Food allergen avoidance in primary prevention of food allergy

Approximately 5-10% of children suffer from allergy to one or more foods. P rimary prevention through a hypoallergenic diet may reduce the prevalence o f food allergy and associated co-morbidity, such as eczema and urticaria. B reastfeeding has many advantages and should be recommended for all children . Those with a history of atopy in the immediate family are at a higher ris k and maternal diet during lactation, avoiding highly allergenic foods, may enhance the benefit. Cow's milk should be strictly avoided, and supplement s, if required, should be with a hypoallergenic formula. Delayed introducti on of egg, nuts, wheat and fish has also been suggested. Dietary restrictio n may have nutritional consequences for the mother and child and supervisio n by a dietician is essential. Maternal diet during pregnancy is not advisa ble as the benefit is minimal and there may be adverse effects on the foeta l nutrition. In high risk infants, a combined approach, where breastfeeding with maternal avoidance of highly allergenic foods, supplemented by extens ively hydrolysed formula during the first 6 months of life, in addition to the delayed introduction of solid foods, has been shown to reduce the devel opment of food allergy in infants.