Breastfeeding May Lower Allergy Risk
Group Issues New Guidelines to Prevent Food Allergies, Asthma, and Eczema in Babies
Jan. 7, 2008 -- Exclusive breastfeeding for at least four months may help prevent
asthma, eczema, and food allergies in high-risk babies, but there is little
evidence that delaying the introduction of specific foods makes a difference,
the nation's leading group of pediatricians now says.
In a newly published policy statement, the American Academy of Pediatrics
(AAP) abandons a previous call for the gradual introduction of foods typically
associated with allergies in high-risk children.
The earlier guidelines recommended delaying the introduction of cow's milk
until after a child's first birthday, eggs until age 2, and tree nuts, peanuts,
and fish until age 3.
"We just do not have the studies to back this up," study
researcher author Frank R. Greer, MD, tells WebMD. "If a child is
going to be allergic to peanuts or eggs, it doesn't seem to matter [after 4 to
6 months] when you introduce these foods."
There is also no convincing evidence to justify telling moms to avoid these
foods during pregnancy and while they are nursing, the new report
What About Formulas?
Published in the January issue of the journal Pediatrics, the report
revisits and revises recommendations made seven years ago by the AAP.
Among the major findings:
- Exclusive breastfeeding for at least four months, compared with feeding
regular formula made from cow's milk, appears to help protect high-risk
children against milk allergy and eczema in the first two years of life, the
- There is "modest evidence" that special formulas that are
extensively or partially hydrolyzed may prevent eczema in infants. Formulas
such as Nestle's Good Start and Mead Johnson's Enfamil Gentlease have milk
proteins that are broken down, making them easier to digest.
- More study is needed to determine whether the benefits of these extensively
or partially hydrolyzed formulas for allergic disease prevention extend into
later childhood and adolescence.
- There is "no convincing evidence" that soy-based formulas help
prevent allergic disease in high-risk children.
"If there is a family history of allergy problems, it is clear that moms
should breastfeed exclusively for at least four months," study co-author
Scott H. Sicherer, MD, tells WebMD. "If that isn't possible and a formula
is needed, don't pick a typical soy formula."
Long-Term Impact Unknown
The new guidelines apply only to babies with a high risk of developing
allergic disease, not those who already have asthma, food allergies, or eczema,
Sicherer points out.
The authors conclude that more research is needed to document the long-term
effect of dietary interventions in infancy for preventing allergic disease
after early childhood.
Sicherer says doing away with the recommendation to delay the introduction
of certain foods will probably have little practical impact because few parents
were following them.
An associate professor of pediatrics at New York City's Mount Sinai Medical
Center, Sicherer says the food restriction guideline may have even made the
parents of children with allergic diseases feel responsible.
"Moms who think they caused their child's milk allergy or egg allergy by
introducing these foods too soon can relax," he says. "We don't have
the evidence to put moms on a guilt trip."