Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas

Frank R. Greer, Scott H. Sicherer, A. Wesley Burks, Robert D. Baker, Jatinder J.S. Bhatia, Stephen Robert Daniels, Marcie B. Schneider, Janet Silverstein, Dan W. Thomas, Paul V. Williams, Michael J. Welch, Sami L. Bahna, Bradley E. Chipps, Mary Beth Fasano, Mitchell R. Lester, Frank S. Virant

Research output: Contribution to journalArticle

761 Citations (Scopus)

Abstract

This clinical report reviews the nutritional options during pregnancy, lactation, and the first year of life that may affect the development of atopic disease (atopic dermatitis, asthma, food allergy) in early life. It replaces an earlier policy statement from the American Academy of Pediatrics that addressed the use of hypoallergenic infant formulas and included provisional recommendations for dietary management for the prevention of atopic disease. The documented benefits of nutritional intervention that may prevent or delay the onset of atopic disease are largely limited to infants at high risk of developing allergy (ie, infants with at least 1 first-degree relative [parent or sibling] with allergic disease). Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation. There is evidence that breastfeeding for at least 4 months, compared with feeding formula made with intact cow milk protein, prevents or delays the occurrence of atopic dermatitis, cow milk allergy, and wheezing in early childhood. In studies of infants at high risk of atopy and who are not exclusively breastfed for 4 to 6 months, there is modest evidence that the onset of atopic disease may be delayed or prevented by the use of hydrolyzed formulas compared with formula made with intact cow milk protein, particularly for atopic dermatitis. Comparative studies of the various hydrolyzed formulas also indicate that not all formulas have the same protective benefit. There is also little evidence that delaying the timing of the introduction of complementary foods beyond 4 to 6 months of age prevents the occurrence of atopic disease. At present, there are insufficient data to document a protective effect of any dietary intervention beyond 4 to 6 months of age for the development of atopic disease.

Original languageEnglish (US)
Pages (from-to)183-191
Number of pages9
JournalPediatrics
Volume121
Issue number1
DOIs
StatePublished - Jan 1 2008

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Breast Feeding
Mothers
Food
Atopic Dermatitis
Milk Proteins
Lactation
Milk Hypersensitivity
Pregnancy
Infant Formula
Food Hypersensitivity
Respiratory Sounds
Siblings
Hypersensitivity
Asthma
Pediatrics

Keywords

  • Asthma
  • Atopic dermatitis
  • Atopy
  • Breastfeeding
  • Complementary foods
  • Food allergies
  • Hydrolyzed formula

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Effects of early nutritional interventions on the development of atopic disease in infants and children : The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. / Greer, Frank R.; Sicherer, Scott H.; Burks, A. Wesley; Baker, Robert D.; Bhatia, Jatinder J.S.; Daniels, Stephen Robert; Schneider, Marcie B.; Silverstein, Janet; Thomas, Dan W.; Williams, Paul V.; Welch, Michael J.; Bahna, Sami L.; Chipps, Bradley E.; Fasano, Mary Beth; Lester, Mitchell R.; Virant, Frank S.

In: Pediatrics, Vol. 121, No. 1, 01.01.2008, p. 183-191.

Research output: Contribution to journalArticle

Greer, FR, Sicherer, SH, Burks, AW, Baker, RD, Bhatia, JJS, Daniels, SR, Schneider, MB, Silverstein, J, Thomas, DW, Williams, PV, Welch, MJ, Bahna, SL, Chipps, BE, Fasano, MB, Lester, MR & Virant, FS 2008, 'Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas', Pediatrics, vol. 121, no. 1, pp. 183-191. https://doi.org/10.1542/peds.2007-3022
Greer, Frank R. ; Sicherer, Scott H. ; Burks, A. Wesley ; Baker, Robert D. ; Bhatia, Jatinder J.S. ; Daniels, Stephen Robert ; Schneider, Marcie B. ; Silverstein, Janet ; Thomas, Dan W. ; Williams, Paul V. ; Welch, Michael J. ; Bahna, Sami L. ; Chipps, Bradley E. ; Fasano, Mary Beth ; Lester, Mitchell R. ; Virant, Frank S. / Effects of early nutritional interventions on the development of atopic disease in infants and children : The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas. In: Pediatrics. 2008 ; Vol. 121, No. 1. pp. 183-191.
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