Breast Feeding, Exclusive, Breastmilk Collection, Food Allergen Sensitisation, Food Allergy in Infants
Conditions
Keywords
food allergy, breastmilk allergen testing, food allergen sensitization, cow milk allergy, egg allergy, wheat allergy
Brief summary
The goal of this prospective cohort pilot study is to learn about food allergens being passed on in breast milk to breast feeding infants. The main question\[s\] it aims to answer are: * Will major allergens for milk, egg, and peanut be passed on to infants in breast milk? * Will the infants become sensitized to and develop an allergy to the food allergens found in breast milk? * Will early introduction interventions prevent the development of these food allergies? Participants will * provide breast milk sample (s) for testing for food allergens * Infants will be tested for sensitization via skin prick and blood testing * Infants will be challenge with suspected foods to determine allergy and undergo early introduction procedures
Detailed description
Recruitment of subjects will be open enrollment pregnant or post-partum women with a personal history of atopic disease such as allergic rhinitis/conjunctivitis, asthma, atopic dermatitis (eczema), and/or food allergy who are exclusively breastfeeding. Mothers will provide a breastmilk sample(s) for testing of allergens to milk, egg, and wheat. Prior to the introduction of solid foods, infants will need to be tested for sensitization to milk, egg, and wheat via skin prick testing and blood allergy testing. Infants that are negative for sensitization will undergo introduction of these foods per standard practice. Infants that are positive for sensitization will undergo an office food challenge for those foods that they are sensitized to. A positive food challenge is diagnostic for a food allergy and they will be managed according to standard practice. A negative food challenge means that they are not allergic, and they will undergo early introduction protocols and monitored to continued tolerance.
Interventions
DIAGNOSTIC_TESTOpen Ended Oral Food Challenge
Allergens determined to be sensitized will be brought in for an oral challenge to that food.
OTHEREarly Introduction
Infants that are not sensitized will have the food introduced to their diet at regular intervals.
Sponsors
The University of Texas Medical Branch, Galveston
Texas Allergy, Asthma, and Immunology Society
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
4 Months to 24 Months
Healthy volunteers
Yes
Inclusion criteria
1. Pregnant or post-partum females who plan to exclusively breastfeed and their infants who have completed at least 37 weeks of gestation 1. These are vulnerable populations 2. Our study involves breastmilk analysis, which we need postpartum mothers to supply. 3. (Parent) Testing will be done solely on breastmilk samples, with only potential dietary intervention done to the parent postpartum depending on the outcomes of the infant and breastmilk. 4. (Infant) In order to determine if allergens in breastmilk play a role in food allergen sensitization, we need to test the infants prior to the introduction of solid foods. 2. Personal history of atopic disease such as allergic rhinitis/conjunctivitis, asthma, food allergies, and atopic dermatitis 3. Maternal diet must include hen's egg, cow's milk, and wheat products.
Exclusion criteria
1. No maternal history of atopic disease 2. Exclusive formula feeding 3. Maternal diet devoid of hen's egg, cow's milk, or wheat, for example, vegan diets and persons with gluten sensitivity.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To assess the detection of allergens in human breast milk | Baseline (4 months of age) | A mass spectrometry will be used to detect the allergens. Mass spectrometry is a technique used in the University of Texas Medical Branch (UTMB) laboratory to detect allergens. |
| To assess breast milk's role in sensitization to allergens | Baseline (4 months of age) | The infant will be skin prick tested for allergens to milk, eggs, and wheat at 4 months, which is the baseline. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of non-sensitized participants | Baseline (4 months of age), 12 months of age, 24 months of age | The infants that are non-sensitized will begin consuming milk, eggs, and wheat, and each well child check visit. |
Outcome results
None listed