IS PREVENTION OF FOOD ALLERGY WORTHWHILE

Several studies performed in high-risk babies have demonstrated a sign ificant reduction in the prevalence and severity of atopic diseases wi th dietary and environmental manipulations. It has been demonstrated t hat prolonged breast-feeding and the avoidance of cow's milk, eggs and fish during the first three months of lactation significantly decreas e both the prevalence and the severity of atopic disease up to the age of 5 years. We have shown a significant reduction in both the prevale nce and the incidence of atopic dermatitis, food allergy and asthma in high-risk children followed up to the age of 5 years who received pre ventive dietary (prolonged breast-feeding, cow's milk- and egg-free di et to the nursing mothers, supplementation with a soya formula contain ing sucrose when breast milk was not available, delayed weaning) and e nvironmental measures (no smoking and no pets in the house, measures f or the elimination of mites, etc.). However, occasionally, breast-fed infants may experience allergic sensitization to food antigens ingeste d by the mother during lactation. The factors that determine which inf ants will develop sensitization to food antigens in breast milk are no t fully understood. The genetic predisposition to IgE-mediated hyperse nsitivity reactions is certainly a prerequisite; however, properties o f human milk, such as immune characteristics, may play a role in the p henotypic expression of sensitization. Our studies suggest that the ab normally low levels of the long-chain polyunsaturated derivatives foun d in infants at risk of atopy are unlikely to be corrected by breast-f eeding and may explain the contradictory results from studies on the e ffectiveness of breast milk against the development of atopic dermatit is.