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Published on: August 7, 2017
Effect of allergen avoidance in infancy on allergic manifestations at age two years
D W Hide1, S Matthews, L Matthews
1Clinical Allergy Research Unit, Saint Mary's Hospital, Newport, Isle of Wight, United Kingdom.
Insights
Prophylactic allergen avoidance, including dietary and environmental measures, significantly reduced allergies and eczema in high-risk infants. This dual approach may increase the sensitization threshold in early life.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Dermatology
Background:
- Study involved 120 infants identified as high-risk for atopy prenatally.
- Participants were assigned to either a prophylactic or control group.
Purpose of the Study:
- To evaluate the efficacy of a dual allergen avoidance strategy in preventing atopic diseases.
- To assess the impact of early-life allergen exposure on sensitization.
Main Methods:
- Prophylactic group infants received hypoallergenic diets (maternal exclusion diet or hydrolyzed formula) and environmental controls (acaricide treatment, special mattresses).
- Control group infants received conventional feeding without environmental interventions.
Main Results:
- Children in the prophylactic group showed significantly lower rates of allergies and eczema at 1 year of age.
- A significant reduction in positive skin prick test results (sensitization) was observed in the prophylactic group (3 vs. 16).
- The reduction in asthma prevalence was not statistically significant in the prophylactic group.
Conclusions:
- A dual approach to allergen avoidance (food and aeroallergens) is beneficial for high-risk infants.
- Early-life avoidance of potent allergens may raise the threshold for sensitization.
- Further research is needed to determine if sensitization is prevented or merely delayed.
Background:
One hundred twenty children, identified before birth as being at high risk for atopy, were prenatally assigned to prophylactic or control groups.
Methods:
The infants in the prophylactic group either received breast milk from mothers on an exclusion diet or an extensively hydrolyzed formula. Their bedrooms and living rooms were treated repeatedly with an acaricide, and they used polyvinyl-covered mattresses with vented head areas. The infants in the control group were fed conventionally, and no environmental control was recommended.
Results:
A significant advantage, first demonstrated at 1 year of age, persists for children in the prophylactic group. They have less of any allergy or eczema, but the reduced prevalence of asthma is no longer significant. Only three children in the prophylactic group had positive skin prick test results compared with 16 in the control group, suggesting a significant 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 allergens in early life increases the threshold for sensitization in these high-risk infants. Whether sensitization has been avoided or merely deferred has yet to be proved.
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