EFFECT OF ALLERGEN AVOIDANCE IN INFANCY ON ALLERGIC MANIFESTATIONS ATAGE 2 YEARS

Background: One hundred twenty children, identified before birth as be ing at high risk for atopy, were prenatally assigned to prophylactic o r control groups. Methods: The infants in the prophylactic group eithe r received breast milk from mothers on an exclusion diet or an extensi vely hydrolyzed formula. Their bedrooms and living rooms were treated repeatedly with an acaricide, and they used polyvinyl-covered mattress es with vented head areas. The infants in the control group were fed c onventionally, and no environmental control was recommended. Results: A significant advantage first demonstrated at I year of age, persists for children in the prophylactic group. They have less of any allergy or eczema, bur the reduced prevalence of asthma is no longer significa nt. Only three children in the prophylactic group had positive skin pr ick test results compared with 16 in the control group, suggesting a s ignificant reduction in sensitization. Conclusion: A dual approach to allergen avoidance, focusing on foods and aeroallergens, appears to be beneficial in selected high-risk infants. Avoidance of potent allerge ns in early life increases the threshold for sensitization in these hi gh-risk infants. Whether sensitization has been avoided or merely defe rred has yet to be proved.