The First 1000 Days of Life: How Changes in the Microbiota Can Influence Food Allergy Onset in Children

Abstract

Background: Allergic disease, including food allergies (FA)s, has been identified as a major global disease. The first 1000 days of life can be a "window of opportunity" or a "window of susceptibility", during which several factors can predispose children to FA development. Changes in the composition of the gut microbiota from pregnancy to infancy may play a pivotal role in this regard: some bacterial genera, such as Lactobacillus and Bifidobacterium, seem to be protective against FA development. On the contrary, Clostridium and Staphylococcus appear to be unprotective.

Methods: We conducted research on the most recent literature (2013-2023) using the PubMed and Scopus databases. We included original papers, clinical trials, meta-analyses, and reviews in English. Case reports, series, and letters were excluded.

Results: During pregnancy, the maternal diet can play a fundamental role in influencing the gut microbiota composition of newborns. After birth, human milk can promote the development of protective microbial species via human milk oligosaccharides (HMOs), which play a prebiotic role. Moreover, complementary feeding can modify the gut microbiota's composition.

Conclusions: The first two years of life are a critical period, during which several factors can increase the risk of FA development in genetically predisposed children.

Keywords: breastfeeding; complementary feeding; dysbiosis; first 1000 days of life; food allergy (FA); gut microbiota; human milk oligosaccharides (HMOs); newborns.

Figure 1

Main factors influencing the composition of children’s gut microbiota in the first 1000 days of life. HMOs: human milk oligosaccharides; TGF-β: transforming growth factor-β.

Figure 2

Protective and unprotective bacterial genera in children’s gut microbiota.