Related Audio Courses: Caring For Your Baby From Birth To Age One
Blog Author: Dr. Dennis Kuo
The American Academy of Pediatrics issued a new clinical report in the January issue of Pediatrics, “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”. The report is an update of the current research looking at how infant feeding may affect a baby’s risk of developing atopic disease.
What is atopic disease? It’s a condition where a child becomes classically allergic to otherwise innocuous things. You may know it as one of the three kinds of atopic disease: eczema (dry itchy skin), allergies (including food or seasonal/environmental allergies), or asthma. The three are all connected and tend to run in families. The ongoing question is whether giving a young infant a food too early in life triggers the child to improperly produce extra antibodies and throws the entire immune system out of whack, causing allergies. In my career I’ve seen various recommendations for avoiding high allergy foods (egg whites, peanuts, shellfish) for longer and longer ages, at least up to age 2, possibly 3 or 4 years of age if there is a strong allergy, or atopic, history.
The report says that current evidence suggests children who are at high risk for atopy, i.e. first degree relative has atopic disease of any sort, are less likely to become atopic themselves if that child breastfeeds exclusively OR takes a hydrolyzed formula (pre-digested) in the first four months of life. It also states that there is insufficient evidence that maternal diet restriction (e.g. mother avoids peanuts) or delaying solids past 4-6 months of age will reduce atopic disease.
The lessons? All things considered, breastfeeding is best. If you have to formula feed, talk with your doctor about a hydrolyzed formula if atopic disease runs in your family. I wouldn’t go nuts (pun intended!) on restricting mother’s diet, but “current evidence does not suggest” means we still need more studies to know for sure. I wouldn’t delay introducing solid foods any longer than 6 months of age, but it may still be prudent to be careful of shellfish and peanuts until we know more, particularly if the allergies do run in the family.
http://pediatrics.aappublications.org/cgi/content/full/121/1/183
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