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Reduce Baby Allergies Before Delivery?

Reduce Baby Allergies

By Dr. Michele Brown.

Parents are persistent in asking their obstetricians, “Is there anything we can do when pregnant or breastfeeding to try and prevent allergies from occurring in our child? Why? Because Parents worldwide are noticing that the incidence of allergy, or atopy, in children is dramatically increasing. This includes asthma, allergic rhinitis (runny nose due to allergy), skin allergies (eczema), and food allergies.

Why is this increase in childhood allergies occurring and are there any nutritional options during pregnancy and lactation which will help prevent allergic disease?

In order to understand what to do, parents must first understand the severity and scope of the problem. This is what my research has uncovered.

What is the incidence of atopy (different allergies) in children?

It is estimated that 5-10% of children suffer from food allergies. Peanut allergy in particular is a growing public health problem effecting 1% of all British and US preschool children. The incidence has doubled in the past decade. Asthma incidence in the U.S. has increased 160% in children up to 4 years of age. Eczema is estimated to effect 10-20% of school age children and has increased 2 to 3 fold.

What causes atopic disease?

Atopic disease has a genetic basis but environmental factors, such as early nutrition, may also play an important role. Food allergy, eczema, and asthma are more likely to occur in infants with a family history of allergy in one or more first degree relatives. Chicken eggs, cow milk, peanuts, fish, nuts, wheat, and soy are the most likely foods that cause an immunologic reaction in childhood, many of which persist into adulthood.

Will altering maternal diet when pregnant prevent or delay atopic disease in children?

Here is what the American Academy of Pediatrics has recommended In the past.

Pregnant women avoid allergenic foods in their diet such as peanuts, eggs, and cows milk. However, recent evidence has NOT felt that dietary manipulations or restrictions make any difference. A large Cochrane review study done in 2006, involving 334 women, concluded that avoidance diets during pregnancy are UNLIKELY to substantially affect the child’s risk of atopic disease. In fact, such diets might adversely effect maternal or fetal nutrition which can cause lower gestational weight gain, slightly higher risk of preterm birth, and a reduction in birthweight of the infants. However, future trials with a larger sample size were recommended.

Similarly…

Another researcher, Muraro in 2004 after reviewing all the literature concluded that there is NO evidence that maternal diet during pregnancy or lactation prevents the development of atopic disease.

However, a study concludes…

A recent study by Soutter at the American Academy of Allergy, Asthma, and Immunology in 2010, involving 274 high risk pregnant women, each with a previous documented child with food allergies, showed that children whose mothers avoided certain allergenic foods during late pregnancy and lactation had a lower chance of developing asthma and allergic sensitization when avoiding peanuts, tree nuts, milk and eggs when examined at 18 months and 3 years of age.

By age 3, there was no significant difference between the groups for eczema symptoms and dust mite sensitization but the differences in rates of peanut and egg sensitization as well as asthma was large and significant. It is felt that avoidance behavior may work for certain people and not for others.

Does breastfeeding effect the development of atopic disease?

There is some evidence that breastfeeding in the first 3 to 4 months of life is associated with a reduced risk of developing allergic disease in early childhood, especially eczema during infancy and childhood asthma and wheezing.

As far as food allergy, breastfeeding for at least 4 months had a lower incidence of cow milk allergy in some studies but in others there was no difference. A Cochrane review from 2006 found that feeding an infant with a hydrolyzed formula compared to cows milk formula did reduce the the development of infant and childhood allergy.

There is no evidence that breastfeeding for greater than 6 months has any protective effect against allergic disease. The studies are controversial and mostly retrospective. Long term effects of breastfeeding on the development of allergy in later life is uncertain.

Why is the peanut allergy so common?

There are many theories as to why there is a rising prevalence in peanut allergies in western countries.

Peanuts are a staple of the American diet and is being used more commonly in “quick energy foods.” Considered excellent nutritionally due to its high protein content it is being ingested more frequently in pregnant and breastfeeding women (One peanut contains 200 mg protein). Peanut protein can be found in breast milk and in utero 1 to 3 hours after ingestion.

Most American children are exposed to peanut butter in their first year of life in contrast to other countries. Americans eat dry-roasted peanuts requiring higher temperatures, which increase the allergenicity. Other countries eat peanuts that are boiled or fried.

Even though the European guidelines and the American Academy of Pediatrics do not recommend avoidance of dietary allergens during pregnancy, the avoidance of peanuts during pregnancy might be an exception for families with a history of peanut allergy.

In summary:

At this time, current evidence does not support a role for dietary restrictions during pregnancy or lactation to prevent allergic disease. It is felt that more studies are needed.

For high risk infants with a strong family history of allergy, there is evidence that exclusive breastfeeding for at least 4 months compared with cow milk formula, decreased or delayed the risk of eczema, cow milk allergy and wheezing in the first 2 years of life.

For infants that are not breast fed but who are at high risk for allergy, there is some evidence that the use of hydrolyzed formula, compared to cows milk, helps prevent or delay allergic disease. Soy formulas are not recommended to prevent allergy.

Peanuts are the one exception where avoidance during pregnancy and breastfeeding may decrease the risk of subsequent peanut allergy.

Article published by Dr. Michele Brown OBGYN and Founder of Beauté de Maman: www.beautedemaman.com

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May 07, 2010 | Category: Health and Beauty | Comments: none | Tags: , , , , ,

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