Diagnosis and Management of Non-IgE gastrointestinal Allergies in Breastfed Infants - an EAACI Position Paper

Rosan Meyer; Adriana Chebar Lozinsky; David M Fleischer; Mario C Vieira; George Du Toit; Yvan Vandenplas; Christophe Dupont; Rebecca Knibb; Piınar Uysal; Ozlem Cavkaytar; Anna Nowak-Wegrzyn; Neil Shah; Carina Venter

doi:10.1111/all.13947

Diagnosis and Management of Non-IgE gastrointestinal Allergies in Breastfed Infants - an EAACI Position Paper

Rosan Meyer
, Adriana Chebar Lozinsky
, David M Fleischer
, Mario C Vieira
, George Du Toit
, Yvan Vandenplas
, Christophe Dupont
, Rebecca Knibb
, Piınar Uysal
, Ozlem Cavkaytar
, Anna Nowak-Wegrzyn
, Neil Shah
, Carina Venter

Department Paediatrics, Imperial College London, UK.
Department of Allergy and Immune Disorders, Murdoch Children's Research Institute, Australia.
University of Colorado Denver School of Medicine, Children's Hospital Colorado, USA.
Department of Paediatrics - Pontifical Catholic, University of Paraná and Center for Pediatric Gastroenterology - Hospital Pequeno Príncipe, Curitiba, Brazil.
Department of Pediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London and Guy's and St, Thomas' National Health Service Foundation Trust, London, UK.
KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Department of Paediatric Gastroenterology, Necker University Children Hospital, Paris, France.
Department of Allergy and Clinical Immunology, Adnan Menderes University, Aydin, Turkey.
Department of Pediatric Allergy and Immunology, Istanbul Medeniyet University, Medical Faculty, Goztepe Training and Research Hospital, Istanbul, Turkey.
Icahn School of Medicine at Mount Sinai, Jaffe Food Allergy Institute, USA.
Department Gastroenterology, Great Ormond Street Hospital, London, UK.
University of Colorado Denver School of Medicine Children's Hospital Colorado, USA.

Research output: Contribution to journal › Article › peer-review

165 Citations (SciVal)

100 Downloads (Pure)

Abstract

It is well-established that food proteins, such as egg, soya, cow's milk and wheat, are detectable in breastmilk for many hours or days after ingestion. Exposure to these proteins is important to the process of developing tolerance but can also sometimes elicit IgE-mediated and non-IgE-mediated allergic symptoms in breastfed infants. Non-IgE-mediated allergy, outside of food protein-induced allergic proctocolitis and eosinophilic oesophagitis, is not well understood, leading to variations in the diagnosis and management thereof. A primary objective of the European Academy for Allergy and Clinical Immunology is to support breastfeeding in all infants, including those with food allergies. A Task Force was established, to explore the clinical spectrum of non-IgE-mediated allergies, and part of its objectives was to establish diagnosis and management of non-IgE-mediated allergies in breastfed infants. Eight questions were formulated using the Patient, Intervention, Comparison, Outcome (PICO) system and Scottish Intercollegiate Guideline Network (SIGN) criteria for data inclusion, and consensus was achieved on practice points through the Delphi method. This publication aims to provide a comprehensive overview on this topic with practice points for healthcare professionals.

Original language	English
Pages (from-to)	14-32
Number of pages	19
Journal	Allergy
Volume	75
Issue number	1
Early online date	14 Jun 2019
DOIs	https://doi.org/10.1111/all.13947
Publication status	Published - 1 Jan 2020

Bibliographical note

This is the peer reviewed version of the following article: Meyer, R. , Chebar Lozinsky, A. , Fleischer, D. M., Vieira, M. C., Du Toit, G. , Vandenplas, Y. , Dupont, C. , Knibb, R. , Uysal, P. , Cavkaytar, O. , Nowak‐Wegrzyn, A. , Shah, N. and Venter, C. (2019), Diagnosis and Management of Non‐IgE gastrointestinal Allergies in Breastfed Infants – an EAACI Position Paper. Allergy. Accepted Author Manuscript, which has been published in final form at https://doi.org/10.1111/all.13947. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

Keywords

breastfed children
diagnosis of non–IgE-mediated allergy
food allergy
maternal elimination
non–IgE-mediated allergy

Access to Document

10.1111/all.13947

Diagnosis and Management of Non‐IgE gastrointestinal Allergies in Breastfed InfantsAccepted author manuscript, 365 KB

Cite this

@article{78c49f16f5cb42739e5c049700ebf4d1,

title = "Diagnosis and Management of Non-IgE gastrointestinal Allergies in Breastfed Infants - an EAACI Position Paper",

abstract = "It is well-established that food proteins, such as egg, soya, cow's milk and wheat, are detectable in breastmilk for many hours or days after ingestion. Exposure to these proteins is important to the process of developing tolerance but can also sometimes elicit IgE-mediated and non-IgE-mediated allergic symptoms in breastfed infants. Non-IgE-mediated allergy, outside of food protein-induced allergic proctocolitis and eosinophilic oesophagitis, is not well understood, leading to variations in the diagnosis and management thereof. A primary objective of the European Academy for Allergy and Clinical Immunology is to support breastfeeding in all infants, including those with food allergies. A Task Force was established, to explore the clinical spectrum of non-IgE-mediated allergies, and part of its objectives was to establish diagnosis and management of non-IgE-mediated allergies in breastfed infants. Eight questions were formulated using the Patient, Intervention, Comparison, Outcome (PICO) system and Scottish Intercollegiate Guideline Network (SIGN) criteria for data inclusion, and consensus was achieved on practice points through the Delphi method. This publication aims to provide a comprehensive overview on this topic with practice points for healthcare professionals.",

keywords = "breastfed children, diagnosis of non–IgE-mediated allergy, food allergy, maternal elimination, non–IgE-mediated allergy",

author = "Rosan Meyer and \{Chebar Lozinsky\}, Adriana and Fleischer, \{David M\} and Vieira, \{Mario C\} and \{Du Toit\}, George and Yvan Vandenplas and Christophe Dupont and Rebecca Knibb and Piınar Uysal and Ozlem Cavkaytar and Anna Nowak-Wegrzyn and Neil Shah and Carina Venter",

note = "This is the peer reviewed version of the following article: Meyer, R. , Chebar Lozinsky, A. , Fleischer, D. M., Vieira, M. C., Du Toit, G. , Vandenplas, Y. , Dupont, C. , Knibb, R. , Uysal, P. , Cavkaytar, O. , Nowak‐Wegrzyn, A. , Shah, N. and Venter, C. (2019), Diagnosis and Management of Non‐IgE gastrointestinal Allergies in Breastfed Infants – an EAACI Position Paper. Allergy. Accepted Author Manuscript, which has been published in final form at https://doi.org/10.1111/all.13947. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving. ",

year = "2020",

month = jan,

day = "1",

doi = "10.1111/all.13947",

language = "English",

volume = "75",

pages = "14--32",

journal = "Allergy",

issn = "0105-4538",

publisher = "Wiley-Blackwell",

number = "1",

}

TY - JOUR

T1 - Diagnosis and Management of Non-IgE gastrointestinal Allergies in Breastfed Infants - an EAACI Position Paper

AU - Meyer, Rosan

AU - Chebar Lozinsky, Adriana

AU - Fleischer, David M

AU - Vieira, Mario C

AU - Du Toit, George

AU - Vandenplas, Yvan

AU - Dupont, Christophe

AU - Knibb, Rebecca

AU - Uysal, Piınar

AU - Cavkaytar, Ozlem

AU - Nowak-Wegrzyn, Anna

AU - Shah, Neil

AU - Venter, Carina

N1 - This is the peer reviewed version of the following article: Meyer, R. , Chebar Lozinsky, A. , Fleischer, D. M., Vieira, M. C., Du Toit, G. , Vandenplas, Y. , Dupont, C. , Knibb, R. , Uysal, P. , Cavkaytar, O. , Nowak‐Wegrzyn, A. , Shah, N. and Venter, C. (2019), Diagnosis and Management of Non‐IgE gastrointestinal Allergies in Breastfed Infants – an EAACI Position Paper. Allergy. Accepted Author Manuscript, which has been published in final form at https://doi.org/10.1111/all.13947. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - It is well-established that food proteins, such as egg, soya, cow's milk and wheat, are detectable in breastmilk for many hours or days after ingestion. Exposure to these proteins is important to the process of developing tolerance but can also sometimes elicit IgE-mediated and non-IgE-mediated allergic symptoms in breastfed infants. Non-IgE-mediated allergy, outside of food protein-induced allergic proctocolitis and eosinophilic oesophagitis, is not well understood, leading to variations in the diagnosis and management thereof. A primary objective of the European Academy for Allergy and Clinical Immunology is to support breastfeeding in all infants, including those with food allergies. A Task Force was established, to explore the clinical spectrum of non-IgE-mediated allergies, and part of its objectives was to establish diagnosis and management of non-IgE-mediated allergies in breastfed infants. Eight questions were formulated using the Patient, Intervention, Comparison, Outcome (PICO) system and Scottish Intercollegiate Guideline Network (SIGN) criteria for data inclusion, and consensus was achieved on practice points through the Delphi method. This publication aims to provide a comprehensive overview on this topic with practice points for healthcare professionals.

AB - It is well-established that food proteins, such as egg, soya, cow's milk and wheat, are detectable in breastmilk for many hours or days after ingestion. Exposure to these proteins is important to the process of developing tolerance but can also sometimes elicit IgE-mediated and non-IgE-mediated allergic symptoms in breastfed infants. Non-IgE-mediated allergy, outside of food protein-induced allergic proctocolitis and eosinophilic oesophagitis, is not well understood, leading to variations in the diagnosis and management thereof. A primary objective of the European Academy for Allergy and Clinical Immunology is to support breastfeeding in all infants, including those with food allergies. A Task Force was established, to explore the clinical spectrum of non-IgE-mediated allergies, and part of its objectives was to establish diagnosis and management of non-IgE-mediated allergies in breastfed infants. Eight questions were formulated using the Patient, Intervention, Comparison, Outcome (PICO) system and Scottish Intercollegiate Guideline Network (SIGN) criteria for data inclusion, and consensus was achieved on practice points through the Delphi method. This publication aims to provide a comprehensive overview on this topic with practice points for healthcare professionals.

KW - breastfed children

KW - diagnosis of non–IgE-mediated allergy

KW - food allergy

KW - maternal elimination

KW - non–IgE-mediated allergy

UR - https://onlinelibrary.wiley.com/doi/abs/10.1111/all.13947

UR - https://www.scopus.com/pages/publications/85071749285

U2 - 10.1111/all.13947

DO - 10.1111/all.13947

M3 - Article

C2 - 31199517

SN - 0105-4538

VL - 75

SP - 14

EP - 32

JO - Allergy

JF - Allergy

IS - 1

ER -

Diagnosis and Management of Non-IgE gastrointestinal Allergies in Breastfed Infants - an EAACI Position Paper

Abstract

Bibliographical note

Keywords

Access to Document

Other files and links

Fingerprint

Cite this