1
|
Soriano VX, Koplin JJ, Forrester M, Peters RL, O'Hely M, Dharmage SC, Wright R, Ranganathan S, Burgner D, Thompson K, Dwyer T, Vuillerman P, Ponsonby AL. Infant pacifier sanitization and risk of challenge-proven food allergy: A cohort study. J Allergy Clin Immunol 2021; 147:1823-1829.e11. [PMID: 33810856 DOI: 10.1016/j.jaci.2021.01.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/07/2020] [Accepted: 01/14/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Environmental microbial exposure plays a role in immune system development and susceptibility to food allergy. OBJECTIVE We sought to investigate whether infant pacifier use during the first postnatal year, with further consideration of sanitization, alters the risk of food allergy by age 1 year. METHODS The birth cohort recruited pregnant mothers at under 28 weeks' gestation in southeast Australia, with 894 families followed up when infants turned 1 year. Infants were excluded if born under 32 weeks, with a serious illness, major congenital malformation, or genetic disease. Questionnaire data, collected at recruitment and infant ages 1, 6, and 12 months, included pacifier use and pacifier sanitization (defined as the joint exposure of a pacifier and cleaning methods). Challenge-proven food allergy was assessed at 12 months. RESULTS Any pacifier use at 6 months was associated with food allergy (adjusted odds ratio, 1.94; 95% CI, 1.04-3.61), but not pacifier use at other ages. This overall association was driven by the joint exposure of pacifier-antiseptic use (adjusted odds ratio, 4.83; 95% CI, 1.10-21.18) compared with no pacifier use. Using pacifiers without antiseptic at 6 months was not associated with food allergy. Among pacifier users, antiseptic cleaning was still associated with food allergy (adjusted odds ratio, 3.56; 95% CI, 1.18-10.77) compared with no antiseptic use. Furthermore, persistent and repeated antiseptic use over the first 6 months was associated with higher food allergy risk (P = .029). CONCLUSIONS This is the first report of a pacifier-antiseptic combination being associated with a higher risk of subsequent food allergy. Future work should investigate underlying biological pathways.
Collapse
Affiliation(s)
- Victoria X Soriano
- Population Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Jennifer J Koplin
- Population Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Mike Forrester
- School of Medicine, Deakin University, Geelong, Australia; Children's Services, Barwon Health, Geelong, Australia; St John of God Hospital, Geelong, Australia
| | - Rachel L Peters
- Population Health, Murdoch Children's Research Institute, Parkville, Australia; Department of Paediatrics, University of Melbourne, Parkville, Australia
| | - Martin O'Hely
- School of Medicine, Deakin University, Geelong, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Parkville, Australia
| | - Rosemary Wright
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Sarath Ranganathan
- Department of Paediatrics, University of Melbourne, Parkville, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - David Burgner
- Department of Paediatrics, University of Melbourne, Parkville, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - Kristie Thompson
- Queensland Alliance for Environmental Health Sciences, The University of Queensland, Brisbane, Australia
| | - Terence Dwyer
- Heart Research Group, Murdoch Children's Research Institute, Parkville, Australia; Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
| | - Peter Vuillerman
- School of Medicine, Deakin University, Geelong, Australia; Children's Services, Barwon Health, Geelong, Australia; Murdoch Children's Research Institute, Parkville, Australia
| | - Anne-Louise Ponsonby
- Murdoch Children's Research Institute, Parkville, Australia; Allergy and Lung Health Unit, School of Population and Global Health, University of Melbourne, Parkville, Australia; Neuroepidemiology Research Group, Florey Institute for Neuroscience and Mental Health, Parkville, Australia.
| | | |
Collapse
|