scholarly journals Dietary exposures and allergy prevention in high-risk infants

2021 ◽  
Vol 26 (8) ◽  
pp. 504-505
Author(s):  
Elissa M Abrams ◽  
Julia Orkin ◽  
Carl Cummings ◽  
Becky Blair ◽  
Edmond S Chan
Keyword(s):  
Food Allergy ◽  
High Risk ◽  
Food Allergies ◽  
Allergy Prevention ◽  
Severe Reaction ◽  
Omega 3 ◽  
Atopic Condition ◽  
Specific Formula ◽  
High Risk Infants ◽  
Hydrolyzed Formula

Abstract Infants at high risk for developing a food allergy have either an atopic condition (such as eczema) themselves or an immediate family member with such a condition. Breastfeeding should be promoted and supported regardless of issues pertaining to food allergy prevention, but for infants whose mothers cannot or choose not to breastfeed, using a specific formula (i.e., hydrolyzed formula) is not recommended to prevent food allergies. When cow’s milk protein formula has been introduced in an infant’s diet, make sure that regular ingestion (as little as 10 mL daily) is maintained to prevent loss of tolerance. For high-risk infants, there is compelling evidence that introducing allergenic foods early—at around 6 months, but not before 4 months of age—can prevent common food allergies, and allergies to peanut and egg in particular. Once an allergenic food has been introduced, regular ingestion (e.g., a few times a week) is important to maintain tolerance. Common allergenic foods can be introduced without pausing for days between new foods, and the risk for a severe reaction at first exposure in infancy is extremely low. Pre-emptive in-office screening before introducing allergenic foods is not recommended. No recommendations can be made at this time about the role of maternal dietary modification during pregnancy or lactation, or about supplementing with vitamin D, omega 3, or pre- or probiotics as means to prevent food allergy.

scholarly journals Should we continue to counsel families to use hydrolyzed formulas as a means of allergy prevention in high-risk infants?

2019 ◽  
Vol 25 (2) ◽  
pp. 79-81
Author(s):  
Megan Burke ◽  
Edmond S Chan ◽  
Elissa M Abrams
Keyword(s):  
High Risk ◽  
Position Statement ◽  
Cow’S Milk ◽  
Milk Formula ◽  
Allergy Prevention ◽  
Recent Systematic Review ◽  
Cow's Milk ◽  
High Risk Infants ◽  
Hydrolyzed Formula ◽  
Over Time

Abstract The prevalence of food allergy in North America is high, and has increased over time. As a result, focus has shifted from treatment to allergy prevention. Previous studies have suggested that hydrolyzed formula may prevent atopic dermatitis in high-risk infants. As a result, multiple international guidelines including the Canadian Paediatric Society (CPS) position statement on allergy prevention recommend the use of hydrolyzed formula as a means of allergy prevention in mothers who are not breastfeeding or using donor breastmilk. However, a recent systematic review has not supported an association between use of hydrolyzed formula and allergy prevention. In addition, studies are emerging supporting the use of early and regular cow’s milk formula as a means of cow’s milk allergy prevention.

scholarly journals Addressing Common Misconceptions in Food Allergy: A Review

Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 497
Author(s):  
Aikaterini Anagnostou
Keyword(s):  
Food Allergy ◽  
The United States ◽  
Specific Ige ◽  
Oral Immunotherapy ◽  
Food Allergies ◽  
Allergy Prevention ◽  
Diagnosis And Management ◽  
Skin Prick Tests ◽  
Food Specific Ige ◽  
Common Misconceptions

Background: Food allergies are common, affecting 1 in 13 school children in the United States and their prevalence is increasing. Many misconceptions exist with regards to food allergy prevention, diagnosis and management. Objective: The main objective of this review is to address misconceptions with regards to food allergies and discuss the optimal, evidence-based approach for patients who carry this diagnosis. Observations: Common misconceptions in terms of food allergy prevention include beliefs that breastfeeding and delayed introduction of allergenic foods prevent the development of food allergies. In terms of diagnosis, statements such as ‘larger skin prick tests or/and higher levels of food-specific IgE can predict the severity of food-induced allergic reactions’, or ‘Tryptase is always elevated in food-induced anaphylaxis’ are inaccurate. Additionally, egg allergy is not a contraindication for receiving the influenza vaccine, food-allergy related fatalities are rare and peanut oral immunotherapy, despite reported benefits, is not a cure for food allergies. Finally, not all infants with eczema will develop food allergies and epinephrine auto-injectors may unfortunately be both unavailable and underused in food-triggered anaphylaxis. Conclusions and relevance: Healthcare professionals must be familiar with recent evidence in the food allergy field and avoid common misunderstandings that may negatively affect prevention, diagnosis and management of this chronic disease.

scholarly journals The Role of Hydrolyzed Formula in Allergy Prevention

2017 ◽  
Vol 70 (Suppl. 2) ◽  
pp. 38-45 ◽  
Author(s):  
Michael D. Cabana
Keyword(s):  
Allergic Rhinitis ◽  
Food Allergy ◽  
Infant Formula ◽  
Allergic Disease ◽  
Clinical Studies ◽  
Atopic Disease ◽  
Allergy Prevention ◽  
Preventive Effect ◽  
History Of ◽  
Hydrolyzed Formula

Asthma, eczema, food allergy, and allergic rhinitis are some of the most common pediatric, chronic conditions in the world. Breastfeeding is the optimal way to feed all infants. For those infants who are exposed to infant formula, some studies suggest that certain partially hydrolyzed or extensively hydrolyzed formulas may decrease the risk of allergic disease compared to nonhydrolyzed formulas for children with a family history of atopic disease. Overall, there is some evidence to suggest that partially hydrolyzed whey formulas and extensively hydrolyzed casein formulas may decrease the risk of developing eczema for infants at high risk of allergic disease. The evidence for a preventive effect of hydrolyzed formulas on allergic rhinitis, food allergy, and asthma is inconsistent and insufficient. Finally, the qualitative changes to the peptides by the method of hydrolysis, not just the degree of protein hydrolysis, may have a large influence on the preventive effect of a particular infant formula for the potential risk of allergic disease. As a result, it may be difficult to generalize findings from clinical studies using a specific infant formula to other infant formulas from different manufacturers using different methods of hydrolysis. Further clinical studies are needed to help clinicians identify which infants may benefit from early intervention, as well as which specific hydrolyzed formulas are best suited to decrease the risk of future allergic disease.

scholarly journals Improved prospects for food allergy prevention

2017 ◽  
Vol 9 (4) ◽  
pp. 254 ◽  
Author(s):  
Rohan Ameratunga
Keyword(s):  
Food Allergy ◽  
High Risk ◽  
Allergy Prevention ◽  
Window Of Opportunity ◽  
Early Introduction ◽  
The World ◽  
Food Challenges ◽  
High Risk Children

ABSTRACT Three recent publications from Professor Gideon Lack have fundamentally changed our understanding of how to prevent food allergy. His team has shown that early introduction of allergenic foods may prevent food allergy in most but not all high-risk children. Various allergy and paediatric societies around the world are changing their recommendations based on these three studies. It appears there is a window of opportunity to safely introduce allergenic foods to high-risk children. This has resource implications, as some of these children will need testing and food challenges.

Effect of Partially Hydrolyzed Formula in Atopy Prevention of High Risk Infants Identified by Atopic Risk Score

2007 ◽  
Vol 119 (1) ◽  
pp. S239
Author(s):  
N. Pitaksit ◽  
P. Tansupapol ◽  
T. Tongkaew ◽  
P. Chatchatee ◽  
J. Ngamphaiboon
Keyword(s):  
High Risk ◽  
Risk Score ◽  
High Risk Infants ◽  
Hydrolyzed Formula

scholarly journals Food Allergy Prevention and Treatment by Targeted Nutrition

2018 ◽  
Vol 72 (Suppl. 3) ◽  
pp. 33-45 ◽  
Author(s):  
Ralf G. Heine
Keyword(s):  
Vitamin D ◽  
Food Allergy ◽  
Food Allergen ◽  
Population Level ◽  
Food Allergies ◽  
Allergy Prevention ◽  
Prevention Strategies ◽  
Allergen Avoidance ◽  
Effective Prevention ◽  
Young Infants

In view of the dramatic rise in the prevalence of food allergy globally, effective prevention strategies have become a public health priority. Several models have emerged around the etiology of food allergy, including the hygiene hypothesis, dual allergen exposure hypothesis, and vitamin D hypothesis. These form the basis for current and potential prevention strategies. Breastfeeding remains a key pillar of primary allergy prevention. Other nutritional interventions, including the use of whey-based, partially hydrolyzed formula in non-breastfed infants, also play an important role. In recent years, there has been a shift away from prolonged food allergen avoidance to the proactive allergen introduction from 4 months of age. This approach is supported by 2 pivotal randomized clinical trials showing that the early introduction of peanut and other food allergens significantly reduces the risk of food allergy. However, the implementation of this strategy at the population level still raises significant logistic problems, including patient selection and development of suitable food formats for young infants. Other prevention strategies, including vitamin D supplementation, are currently under evaluation. Maternal elimination diets during pregnancy and lactation are not recommended for allergy prevention. The treatment of food allergies has also seen major transformations. While strict allergen avoidance is still the key treatment principle, there is a greater focus on desensitization and tolerance induction by oral and epicutaneous immunotherapy. In addition, specialized hypoallergenic infant formulas for the treatment of infants with cow’s milk allergy have undergone reformulation, including the addition of lactose and probiotics in order to modulate the gut microbiome and early immune responses. Further research is needed to inform the most effective food allergy prevention strategies at the population level. In addition, the wider application of food allergen immunotherapy may provide better health outcomes and improved quality of life for families affected by food allergies.

scholarly journals Primary Prevention of Food Allergy—Environmental Protection beyond Diet

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2025
Author(s):  
Hanna Sikorska-Szaflik ◽  
Barbara Sozańska
Keyword(s):  
Food Allergy ◽  
Primary Prevention ◽  
Environmental Factors ◽  
Current Knowledge ◽  
Food Allergies ◽  
Allergy Prevention ◽  
Delivery Mode ◽  
Effective Prevention ◽  
Inhalant Allergens

A food allergy is a potentially life-threatening disease with a genetic and environmental background. As its prevalence has increased significantly in recent years, the need for its effective prevention has been emphasized. The role of diet modifications and nutrients in food allergy reduction has been extensively studied. Much less is known about the role of other environmental factors, which can influence the incidence of this disease. Changes in neonates gut microbiome by delivery mode, animal contact, inhalant allergens, oral and then cutaneous allergen exposure, air pollution, smoking, infections and vaccinations can be the potential modifiers of food allergy development. There is some data about their role as the risk or preventive factors, but yet the results are not entirely consistent. In this paper we present the current knowledge about their possible role in primary prevention of food allergies. We discuss the mechanisms of action, difficulties in designing accurate studies about food allergy and the potential biases in interpreting the connection between environmental factors and food allergy prevention. A better understanding of the role of environmental factors in food allergies development may help in implementing practical solutions for food allergy primary prevention in the future.

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