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Prevention of atopic diseases in high risk babies (long-term follow-up)
Insights
Early dietary and environmental interventions significantly reduce allergic disease in high-risk infants. This preventive program demonstrated a low 10% prevalence of atopic disease, confirming its effectiveness.
Area of Science:
- Pediatrics
- Allergology
- Immunology
Background:
- Infants at risk for atopy may benefit from early life interventions.
- Dietary and environmental factors play a crucial role in allergic disease development.
Purpose of the Study:
- To evaluate the effectiveness of a comprehensive preventive program for allergic diseases in high-risk infants.
- To analyze the incidence and timing of specific atopic manifestations.
Main Methods:
- Prospective follow-up of 174 high-risk infants.
- Implementation of exclusive breastfeeding, soy-protein formula if needed, delayed weaning, and environmental allergen avoidance (house-dust mite, passive smoking).
Main Results:
- A low prevalence of atopic disease (10%) was observed in the intervention group.
- Atopic dermatitis incidence peaked at 6 months, decreasing thereafter.
- Asthma incidence peaked at 6 and 36 months, while food allergy appeared at 6 months and allergic rhinitis after 36 months.
Conclusions:
- The studied dietary and environmental manipulations are effective in preventing atopic disease in high-risk infants.
- The timing of onset for atopic dermatitis, food allergy, asthma, and allergic rhinitis was elucidated.
- Early intervention programs show promise in mitigating the development and severity of allergic conditions.
Abstract:
Several studies have demonstrated that dietary and environmental manipulations in the first months of life have a protective effect on the development of allergic diseases in babies "at risk" of atopy. We have prospectively followed up 174 "high risk" infants who underwent dietary and environmental manipulations, such as exclusive breast-feeding for the first 6 months of life, supplemented if necessary with soy-protein formula (Isomil, Abbott), delayed weaning beyond the 6th month of life, and rigorous environmental manipulations for the elimination of house-dust mite and passive smoking. The low prevalence of atopic disease (10%) and the trivial course of the allergic manifestations in this "at risk" population confirm the effectiveness of this preventive program. Moreover, this study demonstrates that the incidence of atopic dermatitis peaks at 6 months, and decreases until it disappears. Food allergy appears only at 6 months and may disappear later. The incidence of asthma peaks at 6 and 36 months and decreases at low levels in the intervals. Allergic rhinitis develops not sooner than 36 months.