The Influence of Early and Continuous Exposure to Cow`s Milk Formula on The Occurrence of Milk Allergy: The COMEET Study - הכינוס השנתי של החברה הישראלית לפדיאטריה קלינית

עידית לחובר-רוט ^1,2 Anat Cohen-Engler ¹ Yael Furman ^2,3 Ido Shachar ⁴ Yossi Rosman ^1,2 Keren Meir- Shafrir ¹ Michal Mozer-Mandel ³ Sivan Farladansky-Gershnabel ^2,3 Tal Biron-Shental ^2,3 Micha Mandel ⁴ Ronit Confino- Cohen ^1,2

¹Allergy and Clinical Immunology Unit, Meir Medical Center, ישראל
²Sackler School of Medicine, Tel Aviv University, ישראל
³Obstetrics and Gynecology, Meir Medical Center, ישראל
⁴Department of Statistics and Data Science, Faculty of Social Sciences, Hebrew University of Jerusalem, ישראל

Background: Cow`s milk protein (CMP) allergy is a common food allergy in infants. Information regarding the best timing to first introduce CMP is controversial. There are data suggesting that avoidance of CMP for at least the first three days of life has a protective effect for CMP allergy (CMA). Others suggest that introduction of CMP after the first 15-30 days of life, raises the risk for CMA.

Objectives: The current ongoing study assesses the effect of early and continuous exposure to cow`s milk formula (CMF) on the development of CMA.

Methods: Newborns were prospectively recruited shortly before birth and divided to groups according to parents` preference: exclusive breastfeeding; breastfeeding with at least one daily meal of CMF and feeding with CMF only. Infants were followed monthly until the age of 12 months.

Results: To date 1,560 infants were recruited: 1,160 (74.35%) were followed for six months or more, and 635 (40.7%) completed 12 months of follow up. Five hundred and seven infants (51.4%) were exclusively breastfed untill 2 months of age, 318 (32.2%) combined breastfeeding and CMF, and 162 (16.4%) ate only CMF. Immediate reaction proven by skin test developed in 9 infants (0.91%), all were exclusivly breastfed. Within this group, the prevalence of CMA was 1.77% compared to zero in the other groups (RR=1.96, p=0.004).

Conclusions: It appears that early and contineous exposure to CMF since birth has a protective effect against the development of IgE mediated CMA. A larger cohort is needed in order to validate these results.