Date:
01/06/2008 10:31 AM Expert advice changes for preventing allergies in
infants and children
By CARLA K. JOHNSON
Associated Press Writer
CHICAGO (AP) _ Breast-feeding helps prevent
babies' allergies, but there's no good evidence for avoiding
certain foods during pregnancy, using soy formula or delaying
introduction of solid foods beyond six months.
That's the word from the American Academy
of Pediatrics, which is updating earlier suggestions that
may have made some parents feel like they weren't doing enough
to prevent food allergies, asthma and allergic rashes.
In August 2000, the doctors group advised
mothers of infants with a family history of allergies to avoid
cow's milk, eggs, fish, peanuts and tree nuts while breast-feeding.
That advice, along with a recommended schedule
for introducing certain risky foods, left some moms and dads
blaming themselves if their children went on to develop allergies.
"They say, 'I shouldn't have had milk
in my coffee,'" said Dr. Scott Sicherer of the Mount
Sinai School of Medicine's Jaffe Food Allergy Institute in
New York. "I've been saying, 'We don't really have evidence
that it causes a problem. Don't be on a guilt trip about it.'"
Sicherer helped write the new guidance report
for pediatricians, published in the January issue of the journal
Pediatrics. Earlier advice about restricting certain foods
from moms' and babies' diets has been tossed out and the only
surefire advice remaining is to breast-feed.
The report says:
—There is no convincing evidence that
women who avoid peanuts or other foods during pregnancy or
breast-feeding lower their child's risk of allergies.
—For infants with a family history of
allergies, exclusive breast-feeding for at least four months
can lessen the risk of rashes and allergy to cow's milk.
—Exclusive breast-feeding for at least
three months protects against wheezing in babies, but whether
it prevents asthma in older children is unclear.
—There is modest evidence for feeding
hypoallergenic formulas to susceptible babies if they are
not solely breast-fed.
—There is no good evidence that soy-based
formulas prevent allergies.
—There is no convincing evidence that
delaying the introduction of foods such as eggs, fish or peanut
butter to children prevents allergies. Babies should not get
solid food before 4 to 6 months of age, however.
The evidence for the earlier recommendations
was weak and hasn't been strengthened by new research, Sicherer
said.
"You never know what's going to come
around the corner, but in the past seven years there hasn't
been enough evidence to support the old recommendations,"
Sicherer said.
Dr. Peter Vadas of the University of Toronto
conducted prior research that found peanut protein in breast
milk. His work has been cited as a reason for nursing mothers
to avoid eating peanuts.
Vadas said he advises breast-feeding mothers
to avoid peanuts, but only if there is a family history of
peanut allergy, and he makes it clear the advice is arguable.
"There's really no reason to engage in
a lot of dietary manipulation except in very specific instances,"
Vadas said.
