Avoiding cow’s milk formula at birth may prevent asthma or recurrent wheeze among young children

05 Oct 2020 --- Avoiding cow’s milk supplementation at birth may decrease risk of asthma or recurrent wheeze in young children, according to a new study published in the JAMA Network Open journal.

While further research is warranted, the researchers suspect that components in breast milk, including human milk oligosaccharides (HMOs), secretory immunoglobulins, lactoferrin and bacterial microbiota, may help prevent pathogenic bacterial adhesion while also providing nutrition for the microbiome.

“Gut microbiota may play important roles to digest cow’s milk protein as they may still be scarce for the first three days of life,” co-author Dr. Mitsuyoshi Urashima tells NutritionInsight. He is a professor of Molecular Epidemiology at the Jikei University School of Medicine in Tokyo, Japan.

“Thus, during the first three days of life, cow’s milk protein may not be digested by the gut microbiota, penetrate the immature intestinal membrane, stimulate immune cells, and trigger sensitization,” he explains.

The authors found that asthma or recurrent wheeze can be prevented by avoiding cow’s milk formula supplementation at birth.

Study parameters
A clinical trial of 312 Japanese newborns at risk for atopy were split into two groups in late 2013. 

The first group was assigned to either breastfeed with or without amino acid-based elemental formula for at least the first three days of life, while the other breastfed with CMF from birth to five months. Follow-up examinations ran through January 2020.

Asthma or recurrent wheeze developed in 15 (10 percent) of the children in the no CMF group, which the researchers saw as significantly less than the children in the CMF group: 27, or 18 percent of the children.

Higher vitamin D levels in participants in the no CMF group also decreased the risk of asthma and wheezing, but the researchers noted that this was a “weak association.”

Research motivation
In 2010, a cohort study demonstrated that the incidence of cow’s milk allergy was lower in infants who began receiving regular cow’s milk formula (CMF) within the first 14 days of life. The authors of this study recommended CMF supplementation at birth. 

The researchers highlight the relevance of this study as children with food allergies may develop asthma or recurrent wheeze.Many Japanese maternity wards encourage breastfeeding – widely understood to be a best practice in infant nutrition. 

However, some, including Jikei University Hospital, where the current trial was performed, allow mothers or nurses to supplement breastfeeding with small amounts of CMF approximately six to ten hours after birth.

“After Caesarean sections, mothers tend to sleep for a while. Therefore, small amounts of CMF supplementation are preferred to breastfeeding to prevent hypoglycemia. However, most mothers seem to add CMF by seeing what other mothers are doing,” Dr. Urashima elaborates.

Golden liquid
Infant nutrition is one of the most prolific industry segments, with the undeniable nutritional superiority of breast milk instigating continuous R&D.

Building on the growing scientific evidence in favor of breastfeeding, a study in August found that human-based milk fortifiers may have better health outcomes for severely underweight premature babies compared to traditional, cow’s milk-derived fortifiers (CMDF).

NutritionInsight recently spoke with movers in the allergy arena, as food sensitivities are on the rise and consumers are flagging difficulties digesting many dairy products.

Edited by Anni Schleicher