Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children

Greer, Frank R.; Sicherer, Scott H.; Burks, A. Wesley

doi:10.1542/9781581108613-part05-effects

Cited by 4 publications

(5 citation statements)

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“…5 In 2008, the AAP published a clinical report demonstrating the lack of convincing evidence for delaying the introduction of peanut, but it did not provide further guidance. [6][7][8] In 2015, the Learning Early About Peanut Allergy randomized clinical trial demonstrated that early introduction of peanut to infants between age 4 and 11 months who were at high-risk for developing peanut allergy resulted in a considerable reduction (81%) of peanut allergy prevalence by age 5 years. 9 Based on these findings, the National Institute of Allergy and Infectious Diseases convened an expert panel, representing professional organizations, patient advocacy groups, and government agencies, to produce the Addendum Guidelines for the Prevention of Peanut Allergy in the United States.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Pediatrician Awareness and Implementation of the Addendum Guidelines for the Prevention of Peanut Allergy in the United States

et al. 2020

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IMPORTANCE The 2017 Addendum Guidelines for the Prevention of Peanut Allergy in the United States recommend that pediatricians assess infant peanut allergy risk and introduce peanut in the diet at age 4 to 6 months. Early introduction has the potential to prevent peanut allergy development. OBJECTIVES To measure the rates of guideline awareness and implementation and to identify barriers to and factors associated with implementation among US pediatricians. DESIGN, SETTING, AND PARTICIPANTS This population-based study survey used a 29-item electronic survey instrument that was administered to pediatricians practicing across the United States from June 1, 2018, to December 1, 2018. Invitations to complete a survey were emailed to all pediatricians in the American Academy of Pediatrics vendor database. Eligible participants were nonretired US-based pediatricians providing general care to infants aged 12 months or younger. MAIN OUTCOMES AND MEASURES The primary outcome was the prevalence of guideline implementation, which was measured by 1 survey item about awareness followed by a second item about implementation. Secondary outcomes included identification of guidelines-focused services provided by pediatricians, knowledge of the guidelines (measured with 3 clinical scenarios), barriers to guideline implementation, need for training, and facilitators of guideline implementation. RESULTS A total of 1781 pediatricians were eligible to participate and completed the entire survey. Most respondents self-identified as white (1287 [72.5%]) and female (1210 [67.4%]) individuals. Overall, 1725 (93.4%; 95% CI, 92.2%-94.5%) pediatricians reported being aware of the guidelines. Of those pediatricians who had knowledge of the guidelines, 497 (28.9%; 95% CI, 26.8%-31.1%) reported full implementation and 1105 (64.3%; 95% CI, 62.0%-66.6%) reported partial implementation. Common barriers to implementation included parental concerns about allergic reactions (reported by 575 respondents [36.6%; 95% CI, 34.3%-39.1%]), uncertainty in understanding and correctly applying the guidelines (reported by 521 respondents [33.2%; 95% CI, 30.9%-35.6%]), and conducting in-office supervised feedings (reported by 509 respondents [32.4%; 95% CI, 30.1%-34.8%]). Many pediatricians (1175 [68.4%; 95% CI, 66.1%-70.5%]) reported a need for further training on the guidelines. CONCLUSIONS AND RELEVANCE This survey found that most pediatrician respondents appeared to know of the 2017 guidelines, but less than one-third of respondents reported full implementation. Results of this study may inform future efforts to eliminate barriers to guideline implementation and adherence, thereby reducing the incidence of peanut allergy in infants.

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Section: Introductionmentioning

confidence: 99%

Assessment of Pediatrician Awareness and Implementation of the Addendum Guidelines for the Prevention of Peanut Allergy in the United States

et al. 2020

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“…10 Epidemiological studies suggest that breast milk reduces the risk of various immune-mediated childhood diseases, including type 1 diabetes, 11 celiac disease, 12 and inflammatory bowel disease. 13 A relationship between breast-feeding and the development of allergic diseases, including atopic dermatitis, 14 food allergies, and asthma has also been identified.…”

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confidence: 99%

Breast‐feeding regulates immune system development via transforming growth factor‐β in mice pups

Sakaguchi

Koyanagi

Kamachi

et al. 2018

Pediatrics International

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“…Due to the even lower utilization rate, the recommended iron content in formulas based on soy protein isolates intended for infants at that age is much higher (1.3-2.5 mg/100 kcal) [40]. According to current recommendations, complementary foods are introduced to a child aged 4-6 months [41,42].…”

Section: Prevention Of Iron Deficiency In Children and Adolescentsmentioning

confidence: 99%

The basis of prevention of iron deficiency anemia during childhood and adolescence

et al. 2022

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Anemia is a common and etiologically heterogeneous health problem both during the period of growth and development and in other phases of life. It is most often caused by a deficiency of iron, primarily due to inadequate nutrition, and less often as a consequence of various diseases. Particularly risk groups for the occurrence of anemia due to iron deficiency are children in the stages of rapid growth and development, i.e., in the first years after birth and during puberty. In accordance with the fact that it is better to prevent than to treat, in this article are given basic guidelines related to the prevention of this type of anemia in children and adolescents.

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Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children

Cited by 4 publications

References 0 publications

Assessment of Pediatrician Awareness and Implementation of the Addendum Guidelines for the Prevention of Peanut Allergy in the United States

Assessment of Pediatrician Awareness and Implementation of the Addendum Guidelines for the Prevention of Peanut Allergy in the United States

Breast‐feeding regulates immune system development via transforming growth factor‐β in mice pups

The basis of prevention of iron deficiency anemia during childhood and adolescence

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