Arne Høst1, Susanne Halken. 1. Department of Pediatrics, Odense University Hospital, Denmark. arne.hoest@ouh.fyns-amt.dk
Abstract
PURPOSE OF REVIEW: Allergic diseases represent a major burden of health problems in industrialized countries. Though several studies have focused on possible preventive measure and strategies much controversy still exists on this topic. The aim of this review is to discuss the recent literature on primary prevention of food allergy. RECENT FINDINGS: In prospective observational controlled studies of high quality of birth cohorts, exclusive breastfeeding for at least 4 months combined with introduction of solid foods after 4 months of age is associated with a reduced risk of food allergy and atopic dermatitis, particularly in high-risk infants. When breastfeeding for 4-6 months is not possible or insufficient, randomized controlled trials have shown a significant reduction in food allergy and atopic dermatitis in high-risk infants fed a documented hypoallergenic hydrolysed formula. SUMMARY: Breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented hypoallergenic hydrolysed formula is recommended if exclusively breastfeeding is not possible for the first 4 months. As regards primary prevention of food allergy there is no evidence for preventive dietary intervention during neither pregnancy nor lactation. Likewise, preventive dietary restrictions after the age of 4-6 months are not scientifically documented.
PURPOSE OF REVIEW: Allergic diseases represent a major burden of health problems in industrialized countries. Though several studies have focused on possible preventive measure and strategies much controversy still exists on this topic. The aim of this review is to discuss the recent literature on primary prevention of food allergy. RECENT FINDINGS: In prospective observational controlled studies of high quality of birth cohorts, exclusive breastfeeding for at least 4 months combined with introduction of solid foods after 4 months of age is associated with a reduced risk of food allergy and atopic dermatitis, particularly in high-risk infants. When breastfeeding for 4-6 months is not possible or insufficient, randomized controlled trials have shown a significant reduction in food allergy and atopic dermatitis in high-risk infants fed a documented hypoallergenic hydrolysed formula. SUMMARY: Breastfeeding should be encouraged for 4-6 months. In high-risk infants a documented hypoallergenic hydrolysed formula is recommended if exclusively breastfeeding is not possible for the first 4 months. As regards primary prevention of food allergy there is no evidence for preventive dietary intervention during neither pregnancy nor lactation. Likewise, preventive dietary restrictions after the age of 4-6 months are not scientifically documented.