The American Academy of Pediatrics is updating earlier suggestions for the prevention of allergies in infants and children by saying that abstaining from certain foods during pregnancy does not ensure an allergy-free child.
In 2000, the organization advised mothers with a family history of allergies to avoid consuming cow's milk, eggs, fish, peanuts and tree nuts while breast-feeding their babies. The AAP also provided mothers with a recommended schedule for introducing certain risky foods (no solid foods before 6 months of age, no dairy products before the age of 1, no eggs before the age of 2, etc).
A new guidance reports is available now though, which reevaluates recommendations made seven years ago. It is published in the January issue of the journal Pediatrics.
While previous advice on restrictions from both the mothers and the babies’ diets has been removed, breast-feeding is still highly recommended.
The report says that there is no convincing evidence that women who avoid peanuts or other foods during pregnancy or breast-feeding lower their child's risk of allergies, reports the Associated Press.
As opposed to the advice given seven years ago, that a hypoallergenic or soy milk formula should be used with infants at risk of developing allergies, the current guideline says there is no good evidence that soy-based formulas prevent allergies.
The new recommendations add that convincing evidence is also lacking to support the delay of introduction of foods such as eggs, fish or peanut butter to children in an effort to prevent allergies.
However, solid food should not be fed to babies before 4 to 6 months of age.
The AAP still strongly advises mothers to breast-feed, noting that exclusive breast-feeding for at least four months in babies with a family history of allergies can lessen the risk of rashes and allergy to cow's milk.
The organization also says exclusive breast-feeding for at least three months has been shown to protect against wheezing in babies; it is not clear yet whether it prevents asthma in older children.
Dr. Scott Sicherer of the Mount Sinai School of Medicine's Jaffe Food Allergy Institute in New York, who helped write the new guideline, was quoted by the AP as saying: “You never know what's going to come around the corner, but in the past seven years there hasn't been enough evidence to support the old recommendations.”
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"The best prevention for atopic [allergic] disease is exclusive breast-feeding for four months," he added. "And if your infant comes from a family with significant atopic disease, then weaning from breast milk to a partially or extensively hydrolyzed [hypoallergenic] formula [without cow milk protein] may delay or prevent the onset of atopic disease, especially atopic dermatitis [eczema]."
Greer added that this recommendation would also apply to formula-fed infants who are at risk for atopic disease.
The timing and introduction of solid foods has no protective effect on the prevention of atopic disease, according to the new report...
"It's a mixed picture," Wu said. "We don't have proven efficacy for breast-feeding. It may mean that we need more robust studies and a longer-term follow-up for kids."
The new report is titled "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."