Perceived food allergy, sensitivity, or intolerance and its impact on breastfeeding practices

Major medical societies recommend exclusive breastfeeding for the first 6 months of life, solid food introduction no sooner than 4 to 6 months, and a well-balanced, varied maternal diet.1-5 Food-related adverse reactions are commonly reported in infants6,7; symptoms may include cutaneous eruptions (ie, eczematous changes, urticaria, angioedema), gastrointestinal complaints, and, less commonly, anaphylaxis.8 These reactions to breastfeeding or solid foods are important to maternal and infant health as they may impact maternal diet, timing/selection of solid foods, and breastfeeding duration. In this large national survey that followed women from the prenatal period through their infants' first year of life, we found that reported problems with foods that infants ate were associated with earlier breastfeeding cessation, yet seemingly paradoxically, concern for adverse reactions related to foods that the infant was exposed to through breast milk was associated with longer breastfeeding duration. A better understanding of early dietary practices and how specific factors (ie, race, income, maternal and gestational age, family history of atopy) affect these decisions is needed, especially in light of continued questions about the role of early infant diet in allergy development and new perspectives regarding early food allergen introduction.Acknowledgments We would like to acknowledge and thank all participants in the Infant Feeding Practices Study II, as well as the Centers for Disease Control and the Food and Drug Administration for permitting us to use this dataset.Online Repository Study Design The Infant Feeding Practices Study II sample was identified via a national consumer opinion poll, and women who identified as being pregnant were further recruited for participation in the study based on their expected due date. Family history of food allergy was assessed via the question, “As best you know, which of the following health conditions do you yourself or your baby's other relatives have?” Mothers then had the option to select food allergy and indicate which relatives had a food allergy diagnosis: the mother, the baby's father, the baby's brother or sister, and/or the baby's grandparents, aunts, or uncles.Breastfeeding Mothers were asked to report breastfeeding at each postnatal survey.