Prevention of Allergies in Children

by Ren Chats
(Denmark)

Prevention of allergies?
Yes.
Lately preventive dietary aid for childhood allergies has been proposed.

Vast literature has emerged from several scientific studies, but the results are complex and not uniform for precise clinical strategy to intervene allergic march.

Even then some remedies that have jumped the rigorous scientific evidence based evaluation are targeting the needy confused anxious parents with inappropriate claims.

Till date the only recommended evidence based guidelines are:

1. Breastfeeding, preferably exclusive for first 4 months of life. By exclusive breastfeeding I mean that one should avoid introducing any infant formula, cow’s milk or any other food to the baby below 4 months of age.

2. Hypoallergen infant formulas should be given to the baby in event of insufficient or ineffective breastfeeds for optimal child growth, and prevention of dehydration and newborn jaundice.

3. Introduce complementary foods in infant’s diet at around 6 months of age in addition to ongoing mother’s milk feeds.

4. Dietary vitamin supplements have the capacity to alter immune response.
And it is a common practice to use vitamin drops from early months of life. It is noteworthy that clinical studies done to evaluate the effect of vitamin supplementation during infancy show increase in the risk of asthma and food allergies in children.

5. Vitamin D in optimal doses diminishes clinical presentation of allergic diseases; both incidence and severity.

6. Gut flora have potential regulatory influence on infants’ immune system development. The rising incidence of allergies in children is linked to suboptimal gut microbe stimulation of yet developing immune system during early infancy.

7. Dietary DHA and EPA (N-3long chain polyunsaturated fatty acids) have significant influence on immune system modulation: Both inherent and adaptive immune mechanism involved in the initiation and persistence of allergic disease. Therefore optimal DHA intake during pregnancy and lactation offers an effective primary prevention of allergies for high risk infants.

8. Antioxidant rich foods, optimal vitamin E, fresh fruits and vegetables rich in vitamin C, minerals when taken during pregnancy have potential positive influence in evolution of fetal immune system. Thereby the risk of allergic diseases is reduced during infancy and early childhood.
9. Supplements of probiotics and prebiotics through natural foods in the diet of pregnant women reduce the chances and the severity of infantile eczema even in high risk infants. However, similar benefit has not been consistently documented in other childhood allergies.

10. No conclusive scientific evidence has yet been found for the common belief that reactivity to food allergens has its onset during fetal development as a consequence of antigen load in mother’s diet. Nor do restrictions in diet of lactating mother’s prevent food allergy in her baby.

Nevertheless, avoidance of high allergen food proteins like fish, egg and cow’s milk during pregnancy and lactation diminishes the chances of infantile eczema, particularly in high risk infants. But the benefit of such restrictions in mother’s diet have to be weighed its ill effect on mother’s health.

11. Mother’s health during pregnancy:
Optimal nutrition and balanced lifestyle devoid of stress.

12. Minimizing indoor allergens like contact with pets, house dust mites etc.

13. Avoidance of pollutants: Second hand smoke and traffic exhaust exposure both before and after birth increase the chances of childhood allergies.

14. Drugs: Frequent use of acetaminophen, commonly known as paracetamol, increases risk of allergies in children. Moreover, children who receive more than 2 antibiotic courses during infancy have higher chances of food allergies.

References:

1. Pediatr Allergy Immunol. 2004 Jun;15 Suppl 16:4-5, 9-32. Prevention of allergic disease in childhood: clinical and epidemiological aspects of primary and secondary allergy prevention. Halken S. Department of Pediatrics, Sønderborg Hospital, Denmark.

2. Early Infant Multivitamin Supplementation Is Associated With Increased Risk for Food Allergy and Asthma, by Joshua D. Milner, Daniel M. Stein, Robert McCarter and Rachel Y. Moon, published in Pediatrics 2004;114;27

3. Associations between Maternal Antioxidant Intakes in Pregnancy and Infant Allergic Outcomes: Christina E. West, Janet Dunstan, Suzi McCarthy, Jessica Metcalfe, Nina D’Vaz, Suzanne Meldrum, Wendy H. Oddy, Meri K. Tulic and Susan L. Prescott; Nutrients 2012, 4, 1747-1758