Spontaneous integrin expression on CD4+, CD8+ and CD19+ lymphocytes at 6 months was significantly lower in breastfed than formula-fed infants (p < 0.05). In another study of 59 formula-fed and 64 breastfed 12-month-old children blast transformation and cytokine production by lymphocytes, and T cell changes were measured before and after measles-mumps-rubella vaccination (MMR). Before vaccination, lymphocytes of breastfed children had lower levels of blast transformation without antigen (p < 0.001), with tetanus toxoid (p < 0.02) or Candida (p < 0.04), and lower interferon-gamma production (p < 0.03). Fourteen days after the live viral vaccination, only the breastfed children had increased production of interferon-gamma (p < 0.02) and increased percentages of CD56+ (p < 0.022) and CD8+ cells (p < 0.004). These findings are consistent with a Th1 type response by breastfed children, not evident in formula-fed children. Feeding mode has an important long-term immunomodulating effect on infants beyond weaning.