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Background: Cow's milk allergy (CMA) overdiagnosis appears to be increasing and is associated with excessive low‐allergy formula prescription. We evaluated recent trends and regional variation in low‐allergy formula prescribing for CMA in England, and assessed potential risk factors for higher prescribing rates. Methods: Data on national and regional prescribing of low‐allergy formulas were extracted from England's electronic prescription database using R. Region‐level factors were evaluated for potential associations with regional low‐allergy formula prescription rates using multivariate linear regression. Analysis of national prescribing trends covered 2007–2023, analysis of regional variation and region‐level factors examined 2017–2019, prior to a re‐organisation of the regional healthcare structure in England. Results: Low‐allergy formula prescribing increased from 6.1 to 23.3 L per birth nationally, between 2007 and 2023. Regional prescribing rate varied from 0.8 to 47.6 L per birth in 2017–2019. We found significant associations between regional low‐allergy formula prescribing rate and regional prescribing rates for milk feed thickeners Gaviscon Infant and Carobel Instant (β = 0.10, p < 0.01), and for other anti‐reflux medications used in young children (β = 0.89 p < 0.01). Inconsistent associations were seen with prescribing junior adrenaline auto‐injectors and oral antibiotics. A model including these four variables accounted for 37% of regional variation in low‐allergy formula prescribing rate. Region‐level socio‐economic deprivation, CMA guideline recommendations and paediatric allergy service provision were not associated with low‐allergy formula prescribing. Conclusions: Low‐allergy formula prescribing in England is increasing, varies significantly by region and is consistently associated with prescribing rates for milk feed thickeners and other anti‐reflux medication for young children. Community prescribing behaviours may be important determinants of CMA overdiagnosis. [ABSTRACT FROM AUTHOR]

Background: Food protein‐induced enterocolitis syndrome (FPIES) is a food allergy primarily affecting infants, often leading to vomiting and shock. Due to its poorly understood pathophysiology and lack of specific biomarkers, diagnosis is frequently delayed. Understanding FPIES genetics can shed light on disease susceptibility and pathophysiology—key to developing diagnostic, prognostic, preventive and therapeutic strategies. Using a well‐characterised cohort of patients we explored the potential genome‐wide susceptibility factors underlying FPIES. Methods: Blood samples from 41 patients with oral food challenge‐proven FPIES were collected for a comprehensive whole exome sequencing association study. Results: Notable genetic variants, including rs872786 (RBM8A), rs2241880 (ATG16L1) and rs2289477 (ATG16L1), were identified as significant findings in FPIES. A weighted SKAT model identified six other associated genes including DGKZ and SIRPA. DGKZ induces TGF‐β signalling, crucial for epithelial barrier integrity and IgA production; RBM8A is associated with thrombocytopenia absent radius syndrome, frequently associated with cow's milk allergy; SIRPA is associated with increased neutrophils/monocytes in inflamed tissues as often observed in FPIES; ATG16L1 is associated with inflammatory bowel disease. Coexpression correlation analysis revealed a functional correlation between RBM8A and filaggrin gene (FLG) in stomach and intestine tissue, with filaggrin being a known key pathogenic and risk factor for IgE‐mediated food allergy. A transcriptome‐wide association study suggested genetic variability in patients impacted gene expression of RBM8A (stomach and pancreas) and ATG16L1 (transverse colon). Conclusions: This study represents the first case–control exome association study of FPIES patients and marks a crucial step towards unravelling genetic susceptibility factors underpinning the syndrome. Our findings highlight potential factors and pathways contributing to FPIES, including epithelial barrier dysfunction and immune dysregulation. While these results are novel, they are preliminary and need further validation in a second cohort of patients. [ABSTRACT FROM AUTHOR]

There is conflicting evidence on the protective role of breastfeeding in relation to the development of allergic sensitisation and allergic disease. Studies vary in methodology and definition of outcomes, which lead to considerable heterogeneity. Human milk composition varies both within and between individuals, which may partially explain conflicting data. It is known that human milk composition is very complex and contains variable levels of immune active molecules, oligosaccharides, metabolites, vitamins and other nutrients and microbial content. Existing evidence suggests that modulation of human breast milk composition has potential for preventing allergic diseases in early life. In this review, we discuss associations between breastfeeding/human milk composition and allergy development.

The article discusses the health hazards associated with plant-based and dairy-free drinks marketed as 'growing up' or 'toddler' milks for young children. These products, high in free sugars, are advised against due to their potential contribution to dental decay, overweight, and obesity. The lack of regulations on marketing these products raises concerns, especially with the increasing popularity of plant-based alternatives. The authors recommend clear information dissemination and product reformulation to limit free sugars content to align with public health recommendations. [Extracted from the article]

The World Health Organisation (WHO) has released new resources to help Healthcare Professional Associations (HCPAs) avoid conflicts of interest with nutrition companies marketing foods for infants and young children. The resources include a model policy, alternative funding suggestions, and case studies of good practice, with a focus on regions like India and Africa. The WHO recommends that HCPAs should not accept funding from companies marketing foods for infants and young children, but some resistance exists due to challenges in finding alternative funding sources. The document highlights the impact of nutrition industry sponsorship on public health and emphasizes the importance of avoiding conflicts of interest in healthcare practices. [Extracted from the article]

A survey of UK public health system maternity care providers has found that there is inconsistent and conflicting advice regarding infant skincare in the country. The survey revealed that there is no consensus on when to bathe newborns, with recommendations ranging from delaying the first bath for 24 hours to delaying it for up to 2 weeks. There is also variation in recommendations regarding the use of cleansing products and the removal of vernix. The study emphasizes the need for standardized and evidence-based guidelines for infant skincare in the UK. [Extracted from the article]

Background and Aim The burden of childhood asthma and its risk factors is an important but neglected public health challenge in Latin America. We investigated the association between allergic symptoms and dietary intake in children from this region. Methods As part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III, questionnaire collected dietary intake was investigated in relation to risk of parental/child reported current wheeze (primary outcome) and rhino-conjunctivitis and eczema. Per-country adjusted logistic regressions were performed, and combined effect sizes were calculated with meta-analyses. Results 143,967 children from 11 countries had complete data. In children aged 6-7 years, current wheeze was negatively associated with higher fruit intake (adjusted odds ratio [aOR] 0.65; 95% CI 0.74, 0.97). Current rhino-conjunctivitis and eczema were statistically negatively associated with fruit intake (aOR 0.72; 95% CI 0.64, 0.82; and OR 0.64, 95% CI 0.56, 0.74, respectively). Vegetable intake was negatively associated with risk of symptoms in younger children, but these associations were attenuated in the 13-14 years old group. Fastfood/burger intake was positively associated with all three outcomes in the older children. Conclusion A higher intake of fruits and vegetables was associated with a lower prevalence of allergic symptoms in Latin American children. Conversely, intake of fastfood was positively associated with a higher prevalence of wheeze in adolescents. Improved dietary habits in children might help reduce the epidemic of allergic symptoms in Latin America. Food interventions in asthmatic children are needed to evaluate the possible public health impact of a better diet on respiratory health., Author(s): Alfonso Mario Cepeda [sup.1] , Sumaiyya Thawer [sup.2] , Robert J. Boyle [sup.3] , Sara Villalba [sup.1] , Rodolfo Jaller [sup.1] , Elmy Tapias [sup.1] , Ana María Segura [...]

The article discusses the BabyBathe study, which aims to develop an intervention to reduce infant bathing frequency in order to prevent eczema. Eczema is a chronic skin condition that affects a significant number of infants and children worldwide. The study protocol involves working with pregnant women to develop an acceptable intervention and conducting a randomized controlled feasibility trial to assess the willingness, adherence, and acceptability of the intervention. The article highlights the negative effects of frequent bathing on skin physiology and the potential benefits of reducing bathing frequency and intensity. The results of the feasibility trial will inform the possibility of conducting a larger-scale trial. The study is funded by the NIHR Research for Patient Benefit program. [Extracted from the article]

This article discusses three studies related to allergic diseases. The first study focuses on subcutaneous immunotherapy using pollen allergoid tyrosine adsorption, which has been shown to have long-term clinical benefits for individuals with allergic rhinitis and asthma. The second study analyzes the impact of allergen immunotherapy on the progression of allergic rhinitis and the need for asthma medication. The study found that patients who received immunotherapy had fewer prescriptions for allergy and asthma medications compared to the control group. The third study introduces a novel assay that measures the affinity of allergen-specific IgG antibodies following immunotherapy. The study found that individuals with reduced apple allergy had higher collective binding strength of protective antibodies compared to those without reduced apple allergy. These findings provide valuable insights into the treatment and management of allergic diseases. [Extracted from the article]