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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.

Abstract

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.

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  • Publisher Full Text
  • Authors

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    Source

    Pediatrics 121:1 2008 Jan pg 183-91

    MeSH

    Breast Feeding
    Child
    Child, Preschool
    Dermatitis, Atopic
    Feeding Behavior
    Female
    Food Hypersensitivity
    Humans
    Hypersensitivity
    Infant
    Infant Formula
    Infant Nutritional Physiological Phenomena
    Infant, Newborn
    Male
    Nutrition Assessment
    Pregnancy
    Prenatal Care
    Primary Prevention
    Risk Assessment
    Sensitivity and Specificity
    Time Factors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    18166574

    Citation

    Greer, Frank R., et al. "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." Pediatrics, vol. 121, no. 1, 2008, pp. 183-91.
    Greer FR, Sicherer SH, Burks AW, et al. 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. Pediatrics. 2008;121(1):183-91.
    Greer, F. R., Sicherer, S. H., & Burks, A. W. (2008). 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. Pediatrics, 121(1), pp. 183-91. doi:10.1542/peds.2007-3022.
    Greer FR, et al. 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. Pediatrics. 2008;121(1):183-91. PubMed PMID: 18166574.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - 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. AU - Greer,Frank R, AU - Sicherer,Scott H, AU - Burks,A Wesley, AU - ,, AU - ,, PY - 2008/1/2/pubmed PY - 2008/2/6/medline PY - 2008/1/2/entrez SP - 183 EP - 91 JF - Pediatrics JO - Pediatrics VL - 121 IS - 1 N2 - 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. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/18166574/full_citation L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=18166574 DB - PRIME DP - Unbound Medicine ER -