Breast Milk and Allergic Disease Development: Immunological Factors Associated with Eczema, Food Allergy and Wheezing/Asthma

Abstract Purpose of Review Human milk (HM) contains a diverse array of immunological, microbial, and metabolic bioactive factors that may influence early immune maturation and allergic disease susceptibility. This narrative review examines current evidence linking major HM bioactives with eczema, food allergy, and wheezing/asthma, integrating mechanistic findings with human observational and clinical data. Recent Findings Transforming growth factor-β (TGF-β), secretory IgA (sIgA), human milk oligosaccharides (HMOs), cytokines, fatty acids, short-chain fatty acids, the HM microbiome, and extracellular vesicles have all been implicated in pathways relevant to epithelial integrity, microbial colonization, and immune tolerance. However, associations with allergic outcomes are heterogeneous and frequently context dependent. Findings vary according to lactation stage, maternal characteristics, infant susceptibility, microbial exposures, and outcome definition. Mechanistic evidence is often stronger than prospective clinical evidence, and no individual HM component or bioactive profile has yet emerged as a reproducible predictor of allergy protection. Summary Current evidence supports viewing HM as a dynamic maternal–milk–infant biological network rather than as a source of isolated protective factors. Future studies should integrate repeated HM sampling, rigorous allergic phenotyping, and multi-omic approaches to distinguish causal mediators from biomarkers of maternal or infant biology.

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Publication Details

Journal
Current Allergy and Asthma Reports
Published
2026-10-29
DOI
https://doi.org/10.1007/s11882-026-01299-w
Primary Topic
Infant Nutrition and Health
Type
article
Field-Weighted Citation Impact
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article

Breast Milk and Allergic Disease Development: Immunological Factors Associated with Eczema, Food Allergy and Wheezing/Asthma

Laura R. Carucci, Mattia Giovannini, Francesca Mori, Rita Nocerino et al.
Current Allergy and Asthma Reports
Infant Nutrition and Health
article

Breast Milk and Allergic Disease Development: Immunological Factors Associated with Eczema, Food Allergy and Wheezing/Asthma

Laura R. Carucci, Mattia Giovannini, Francesca Mori, Rita Nocerino, Roberto Berni Canani, Bernardo Sousa‐Pinto, Simona Barni, Giulia Carla Immacolata Spolidoro, Gregorio Paolo Milani, Serena Coppola, Daniel Munblit, Letizia Ciliberti, Antonio Corsello, Carlo Virginio Agostoni, Alessandra Catalogna
article en

Abstract

Abstract Purpose of Review Human milk (HM) contains a diverse array of immunological, microbial, and metabolic bioactive factors that may influence early immune maturation and allergic disease susceptibility. This narrative review examines current evidence linking major HM bioactives with eczema, food allergy, and wheezing/asthma, integrating mechanistic findings with human observational and clinical data. Recent Findings Transforming growth factor-β (TGF-β), secretory IgA (sIgA), human milk oligosaccharides (HMOs), cytokines, fatty acids, short-chain fatty acids, the HM microbiome, and extracellular vesicles have all been implicated in pathways relevant to epithelial integrity, microbial colonization, and immune tolerance. However, associations with allergic outcomes are heterogeneous and frequently context dependent. Findings vary according to lactation stage, maternal characteristics, infant susceptibility, microbial exposures, and outcome definition. Mechanistic evidence is often stronger than prospective clinical evidence, and no individual HM component or bioactive profile has yet emerged as a reproducible predictor of allergy protection. Summary Current evidence supports viewing HM as a dynamic maternal–milk–infant biological network rather than as a source of isolated protective factors. Future studies should integrate repeated HM sampling, rigorous allergic phenotyping, and multi-omic approaches to distinguish causal mediators from biomarkers of maternal or infant biology.

Current Allergy and Asthma ReportsVol. 26(1)
University of Teramo (IT), Sechenov University (RU), Universidade do Porto (PT), King's College London (GB), University of Milan (IT), University of Pavia (IT), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Meyer Children's Hospital (IT), Federico II University Hospital (IT), Ospedale Annunziata di Cosenza (IT), Centre for Health Technology and Services Research (PT), ASST Fatebenefratelli Sacco (IT), University of Florence (IT), University of Calabria (IT), University of Naples Federico II (IT)
Openalex Percentile: Top 13%
Infant Nutrition and Health
DOIOpen Access PDFOpenAlex
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