Gülten TUNÇERLER, Simge ATAR BEŞE, Duygu ERGE, Pınar UYSAL
Trends in Pediatrics - 2026;7(3):184-192
Background: A limited number of studies have shown that fermented milk products (FMPs) regularly consumed by mothers during pregnancy may be beneficial for atopic dermatitis and food allergy in their children. In this study, we aimed to investigate the effect of regular maternal consumption of yogurt and cheese during pregnancy on the remission period of cow's milk protein allergy (CMPA) in their children. Methods: In this retrospective cohort study, 59 consecutive children who presented to the pediatric allergy outpatient clinic between January 2020 and January 2023 and were evaluated for IgE-mediated CMPA were screened; 19 were excluded (incomplete data, non-IgE-mediated findings, or declined participation), leaving 40 children for analysis. The diagnosis of CMPA was made by skin prick test (SPT) and/or cow's milk-specific IgE and oral food challenge (OFC). Demographic characteristics, laboratory data, duration of tolerance development and frequency of regular FMP consumption by mothers during pregnancy were recorded using a structured questionnaire. Results: Among cases, 42.5% were girls and 57.5% were boys. The median age of cases was 38.5 months (24-47.75). The median duration of breast milk intake was 20 months (14-24). Parental atopy was present in 45% of cases. The median age at symptom onset was 4.5 (2-6) months. Prediagnoses at presentation included atopic dermatitis in 57.5%, allergic proctocolitis in 5%, urticaria and angioedema in 32.5%, and anaphylaxis in 5%. The median cow's milk SPT wheal diameter was 8 (5-13) mm, yogurt SPT wheal diameter was 5 (0-10) mm, and cow's milk-specific IgE value was 0.66 (0.13-5.68) kU/L. Baked cow's milk products were tolerated by 67.5% of subjects. Prevalence of daily FMP consumption during pregnancy was 55%, yogurt consumption was 62.5%, and cheese consumption was 70%. Although there was no significant difference between subgroups in age at onset of clinical symptoms, the age at first tolerance to cow's milk, duration of tolerance development and yogurt SPT wheal diameter were significantly lower in children of mothers who consumed FMPs daily during pregnancy compared with those who did not (p<0.05); this lower yogurt wheal diameter may in part reflect a milder baseline sensitization profile in this subgroup. Age at symptom onset was correlated with serum total IgE and cow's milk-specific IgE. Conclusion: The duration of remission of CMPA in offspring was found to be shorter if the mother used FMPs daily during pregnancy.
