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
Allergen avoidance in infancy and allergy at 4 years of age
In an attempt to prevent or reduce the manifestations of atopic disease , a group of infants considered to be genetically at high risk of atopy was entered in a prenatally r and omized , controlled study . A prophylactic group ( n= 58 ) was either breast‐fed with their mothers excluding foods regarded as highly antigenic from their diets , or given an extensively hydrolysed formula . In addition , strenuous efforts were made to reduce exposure to the house‐dust mite by application of acaricide to the bedroom and living room carpets and upholstered furniture . A control group ( n= 62 )  was fed conventionally by breast or on formula , and no specific environmental measures were taken . The results ( previously reported ) after 1 year showed significantly less total allergy , asthma , and eczema in the prophylactic group . Similar results were obtained at 2 years although the reduction in asthma no longer achieved statistical significance . However , there was significantly less sensitization , as shown by a battery of skin prick tests ( SPTs ) , to both dietary allergens and aeroallergens in the prophylactic group . A11 the children have now been review ed at the age of 4 years , and SPTs to a wide range of dietary allergens and aeroallergens have been performed . The control group continues to show more total allergy ( odds ratio [ OR ] 2.73 , 95 % confidence interval [ CI ] 1.21–6.13 , P<0.02 ) , definite allergy ( allergic symptoms plus positive SPT ) ( OR 5.6 , CI 1.8–17.9 , P<0.005 ) , and eczema ( OR 3.4 , CI 1.2–10.1 , P<0.05 ) . More control children have positive SPTs ( OR 3.7 , CI 1.3–10.0 , P<0.02 ) . A dual approach to the prevention of allergic disease , avoiding as far as possible sensitization to food and aeroallergens , significantly reduces the risk of atopic disease . This should be reserved for infants considered at very high risk of atopy , and close medical and dietetic supervision must be available
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