Prather Pediatric and Allergy Center - Ask Doctor Brent

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Title: Preventing Food Allergy in Infancy

Category: Asthma and Allergy


Many recent studies have shown that it is possible to take measures to prevent food allergy in infancy. Of the allergic diseases best prevented by avoiding certain foods and breast feeding atopic dermatitis or eczema is the disease which seems to be most preventable. In a large prospective study done by Dr. Chandra it was shown that the risk of developing atopic dermatitis could be decreased from almost 50% to 20% simply by breast feeding for up to six months an infant who is highly likely to develop atopic dermatitis and by avoiding intake of certain high risk foods by the mother while she is breast feeding. These foods include milk, wheat, soy, corn, citrus, egg, peanut and fish. If the mother totally avoids milk and milk products she should supplement her diet with 1500 mg. of elemental calcium.

Other measures shown to help decrease eczema development in infants as well as other allergic conditions such as allergic rhinitis (hay fever) and bronchial asthma, include the above measures as well as controlling the home environment. This means cleaning up the home environment for dust mite and mold and avoiding pets indoors particularly cats. This has also been shown to be helpful to decrease circulating inhalant pollens and other inhalants by keeping clean air filter and using air purifiers particularly those with a HEPA (high efficiency particulate air) filter in place. When using an air cleaner two things are important to ask: (1) Does it have a HEPA filter; and (2) The rate of air exchange or the blowing power of the machine.

One of the best air cleaners for the money on the market today is the Envirocare unit which ranges from $180 to $250 and can be bought through several national companies in the medical supply business or at stores such as Service Merchandise.

Another very important factor in development of allergies, both eczema and hay fever and asthma in children is whether or not the mother smokes or any one else in the house smokes. Ideally there should be no smoking by the mother during pregnancy and no smoking by the mother or anyone else in the home environment after the baby is born. Other forms of pollution can also effect the development of allergies. Most of the studies, including Dr. Chandra's, continue to be carried on and, hopefully, within a few years we can have more hard data to recommend specific measures in delaying the onset of allergies and even in preventing allergies in highly prone children.

Children who are highly prone to develop allergies include children who's parents have allergies, either one or both parents. If an older sibling has allergies the risk of a child having allergies is greater. The range of development of allergy is considered to be 50 to 80 percent if both parents have allergy, 40 to 60 percent if one parent and a sibling have allergies, and 20 to 40 percent if one parent or one sibling has allergies. If no parent or sibling has allergies, the rate is only 5 to 15 percent. This shows clearly that heredity is the major factor in the development of allergies.

Which formulas are best to prevent allergies? It has long been thought that soy formulas were significantly less allergenic (allergy producing) than cow milk formulas. Recent studies have shown that this is not necessarily so and that soy milk formulas may be just as allergy producing as cow milk formulas. Without a doubt, the best means of reducing allergies and delaying the onset of allergies is to breast feed until the child's GI tract and immune system is better able to handle large protein such as cow milk or soy proteins. Some of the formulas touted to be low in allergy production such as Good Start have not panned out in large studies and may actually be greater in producing allergies than standard cow milk formulas and soy milk formulas. Two formulas which have been proven to be somewhat effective in decreasing production of allergies in highly prone infants include Nutramigen (Mead Johnson has had it on the market since 1942) and Alimentum (Ross Pharmaceuticals has had it on the market since 1989). Both of these are somewhat more expensive than standard formulas and should be reserved for highly susceptible children as recommended by your pediatrician.

In summary, the best means of decreasing onset of allergies and preventing ultimate degree of allergy in any child is to control the mom's diet in pregnancy for high risk foods, to breast feed and to control the environment the infant is growing up in particularly in the first six to nine months.