19th Annual Child Health Research Days

RBC Convention Center

Oct. 24 & 26, 2023


#41 Human milk oligosaccharides and food sensitization among infants in the CHILD Study

Kozeta Miliku, University of Manitoba; Lars Bode, Director, UC San Diego Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence; Bianca Robertson, UC San Diego Larsson-Rosenquist Foundation Mother-Milk-Infant Center of Research Excellence; Atul Sharma, University of Manitoba; Padmaja Subbarao, University of Toronto; Allan Becker, University of Manitoba; Piushkumar Mandhane, University of Alberta; Stuart Turvey, University of British Columbia; Diana Lefebvre, McMaster University; Malcolm Sears, McMaster University; Meghan Azad, University of Manitoba


Human milk oligosaccharides (HMOs) shape the infant gut microbiota and may influence development of the immune system. HMOs appear to modify allergic disease risk in rodents, but this has not been confirmed in humans. Our objective was to examine the association of HMOs with infant food sensitization.


We studied a representative subset of 421 mother-infant dyads from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Milk samples were collected at 3-4 months postpartum and analyzed by rapid high-throughput HPLC to quantify the 20 most abundant HMOs. Food sensitization at 1 year was determined by skin prick testing (≥2mm wheal) to egg, milk, soy and peanut. Associations were examined for total and individual HMO concentrations (Mann-Whitney test) and overall HMO profiles (partial least squares discriminant analysis (PLS-DA)). Discriminant scores were examined in regression models with adjustment for potential confounders and known allergy risk factors.


Overall, 59/421 infants (14.0%) were sensitized to one or more food allergen at 1 year of age. Total and individual HMO concentrations were not associated with food sensitization. However, overall HMO profiles differed significantly in milk consumed by sensitized vs. non-sensitized infants (mean PLS-DA score: 0.21 vs. 0.13, p<0.001; area-under-the-curve: 0.73, 95% Confidence Interval (CI) 0.66-0.79). Each unit increase in HMO discriminant score was associated with a 2.3-fold increased odds of food sensitization (Odds Ratio 2.32, 95% CI 1.66-3.23). This association was independent of maternal atopy and other known allergy risk factors. HMO profiles associated with higher odds of food sensitization were characterized by lower concentrations of fucosyl-disialyllacto-N-hexaose (FDSLNH), and lacto-N-fucopentaose-II (LNFPII), and higher concentrations of lacto-N-hexaose (LNH) and lacto-N-tetraose (LNT).


HMO composition is associated with food sensitization in the first year of life. Further research is needed to evaluate confirmed food allergy later in childhood, and explore the biological mechanisms.