Which advises for primary food allergy prevention in normal or high-risk infant?

2016 ◽  
Vol 27 (8) ◽  
pp. 774-778 ◽  
Author(s):  
Giampaolo Ricci ◽  
Francesca Cipriani
Keyword(s):  
Food Allergy ◽  
High Risk ◽  
Allergy Prevention ◽  
High Risk Infant

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.

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 Introduction of Complementary Foods to Infants

2017 ◽  
Vol 70 (Suppl. 2) ◽  
pp. 47-54 ◽  
Author(s):  
Christina West
Keyword(s):  
Food Allergy ◽  
High Risk ◽  
Infant Feeding ◽  
Allergic Disease ◽  
Peanut Allergy ◽  
Future Research ◽  
Optimal Timing ◽  
Controlled Trials ◽  
Allergy Prevention ◽  
Complementary Foods

While earlier food allergy prevention strategies implemented avoidance of allergenic foods in infancy, the current paradigm is shifting from avoidance to controlled exposure. This review focuses on the outcome of recent randomized controlled trials, which have examined the early introduction of allergenic foods for allergy prevention, and discusses the implementation of results in clinical practice. In infants at high risk of allergic disease, there is now direct evidence that regular early peanut consumption will reduce the prevalence of peanut allergy, compared to avoidance. Many international infant feeding guidelines already recommend complementary foods, including allergenic foods, to be introduced from 4 to 6 months of age irrespective of family history risk. Interim guidelines from 10 International Pediatric Allergy Associations state that healthcare providers should recommend the introduction of peanut-containing products into the diets of infants at high risk of allergic disease in countries where peanut allergy is prevalent. Direct translation of the results obtained from a cohort of high-risk infants to the general population has proved difficult, and issues regarding feasibility, safety, and cost-effectiveness have been raised. Five randomized placebo-controlled trials have assessed the effects of early egg exposure in infancy with varying results. In a recent comprehensive meta-analysis, there was moderate-certainty evidence that early versus late introduction of egg was associated with a reduced egg allergy risk. Although promising, optimal timing, doses, and if the feeding regimen should be stratified according to infant allergy risk remain to be determined. The single study that assessed introduction of multiple foods from 3 months whilst breastfeeding compared with exclusive breastfeeding until 6 months of age showed no reduction in food allergy prevalence. Future research should aim at optimizing infant feeding regimens and support a tolerogenic gastrointestinal microenvironment during the period of food allergen introduction.

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.

The High-Risk Infant

1975 ◽  
Vol 55 (10) ◽  
pp. 1092-1096 ◽  
Author(s):  
Karen Goldberg
Keyword(s):  
High Risk ◽  
High Risk Infant

Resolving driver events in MLL-r negative high-risk infant ALL.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 10030-10030
Author(s):  
Jennifer Seelisch ◽  
Matthew Zatzman ◽  
Federico Comitani ◽  
Fabio Fuligni ◽  
Ledia Brunga ◽  
...  
Keyword(s):  
Gene Expression ◽  
T Cell ◽  
High Risk ◽  
B Cell ◽  
Gene Expression Profiling ◽  
Rna Sequencing ◽  
Clinical Features ◽  
Expression Profiling ◽  
High Risk Infant ◽  
Childhood All

10030 Background: Infant acute lymphoblastic leukemia (ALL) is the only subtype of childhood ALL whose outcome has not improved over the past two decades. The most important prognosticator is the presence of rearrangements in the Mixed Lineage Leukemia gene (MLL-r), however, many patients present with high-risk clinical features but without MLL-r. We recently identified two cases of infant ALL with high-risk clinical features resembling MLL-r, but were negative for MLL-r by conventional diagnostics. RNA sequencing revealed a partial tandem duplication in MLL (MLL-PTD). We thus aimed to determine if MLL-PTD, other MLL abnormalities, or other genetic or transcriptomic features were driving this subset of high-risk infant ALL without MLL-r. Methods: We obtained 19 banked patient samples from the Children’s Oncology Group (COG) infant ALL trial (AALL0631) from MLL wildtype patients as determined by FISH and cytogenetics. Utilizing deep RNA-sequencing, we manually inspected the MLL gene for MLL-PTD, while also performing automated fusion detection and gene expression profiling in search of defining features of these tumors. Results: 3 additional MLL-PTDs were identified, all in patients with infant T-cell ALL, whereas both index cases were in patients with infant B-cell ALL. Gene expression profiling analysis revealed that all five MLL-PTD infants clustered together. Eight infants (7 with B-cell ALL) were found to have Ph-like expression. Five of these 8 infants were also found to have an IKZF1/JAK2 expression profile; one of these five had a PAX5-JAK2 fusion detected. Two infants (including the one noted above) had novel PAX5 fusions, known drivers of B-cell leukemia. Additional detected fusions included TCF3-PBX1 and TCF4-ZNF384. Conclusions: MLL-PTDs were found in both B- and T-cell infant ALL. Though Ph-like ALL has been described in adolescents and young adults, we found a substantial frequency of Ph-like expression among MLL-WT infants. Further characterization of these infants is ongoing. If replicated in other infant cohorts, these two findings may help explain the poor prognosis of MLL-WT ALL when compared to children with standard risk ALL, and offer the possibility of targeted therapy for select infants.

scholarly journals Early Solid Food Introduction: Role in Food Allergy Prevention and Implications for Breastfeeding

2017 ◽  
Vol 184 ◽  
pp. 13-18 ◽  
Author(s):  
Elissa M. Abrams ◽  
Matthew Greenhawt ◽  
David M. Fleischer ◽  
Edmond S. Chan
Keyword(s):  
Food Allergy ◽  
Solid Food ◽  
Allergy Prevention ◽  
Solid Food Introduction

Infant Intervention and Parent Education: The Necessity for an Interdisciplinary Approach

1981 ◽  
Vol 163 (3) ◽  
pp. 275-281 ◽  
Author(s):  
Jeffrey L. Derevensky
Keyword(s):  
High Risk ◽  
Parent Education ◽  
Interdisciplinary Approach ◽  
Intervention Programs ◽  
Team Approach ◽  
High Risk Infant ◽  
Early Infant ◽  
Parent Education Programs ◽  
High Risk Children ◽  
Parent Program

Considerable attention has been given to a growing literature concerning early infant stimulation and parent education programs for the ‘high risk’ infant. While specific innovative intervention programs have been implemented for these ‘high risk’ children, little work has been done toward the implementation of preventative psychotherapeutic models for the normal child. This paper describes the Ready-Set-Go Infant-Child-Parent Program and its implementation stressing the necessity for an interdisciplinary team approach in establishing a viable and effective infant stimulation-parent education program.

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.

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