wheezing in the first 2 years of life. A longer duration of breastfeeding protects against asthma even up to 5 years of age. Food allergies in breastfeeding infants do occur, although the exact timing and mechanism(s) of sensitization are poorly understood. Maternal elimination diets in pregnancy and/or lactation do not prevent atopic disease, but infant avoidance of foods and maternal elimination diet may be useful in infants with diagnosed food allergies and specifically food protein induced enterocolitis syndrome. An expert panel of the American Academy of Pediatrics now recommends early introduction (4 to 6 months of age) of infant-safe forms of peanuts to decrease the risk for peanut allergy in at-risk infants.