Study population
The study population was collected from three Pediatric allergy (Koc
University, Mersin City Hospital, Bakirkoy Dr. Sadi Konuk Research and
Training Hospital) and one Pediatric Gastroenterology (Koc University
Pediatric Gastroenterology) centers from Turkey. The study population
consisted of breastfeeding mothers who were on an elimination diet due
to a diagnosis of FA in their children aged 1-to-12 months. The
breast-feeding mothers presented to the study centers who were willing
to participate in the study were included, consecutively. Food allergy
was classified as IgE-mediated (IgE), non-IgE-mediated (Non-IgE) and
mixed (both IgE- and non-IgE-mediated FA) FA. The diagnosis of
IgE-mediated FA was established according to the following criteria: 1.
A consistent and clear-cut history of FA-related symptoms that developed
within minutes to hours following the ingestion of food, 2. Positive
serum levels of sIgE (> 0.35 kUA/L) for the
specific food, 3. Positive skin prick test (SPT) for the specific food
(a wheal diameter of 3 mm or greater than the negative control).The
diagnosis of non-IgE mediated FA was established according to the
following criteria: 1. The presence of blood in the stool after in
otherwise healthy infants and the disappearance of blood with the
elimination of the suspected food(s) from maternal diet within 1 week,
2. The presence of isolated gastrointestinal symptoms, such as
repetitive-to-profuse emesis and vomiting with diarrhea, which can lead
to dehydration, lethargy, hypotension, or shock, 1–3 hours after the
ingestion of the suspected food or with persistence of these symptoms
for 2 weeks without any other cause and also with resolution of symptoms
after the removal of the causative food(s) from the diet, with a
recurrence of symptoms when reintroducing the causative food(s).The
mothers on dietary elimination whose infants had a diagnosis of FA
according to the criteria specified above were called as FA.
The mothers following an elimination diet with the thought of FA in
their children despite the absence of diagnostic criteria and laboratory
findings consistent with FA in their children were called as
“Indecisive symptoms for food allergy”. The considerations regarded as
Indecisive symptoms for food allergy were as follows: 1. Mucous but no
blood in stool, 2. Colic, sleep problems, irritability but no vomiting,
diarrhea, loss of weight and percentiles for height & weight were in
normal range and gain of weight were within normal limits.
The control group involved breastfeeding mothers of healthy children at
the same age range having no allergic, chronic or systemic disease who
were admitted to well-child care outpatient clinic at the study centers.
This group was called as “Healthy” or “Healthy controls” throughout
the study. The Koc University Ethics Committee approved the study and
written informed consent were obtained from all participants.