Prescott Susan L, Tang Mimi L K
School of Paediatrics and Child Health Research, University of Western Australia, PO Box D184, Princess Margaret Hospital, Perth, WA 6001.
Med J Aust. 2005 May 2;182(9):464-7. doi: 10.5694/j.1326-5377.2005.tb06787.x.
A family history of allergy and asthma identifies children at high risk of allergic disease. Dietary restrictions in pregnancy are not recommended. Avoiding inhalant allergens during pregnancy has not been shown to reduce allergic disease, and is not recommended. Breastfeeding should be recommended because of other beneficial effects, but if breast feeding is not possible, a hydrolysed formula is recommended (rather than conventional cow's milk formulas) in high-risk infants only. Maternal dietary restrictions during breastfeeding are not recommended. Soy formulas and other formulas (eg, goat's milk) are not recommended for reducing food allergy risk. Complementary foods (including normal cow's milk formulas) should be delayed until a child is aged at least 4-6 months, but a preventive effect from this measure has only been demonstrated in high-risk infants. There is no evidence that an elimination diet after age 4-6 months has a protective effect, although this needs additional investigation. Further research is needed to determine the relationship between house dust mite exposure at an early age and the development of sensitisation and disease; no recommendation can yet be made about avoidance measures for preventing allergic disease. No recommendations can be made about exposure to pets in early life and the development of allergic disease. If a family already has pets it is not necessary to remove them, unless the child develops evidence of pet allergy (as assessed by an allergy specialist). Women should be advised not to smoke while pregnant, and parents should be advised not to smoke. No recommendations can be made on the use of probiotic supplements (or other microbial agents) for preventing allergic disease at this time. Immunotherapy may be considered as a treatment option for children with allergic rhinitis, and may prevent the subsequent development of asthma.
有过敏和哮喘家族史的儿童属于过敏性疾病的高危人群。不建议孕期进行饮食限制。尚无证据表明孕期避免吸入性过敏原可降低过敏性疾病的发生风险,因此不建议这样做。由于母乳喂养还有其他益处,所以应提倡母乳喂养,但如果无法进行母乳喂养,仅建议高危婴儿使用水解配方奶粉(而非传统的牛奶配方奶粉)。不建议母乳喂养期间母亲进行饮食限制。不建议使用大豆配方奶粉和其他配方奶粉(如羊奶)来降低食物过敏风险。辅食(包括普通牛奶配方奶粉)应推迟至儿童至少4至6个月大时添加,但这一措施的预防效果仅在高危婴儿中得到证实。虽然这需要进一步研究,但尚无证据表明4至6个月龄后进行食物排除饮食具有保护作用。需要进一步研究以确定早期接触屋尘螨与致敏及疾病发生之间的关系;目前无法就预防过敏性疾病的回避措施给出建议。对于早期接触宠物与过敏性疾病的发生之间的关系,目前无法给出建议。如果家庭中已经养有宠物,除非孩子出现宠物过敏的证据(由过敏专科医生评估),否则无需将其送走。应建议女性在孕期不要吸烟,同时也应建议家长不要吸烟。目前无法就使用益生菌补充剂(或其他微生物制剂)预防过敏性疾病给出建议。免疫疗法可作为过敏性鼻炎患儿的一种治疗选择,并且可能预防随后哮喘的发生。
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