Prevention of food allergy in infancy: the role of maternal interventions and exposures during pregnancy and lactation.

There is increased focus on the role of maternal interventions in the prevention of food allergy in infancy. There is no role for maternal dietary modifications during pregnancy or lactation, such as allergen avoidance, as a means of infant allergy prevention. Although exclusive breastfeeding is the recommended infant nutrition source globally, the effect of breastfeeding on infant allergy prevention remains unclear. There is emerging evidence that irregular cow's milk exposure (ie, infrequent formula supplementation) might increase the risk of cow's milk allergy. Although further studies are required, there is also emerging evidence that maternal peanut ingestion during breastfeeding along with early peanut introduction in infancy might have a preventive role. The effect of maternal dietary supplementation with vitamin D, omega-3, and prebiotics or probiotics remains unclear.
Competing Interests: Declaration of interests EMA is an employee of Public Health Agency of Canada and the views expressed here are her own and not those of the institution. MSS serves on the editorial board of The Journal of Allergy and Clinical Immunology: In Practice; is an associate editor of Annals of Allergy, Asthma, and Immunology; is a member of the Joint Task Force on Practice Parameters, and has participated in research that has received funding from DBV Technologies. HAB receives research grant funding from the National Institutes of Health; is sub-investigator for DBV Technologies and Aimmune research studies, and has received speaker honoraria from DBV Technologies, GlaxoSmithKline, and Sanofi. ESC has received research support from DBV Technologies; has been a member of advisory boards for Pfizer, Miravo, Medexus, Leo Pharma, Kaleo, DBV Technologies, AllerGenis, Sanofi Genzyme, Bausch Health, Avir Pharma, AstraZeneca, and ALK; is on the executive board of the CSACI; is on the executive board of the Canadian Paediatric Society Allergy Section, and is a member of the health-care advisory board for Food Allergy Canada. MG is a consultant for Aquestive; is a member of physician and medical advisory boards for DBV Technologies, Sanofi/Regeneron, Nutricia, Novartis, Acquestive, Allergy Therapeutics, AstraZeneca, ALK-Abello, and Prota; is an unpaid member of the scientific advisory council for the National Peanut Board and medical advisory board of the International Food Protein Induced Enterocolitis Syndrome Association; is a member of the Brighton Collaboration Criteria Vaccine Anaphylaxis 2.0 working group; is the senior associate editor for the Annals of Allergy, Asthma, and Immunology, and is member of the Joint Taskforce on Allergy Practice Parameters. MG has received honorarium for lectures from ImSci, MedLearningGroup, RMEI Medical Education, and multiple state and local allergy societies. MG received past research support ending in 2020, from the Agency for Healthcare Quality and Research (K08-HS024599).
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