PREVENTION OF FOOD ALLERGY

Development of a food allergy appears to depend on both genetic factor s and exposure - especially in early infancy - to food proteins. In pr ospective studies, the effect of dietary allergy prevention programmes has only been demonstrated in high-risk infants, i.e. infants with at least one first degree relative with documented atopic disease. High- risk infants feeding exclusively on breast milk and/or extensively hyd rolysed formula (eHF) combined with avoidance of cow's milk proteins a nd solid foods during at least the first 4 months of life are found to have a significant reduction in the cumulative incidence of food alle rgy, especially cow's milk protein allergy/intolerance (CMPA/CMPI), in the first 4 years of life. As no studies have been conducted pertaini ng to the preventive effect of avoidance of milk and other foods after the age of 4-6 months, recommendation of preventive elimination diets beyond this age is empirically based. In order to reduce costs and to minimize the risks of stigmatisation and malnutrition, it is importan t to avoid unnecessary restrictive and prolonged diets. A diet period of 4-6 months appears to be sufficient in the majority of infants. At present, eHF are recommended as a substitute for cow's milk. A few hig h risk infants may benefit from a maternal diet during lactation, but there is no documented beneficial effect of maternal dieting during pr egnancy. (C) 1997 Elsevier Science B.V.