Diet and the prevention of childhood allergic disease

Childhood allergic disease is common and is becoming more so. The relationship between such disease and infant feeding and early exposure to food antigens is reviewed. The studies appearing to confirm and refute the theory that breast feeding prevents allergic disease are critically surveyed and it is concluded that the best studies strongly support the view that breast feeding is beneficial. The notion that feeding a soya formula is protective is reviewed and little evidence is found to uphold this claim. Caution is urged concerning the feeding of goat's milk to infants as it has not been shown to prevent allergy, is nutritionally inadequate, and potentially hazardous. The evidence that food antigens cross the placenta and enter breast milk and can then sensitize the baby is analysed and the studies concerning the role of weaning diet in the development of allergic disease are reviewed. It is concluded that, especially for the genetically-at-risk infant, prolonged breast feeding and selective weaning does decrease the risk of allergic disease, whereas feeding a soya formula does not, and that it is not yet known if maternal exclusion of certain foods in pregnancy and lactation is beneficial.