Unlike the conclusions of the revised Cochrane review the export group set up by the Section on Paediatrics , European Academy of Allergology and Clinical Immunology ( SP-EAACI ) do not find that the exclusion of the four trials dem and s a change of the previous recommendations regarding primary dietary prevention of allergic diseases .
Based on analysis of published peer- review ed observational and interventional studies the results still indicate that breastfeeding is highly recommended for all infants irrespective of atopic heredity .
A dietary regimen is effective in the prevention of allergic diseases in high-risk infants , particularly in early infancy regarding food allergy and eczema .
The most effective dietary regimen is exclusively breastfeeding for at least 4 - 6 months or , in absence of breast milk , formulas with documented reduced allergenicity for at least the first 4 months , combined with avoidance of solid food and cow 's milk for the first 4 months
A randomized controlled study on the effectiveness of a multifaceted intervention program in the primary prevention of asthma in high-risk infants.
BACKGROUND The prevalence of asthma has increased in developed countries in the past 2 decades . The effectiveness of intervention measures on the primary prevention of asthma has not been well studied . OBJECTIVE To assess the effectiveness of a multifaceted intervention program in the primary prevention of asthma in high-risk infants ( in this study , infants are defined as persons from birth to the age of 1 year ) . DESIGN Prospect i ve , prenatally r and omized , controlled study with follow-up through the age of 1 year . SETTING University hospital-based setting s at 2 Canadian centers : Vancouver , British Columbia , and Winnipeg , Manitoba . PARTICIPANTS A total of 545 high-risk infants ( at least 1 first-degree relative with asthma or 2 first-degree relatives with other IgE-mediated allergic diseases ) identified before birth . INTERVENTIONS Avoidance of house dust mite and pet allergens and environmental tobacco smoke , encouragement of breastfeeding , and supplementation with a partially hydrolyzed formula . MAIN OUTCOME MEASURES Probable or possible asthma , rhinitis without apparent colds , and a prick skin test result positive for common inhalant allergens . RESULTS Thirty-eight ( 15.1 % ) of the 251 infants available for assessment in the intervention group and 49 ( 20.2 % ) of the 242 infants available for assessment in the control group fulfilled the criteria for possible or probable asthma ( adjusted relative risk , 0.66 ; 90 % confidence interval , 0.44 - 0.98 ) . Also , 16.7 % of the infants in the intervention group and 27.3 % of the infants in the control group developed rhinitis without colds ( adjusted relative risk , 0.51 ; 90 % confidence interval , 0.35 - 0.74 ) . The incidence of positive skin test results to 1 or more inhalant allergens was similar in both groups ( 4.4 % in the intervention group and 4.6 % in the control group ) . CONCLUSIONS Our multifaceted intervention program result ed in a modest but significant ( P= .04 ) reduction in the risk of possible or probable asthma and rhinitis without apparent colds at the age of 12 months in high-risk infants . In the absence of a vali date d definition of asthma at the age of 12 months , follow-up studies are needed to determine the effectiveness of the intervention program in the primary prevention of asthma in high-risk infants
Unlike the conclusions of the revised Cochrane review the export group set up by the Section on Paediatrics , European Academy of Allergology and Clinical Immunology ( SP-EAACI ) do not find that the exclusion of the four trials dem and s a change of the previous recommendations regarding primary dietary prevention of allergic diseases .
Based on analysis of published peer- review ed observational and interventional studies the results still indicate that breastfeeding is highly recommended for all infants irrespective of atopic heredity .
A dietary regimen is effective in the prevention of allergic diseases in high-risk infants , particularly in early infancy regarding food allergy and eczema .
The most effective dietary regimen is exclusively breastfeeding for at least 4 - 6 months or , in absence of breast milk , formulas with documented reduced allergenicity for at least the first 4 months , combined with avoidance of solid food and cow 's milk for the first 4 months