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Maternal and pediatric nutrition

Retrospective observational cohort study regarding the effect of breastfeeding on challenge-proven food allergy



Human breast milk is generally regarded as the best nutrition for infants in their first months of life. Whether breastfeeding has a protective effect on food allergy is a point of debate and the subject of this study.


This retrospective study was conducted in 649 children who underwent a double-blind placebo-controlled food challenge (DBPCFC) as part of routine care in a tertiary care clinic. Food allergy was defined as having at least one positive DBPCFC to any food. The association between both “any” breastfeeding (yes/no) and its duration in months with food allergy was studied by logistic regression analysis with correction for confounding variables.


The prevalence of food allergy was 58.9% (n = 382). Of all subjects, 75.8% (n = 492) was breastfed and 24.2% (n = 157) bottle-fed. There was no significant association between food allergy and breastfeeding versus bottle-feeding after correction for the confounding effect of increased breastfeeding by atopic parents and a history of asthma in the child (OR = 1.24, 95% CI = 0.85–1.79, p = 0.27). However, in breastfed children, every additional month of breastfeeding lowered the risk for food allergy by ~4% (OR = 0.96, 95% CI = 0.93–0.99, p = 0.02). No confounders were identified in this association.


These results show for the first time that in children investigated for possible food allergy, every additional month of breastfeeding is associated with a lower risk of developing clinical food allergy as diagnosed by DBPCFC. However, overall, there was no association between the prevalence of food allergy and breastfeeding versus bottle-feeding in this tertiary care population.

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This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

Author contributions

CDvG performed the data preparation, data analysis, interpretation, and wrote the manuscript. GNvdM contributed to the hypothesis, interpretation of the data, and writing of the manuscript. EB contributed to the data preparation. BMJFdB contributed to the data preparation and writing of the manuscript. BJK checked and supervised the statistical analyses and contributed to the writing of the manuscript. GHK contributed to the interpretation of the data and writing of the manuscript. AEJD was the senior author who proposed the study design and supervised the study.

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The authors declare that they have no conflict of interest.

Correspondence to C. D. van Ginkel.

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