No Magic Bullet for Children's Allergies
Breast-feeding is among strategies that might offer protection
 (HealthDay News) -- Parents of children at high risk of developing food allergies might need more than one weapon in their arsenal of protections.
"There is no single best strategy and, if a child is highly prone to develop allergies, nothing may help," said Dr. Robert Wood, professor of pediatrics and chief of pediatric allergy and immunology at Johns Hopkins University School of Medicine in Baltimore .
One possible strategy: breast-feeding infants. In a review of 18 prospective studies, Israeli researchers concluded that exclusive breast-feeding during the first three months of life is associated with a lower incidence of "atopic dermatitis," often called eczema, during childhood in children with a family history of allergy.
But, "it is only protective when compared to feeding milk or soy-based formulas," Wood noted. "The protection is very similar if babies are fed hypoallergenic formulas."
Of the more than 12 million Americans with food allergies, 3 million of them are children, reports the Food Allergy & Anaphylaxis Network (FAAN). The most common culprits are peanuts, tree nuts (including walnuts, pecans, almonds and cashews), milk, eggs, fish, shellfish, wheat and soy.
People often confuse food allergy with food intolerance, but they are not the same.
When the immune system mistakenly identifies a food as a foreign invader, the body creates specific immunoglobulin E (IGE) antibodies to that food, according to FAAN. The next time the person encounters that food, IGE antibodies signal the release of chemicals and histamines. These cause allergic symptoms that can affect the respiratory system, gastrointestinal tract, skin or cardiovascular system.
A food intolerance, on the other hand, is a metabolic disorder. People who are lactose intolerant, for example, lack the enzyme needed to digest a type of sugar found in milk. Consuming milk and milk products can produce bloating, gas and abdominal pain.
Wood, who has conducted extensive research on food allergies in children, generally recommends that parents follow guidelines put out by the American Academy of Pediatrics.
For infants at high risk of developing allergies, the academy says there is evidence that breast-feeding exclusively for four months decreases the incidence of cow milk allergy in the first two years of life.
There is no convincing evidence, however, that delaying the introduction of solid foods, including foods thought to be highly allergic, beyond the first four to six months of life has a significant protective effect on the development of allergy, the academy adds.
To complicate matters, a person might be allergic to one member of a food family but not others or to one part of a food but not another part, Dr. Sami Bahna, a professor of pediatrics and medicine, and chief of allergy and immunology at Louisiana State University , noted in a prepared statement. In a study of 60 people allergic to peanuts, for example, none reacted to refined peanut oil, and 10 percent reacted to crude peanut oil.
For high-risk families, especially those who already have an affected child, Wood recommends:
- Avoiding peanut and tree nuts during pregnancy and while breast-feeding.
- Supplementing breast-feeding with a hypoallergenic formula (extensively or partially hydrolyzed).
- Delaying solid foods until age 6 months.
- Delaying introduction of milk and eggs until 1 year of age and peanut and tree nuts until age 3.
- Intervening early when signs of food allergy appear.
On the Web
To help children understand food allergies, have them visit the special kids' Web site created by the Food Allergy & Anaphylaxis Network.
SOURCES:
HealthDay News ; Robert Wood, M.D., professor of pediatrics and chief of pediatric allergy and immunology, Johns Hopkins University School of Medicine, and professor of international health, Johns Hopkins Bloomberg School of Public Health, Baltimore; American College of Allergy, Asthma & Immunology, news release, Nov. 14, 2007; Food Allergy & Anaphylaxis Network, Fairfax, Va.; October 2001, Journal of the American Academy of Dermatology ; Jan. 1, 2008, online, Pediatrics
Author:
Karen Pallarito
Publication Date:
Oct. 31, 2008
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