PURPOSE OF THE STUDY.
The goal of this study was to systematically review the literature on how to prevent the development of food allergy.
A systematic review was performed on articles published through September 2012. Meta-analyses, randomized controlled trials, and prospective cohort studies designed to prevent food sensitization and/or the development of food allergy were identified from Medline, Embase, Cochrane, CINAHL, Web of Science, TRIP Database, and ClinicalTrials.gov and were assessed for systematic bias. Because the studies varied in terms of design, target populations, and interventions, a meta-analysis was not performed.
Seventy-four studies were included in this systematic review. For infants at high risk for developing food allergy (defined by the authors as children with a family history of allergic disease), there was evidence to support avoiding cow’s milk and using extensively or partially hydrolyzed whey or casein formulas for the first 4 months of life to prevent the development of food allergy. In contrast, the evidence was conflicting for other primary prevention techniques, including maternal restriction of common food allergens during pregnancy or while breastfeeding, the use of probiotics during infancy, breastfeeding during infancy, or delaying the introduction of solid foods beyond 4 months.
In this systematic review of the literature, the only intervention for which there is evidence of preventing the development of food allergy is to avoid cow’s milk during the first 4 months of life in children at high risk.
This article is an updated systematic review of the literature regarding primary prevention of food allergy. As highlighted in this review and in others, data regarding primary prevention of food allergy remain weak and conflicting. Current evidence does not support avoiding allergenic foods during pregnancy or while breastfeeding, delaying the introduction of solid foods, or breastfeeding during infancy for primary prevention of food allergy. This study highlights the fact that further research on effective interventions to prevent food allergy is necessary.
- Copyright © 2014 by the American Academy of Pediatrics