Early Allergen Introduction for Preventing Development of Food Allergy

Greenhawt, Matthew

doi:10.1001/jama.2016.12715

Cited by 9 publications

(2 citation statements)

References 12 publications

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“…For egg introduction, thousands of additional trial participants would be needed to confirm with reasonable certainty that early egg introduction has an effect size of a 30% reduction. 32 Since the publication of the LEAP and EAT trials, there have been revised recommendations from a number of groups regarding the early nutritional interventions for the prevention of atopic disease, specifically regarding food allergies. 31,[33][34][35][36] In general, these groups have acknowledged that there is no need to delay the introduction of allergenic foods beyond 6 months of age and that they should not be introduced before 4 months of age.…”

Section: Timing Of Introduction Of Allergenic Complementary Foods Andmentioning

confidence: 99%

The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods

et al. 2019

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This clinical report updates and replaces a 2008 clinical report from the American Academy of Pediatrics, which addressed the roles of maternal and early infant diet on the prevention of atopic disease, including atopic dermatitis, asthma, and food allergy. As with the previous report, the available data still limit the ability to draw firm conclusions about various aspects of atopy prevention through early dietary interventions. Current evidence does not support a role for maternal dietary restrictions during pregnancy or lactation. Although there is evidence that exclusive breastfeeding for 3 to 4 months decreases the incidence of eczema in the first 2 years of life, there are no short-or long-term advantages for exclusive breastfeeding beyond 3 to 4 months for prevention of atopic disease. The evidence now suggests that any duration of breastfeeding $3 to 4 months is protective against wheezing in the first 2 years of life, and some evidence suggests that longer duration of any breastfeeding protects against asthma even after 5 years of age. No conclusions can be made about the role of breastfeeding in either preventing or delaying the onset of specific food allergies. There is a lack of evidence that partially or extensively hydrolyzed formula prevents atopic disease. There is no evidence that delaying the introduction of allergenic foods, including peanuts, eggs, and fish, beyond 4 to 6 months prevents atopic disease. There is now evidence that early introduction of peanuts may prevent peanut allergy.

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Section: Timing Of Introduction Of Allergenic Complementary Foods Andmentioning

confidence: 99%

The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods

et al. 2019

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“…These treatments have been demonstrated to result in unintended outcomes, including increased risk of true allergy. [26][27][28][29][30][31][32][33] Similarly, breastfed babies demonstrating back-arching, fussing, and pulling off the breast or whose mothers experience nipple pain are currently at risk of unnecessary lingual and/or labial frenotomy, which may also result in unintended outcomes. [34][35][36][37][38][39][40][41] Given these concerns, it is essential that every effort is made to optimise breastfeeding prior to considering medical or surgical intervention, yet current approaches to fit and hold are not demonstrated to help.…”

Section: Introductionmentioning

confidence: 99%

A brief gestalt intervention changes ultrasound measures of tongue movement during breastfeeding: case series

Douglas

Perella

Geddes

2021

Preprint

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Background Lactation consultants frequently advise adjustments to fit and hold (or positioning and attachment) with the aim of optimising intra-oral nipple placement. However, approaches to fit and hold interventions vary widely, with little evidence of benefits, and effects of fit and hold on infant tongue movement have not been examined. The aim of this preliminary study was to investigate whether a gestalt breastfeeding intervention alters tongue movement, using measurements from ultrasound imaging to determine nipple placement and intra-oral nipple and breast tissue dimensions. Methods Ultrasound measurements were conducted in five breastfeeding dyads, infants aged between four and 20 weeks, while feeding in their usual or ‘standard’ position and again after brief application of gestalt principles of fit and hold. Four of the mother-baby pairs, who had received comprehensive lactation support, reported persisting nipple pain. Three of these infants had difficulty latching and fussed at the breast; three had been diagnosed with oral ties. A fifth pair was breastfeeding successfully. Results Ultrasound demonstrated that the distance from nipple tip to junction of the hard and soft palate decreased, intra-oral nipple and breast tissue dimensions increased, and nipple slide decreased after a brief gestalt intervention. Conclusion These preliminary findings suggest that changes in fit and hold impact on infant tongue movement. Further research investigating short-and long-term outcomes of a gestalt breastfeeding intervention in larger cohorts is required.

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Primary Prevention of Food Allergy

Greenhawt

Fleischer

2017

Curr Allergy Asthma Rep

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Food allergy is estimated to affect approximately 8% of children in the USA. This is a disease without any known treatment or cure and, for some, a disease that can be quite severe, even life-threatening. While recent advances in potential treatment have made remarkable strides, with two food-targeted immunotherapy products now in phase III trials, perhaps the biggest gains in the field have come in the advent of potential preventative strategies to avoid the development of food allergy in high-risk individuals. There have been multiple, randomized, controlled trials (RCTs) performed in the past 5 years that have demonstrated significant risk reduction from early allergen introduction. These include two trials for early peanut introduction and five trials for early egg introduction in the first year of life. The results indicate that primary prevention of food allergy through early allergen introduction may represent a strategy that could potentially avert tens of thousands of children from becoming food allergic. In support of the data for peanut, the National Institute of Allergy and Infectious Diseases recently sponsored an addendum to the 2010 food allergy guidelines, specifically recommending peanut be introduced in both high- and standard-risk infants to reduce the risk of developing peanut allergy. To date, no formal recommendations have been made for egg, however. This review will focus on the latest evidence supporting early introduction as a strategy to prevent food allergy, as well as on practical aspects for its successful implementation.

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Early Allergen Introduction for Preventing Development of Food Allergy

Cited by 9 publications

References 12 publications

The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods

The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods

A brief gestalt intervention changes ultrasound measures of tongue movement during breastfeeding: case series

Primary Prevention of Food Allergy

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