Prevention of IgE-Mediated Food Allergy: Emerging Strategies Through Maternal and Neonatal Interventions

Abstract

Whereas the early introduction of highly allergenic foods has been shown to be effective at preventing the onset of food allergy (FA) in high-risk infants, sensitization to food antigens can occur prior to complementary food introduction, and thus, additional earlier FA prevention strategies are urgently needed. Currently, aside from early introduction of peanut and egg, no therapies are strongly recommended by international professional allergy societies for the primary prevention of FA. This review focuses on maternal- and neonatal-directed interventions that are being actively investigated and developed, including maternal dietary factors and supplementation, specific elimination diets, breastfeeding, cow's milk formula supplementation, microbiome manipulations, bacterial lysate therapy, and skin barrier therapies. Evaluating how these factors and various prenatal/early life environmental exposures may impact the development of FA is crucial for accurately counseling caregivers in the prevention of FA.

Keywords: Atopic dermatitis; Breastfeeding; Food allergy; Food antigen; Nutrition; Prevention; Skin barrier function.

Figure 1.

Complex interactions between maternal and infant diet/micronutrients, host microbiome, host exposome, and subsequent epigenetic changes may contribute to the development of food allergy. Targeting these various domains may be beneficial for the prevention and/or treatment of food allergy. Figure created with Biorender.