A review in Clinical & Experimental Allergy highlights a problematic relationship between the infant formula industry and allergy health professionals. The authors express concern that this could undermine breastfeeding in countries such as India, whose allergy management practices are often extrapolated from guidance developed in high-income countries with low breastfeeding rates.

The article by international experts in infant nutrition and allergy health documents the high rate of breastfeeding in India, where one-quarter of the world’s children are born. It also points to growing evidence that excessive concern about infant allergies in high-income countries is undermining mother-infant bonding, breastfeeding, and child nutrition.

Because data specific to allergic disease prevalence in India are incomplete and allergy specialists represent a new category of health professionals in the country, it will be important for clinicians to avoid conflicts of interest with the infant formula industry. “As the allergy specialty develops in India, local guidance and practice will need to recognize the threat that current allergy practice poses to India’s normative infant feeding culture and ensure that breastfeeding continues to be supported at all levels,” the authors wrote.