D3.286 - Infant feeding patterns, perinatal history and the development of food allergy in early childhood

The rising prevalence of food allergy (FA) worldwide requires a deeper understanding of modifiable risk factors, particularly in understudied populations. This study aimed to analyze associations between early-life nutrition, perinatal factors and FA development in children aged 0–2 years within a Russian cohort, to identify culturally relevant prevention strategies.

We conducted a retrospective analysis of nationwide parent-reported survey data from 2022, which included 2,199 questionnaires on Russian children (269 with FA and 1,930 controls). The study examined infant feeding practices (breastfeeding, formula use, timing and prevalence of complementary feeding), birth parameters (weight, length) and perinatal factors. Statistical analysis employed Fisher's exact, Wilcoxon rank-sum, and Pearson's χ² tests with significance set at p<0.05.

The FA prevalence was 12.2%. Cases were significantly older at assessment (mean age 1.41 vs. 1.16 years, p < 0.001), with a non-significant male predominance (54% vs. 49%, p = 0.114). Allergic children were significantly less likely to be breastfed (52% vs. 61%, p < 0.001) and more likely to receive formula (57% vs. 46%, p < 0.001). Complementary feeding was more common in allergic children (90% vs. 81%, p < 0.001), although its median timing (6.0 (5.0, 8.0) vs. 6.0 (5.0, 7.0) months, p = 0.294) did not differ between groups. Preterm birth (7.4% vs. 4.4%, p = 0.029) and birth complications (7.1% vs. 3.6%, p = 0.023) were significantly associated with FA, while maternal smoking and birth parameters (weight, length) showed no significant associations.

In this Russian cohort, FA development shows stronger associations with infant feeding practices than with most perinatal factors. The observed discordance between the higher prevalence of complementary feeding along with the absence of difference in its median timing in allergic children may reflect specific cultural practices, such as delayed or selective introduction of allergenic foods. These findings underscore the need for region-specific dietary guidelines that emphasize the promotion of breastfeeding and the evidence-based, timely introduction of allergenic complementary foods within the recommended 4–6-month window of tolerance.