PEDIATRICS Vol. 121 No. 1 January 2008, pp. 183-191 (doi:10.1542/10.1542/peds.2007-3022)
CLINICAL REPORT |
Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas
This clinical report reviews the nutritional options during pregnancy, lactation, and the first year of life that may affect the development of atopic disease (atopic dermatitis, asthma, food allergy) in early life. It replaces an earlier policy statement from the American Academy of Pediatrics that addressed the use of hypoallergenic infant formulas and included provisional recommendations for dietary management for the prevention of atopic disease. The documented benefits of nutritional intervention that may prevent or delay the onset of atopic disease are largely limited to infants at high risk of developing allergy (ie, infants with at least 1 first-degree relative [parent or sibling] with allergic disease). Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation. There is evidence that breastfeeding for at least 4 months, compared with feeding formula made with intact cow milk protein, prevents or delays the occurrence of atopic dermatitis, cow milk allergy, and wheezing in early childhood. In studies of infants at high risk of atopy and who are not exclusively breastfed for 4 to 6 months, there is modest evidence that the onset of atopic disease may be delayed or prevented by the use of hydrolyzed formulas compared with formula made with intact cow milk protein, particularly for atopic dermatitis. Comparative studies of the various hydrolyzed formulas also indicate that not all formulas have the same protective benefit. There is also little evidence that delaying the timing of the introduction of complementary foods beyond 4 to 6 months of age prevents the occurrence of atopic disease. At present, there are insufficient data to document a protective effect of any dietary intervention beyond 4 to 6 months of age for the development of atopic disease.
Key Words: atopy • food allergies • breastfeeding • complementary foods • hydrolyzed formula • atopic dermatitis • asthma
Abbreviations: AAP—American Academy of Pediatrics • IgE—immunoglobulin E • OR—odds ratio • CI—confidence interval
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
The following policy statement has been revised:
- Hypoallergenic Infant Formulas
Pediatrics 106: 346-349.[Full Text]
This article has been cited by other articles:
|
|
 |
|
  J. R Apps and R M. Beattie Cow's milk allergy in children BMJ, July 3, 2009; 339(jul03_1): b2275 - b2275. [Full Text]
|
|
|
|
 |
|
 H. Bauchner Atoms Arch. Dis. Child., January 1, 2009; 94(1): i - i. [Full Text] [PDF]
|
|
|
|
 |
|
 A. C. Krakowski, L. F. Eichenfield, and M. A. Dohil Management of Atopic Dermatitis in the Pediatric Population Pediatrics, October 1, 2008; 122(4): 812 - 824. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Lack Food Allergy N. Engl. J. Med., September 18, 2008; 359(12): 1252 - 1260. [Full Text] [PDF]
|
|
|
|
 |
|
 Early Nutrition and Development of Atopic Disease Journal Watch Pediatrics and Adolescent Medicine, February 20, 2008; 2008(220): 1 - 1. [Full Text]
|
|
|
|
 |
|
 Can We Prevent Atopic Disease by What We Feed Our Babies? Journal Watch Dermatology, February 15, 2008; 2008(215): 1 - 1. [Full Text]
|
|
|
|
 |
|
 F. R. Greer and S. H. Sicherer Report reviews evidence on whether early dietary practices can reduce atopy AAP News, January 1, 2008; 29(1): 12 - 12. [Full Text] [PDF]
|
|
