METHODS: A cohort of 58 patients with IgE-CMA was identified from a large scale population-based study of 13,019 infants followed from birth. A group of 116 infants matched for sex and breastfeeding only duration (beyond the nursery period), and another random group of 259 healthy infants were used as controls. Parents were interviewed and the infants\' medical records were searched to assess CMF consumption in the nursery.
RESULTS: While 96% of the mothers of the 174 infants (58 with Cow\'s milk allergy and 116 controls) reported on exclusive breastfeeding during the stay in the nursery, CMF consumption was documented in 96 (55%) of the infants. Of those, most (57; 59%) received one to three feedings, 20 (21%) received four to nine feedings, and 19 (20%) received ≥10 feedings. Fewer formula feeds (1-3) were significantly more common in the allergic group than ≥4 feeds (p = 0.0003) and no feeds at all (p = 0.02) compared to controls (n = 116). Of those exclusively breastfed in the nursery, 13/23 allergic infants (57%) introduced CMF at age 105-194 days (the period with highest-risk for IgE-CMA) compared to 33/98 (34%) from the random control group (n = 259) (p = 0.04).
CONCLUSIONS: Most infants end up receiving few CMF feeds in the nursery. Transient CMF in the nursery is associated with increased risk of IgE-CMA.
方法:从一项大规模的基于人群的研究中确定了58名IgE-CMA患者的队列,该研究包括13,019名出生后的婴儿。一组116名婴儿的性别和母乳喂养的时间相匹配(超过了婴儿时期),另一个随机组259名健康婴儿作为对照。对父母进行了访谈,并搜索了婴儿的病历,以评估托儿所的CMF消耗量。
结果:174名婴儿(58名牛奶过敏婴儿和116名对照婴儿)的母亲中有96%报告了在托儿所停留期间的纯母乳喂养,在96(55%)的婴儿中记录了CMF的消耗。其中,大多数(57;59%)接受一到三次喂养,20人(21%)接受了4到9次喂养,19人(20%)接受≥10次喂养。与对照组(n=116)相比,过敏组的配方饲料(1-3)比≥4饲料(p=0.0003)明显更常见,根本没有饲料(p=0.02)。在托儿所完全母乳喂养的人中,13/23过敏性婴儿(57%)在105-194天(IgE-CMA风险最高的时期)引入CMF,而随机对照组(n=259)为33/98(34%)(p=0.04)。
结论:大多数婴儿最终在托儿所接受的CMF喂养很少。苗圃中的瞬时CMF与IgE-CMA的风险增加有关。