Cow ’s Milk and Vitamin D Supplementation in Infants

In this issue of JAMA Pediatrics, Urashima and colleagues ask whether very early (within 3 days of birth) exposure to cow ’s milk formula (CMF) (a common practice in Japan) and vitamin D supplementation (uncommon in Japan) lowers or increases the risk of developing food allergy (as determined by cow’s milk–specific IgE [CM-IgE] sensitization at 5 months and 2 years of age) in infants at risk of atopy (risk was de fined as having ≥1 of the father, mother, and/or siblings with current and/or past atopic diseases [eg, asthma]). In recent years, the approach for primary prevention of food allergy has changed dramatically. Earlier recommendations to delay the introduction of allergenic foods to 1 to 3 years of age have now been replaced by newer recommendations to introduce allergenic foods such as peanut and egg at 4 to 6 months of age, after a period of exclusive breastfeeding (EBF). The World Health Organization and the European Academy of Allergy and Clinical Immunology (EEACI) recommend EBF for a min imum of 6 months and 4 months, respectively. However, whether introduction of all typically allergic foods before 4 to 6 months can decrease risk of allergy is unclear. In the case of CM, this issue is of special importance because supplementation or replacement with formula, even in the first days of life, is not infrequent. Partially or extensively hydrolyzed formulas have been developed to reduce the allergenicity of CM. There is currently a lack of consensus among nat...
Source: JAMA Pediatrics - Category: Pediatrics Source Type: research