Clinical practice: Breastfeeding and the prevention of allergy.
The increase in allergic disease prevalence has led to heightened interest in the factors determining allergy risk, fueled by the hope that by influencing these factors one could reduce the prevalence of allergic conditions. The most important modifiable risk factors for allergy are maternal smoking behaviour and the type of feeding. A smoke-free environment for the child (to be), exclusive breastfeeding for 4-6 months and the postponement of supplementary feeding (solids) until 4 months of age are the main measures considered effective. There is no place for restricted diets during pregnancy or lactation. Although meta-analyses suggest that hypoallergenic formula after weaning from breastfeeding grants protection against the development of allergic disease, the evidence is limited and weak. Moreover, all current feeding measures aiming at allergy prevention fail to show effects on allergic manifestations later in life, such as asthma. In conclusion, the allergy preventive effect of dietary interventions in infancy is limited. Counselling of future parents on allergy prevention should pay attention to these limitations.
Department of Paediatrics, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. cmf.kneepkens@vumc.nl
C M Frank
CM
Kneepkens
Paul L P
PL
Brand
D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D002648:Child; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology / Q000517:prevention & control*; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008425:Maternal Behavior; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013997:Time Factors