Shao Jie, Sheng Jun, Dong Wei, Li Yun-zhu, Yu Shan-chang
Department of Pediatrics, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200025, China.
Zhonghua Er Ke Za Zhi. 2006 Sep;44(9):684-7.
To assess the preventive effects of different dietary regimens on development of eczema and food allergy in infants at high-risk for allergy.
Forty-six infants whose parents were atopic and umbilical cord IgE > 0.35 kU/L were enrolled in the study. The infants were randomly assigned at birth to one of 2 dietary regimen protocols: those in intervention group (23 cases) were breast fed till more than 4 months of age, then followed by feeding with partially hydrolyzed formula (pHF), combined solid foods avoidance until 4-month of age, egg, fish, shrimp avoidance until 12-month of age. The other 23 cases in non-intervention group were breast fed for less than 4 months, or bottle fed with cow's milk-based formula, egg yolk was introduced at 4-month of age, and egg white at 6-month of age, besides, no any other dietary avoidance was applied. All the infants were followed-up for 18 months. The primary end point was the presence of atopic eczema. Food allergy was detected by fresh food prick-to-prick tests or in vitro sIgE or Fx5E.
At 6 months, 12 months and 18 months, the incidence of eczema in intervention group was 4.3% (1/23), 8.7% (2/23), and 17.4% (4/23), respectively, which was significantly reduced as compared to that of the non-intervention group, which was 26.1% (6/23), 34.8% (8/23), and 39.1% (9/23), respectively. Food allergy was found in 13.0% (3/23) of intervention group and 34.8% (9/23) of non-intervention group by skin prick tests or sIgE. Egg white was the most common offending food.
Early life dietary interventions which included breastfeeding, delayed solid food introducing, pHF feeding, and high risk food avoidance could reduce the risk of atopic eczema and food allergy development, and was probably an effective primary intervention method for infants at high risk for atopy.
评估不同饮食方案对过敏高危婴儿湿疹和食物过敏发生的预防作用。
46名父母患有特应性疾病且脐带血IgE>0.35 kU/L的婴儿纳入本研究。婴儿出生时随机分为两种饮食方案组之一：干预组（23例）母乳喂养至4个月以上，然后用部分水解配方奶粉（pHF）喂养，4个月内避免添加辅食，12个月内避免食用鸡蛋、鱼、虾。非干预组的另外23例婴儿母乳喂养不足4个月，或用基于牛奶的配方奶粉人工喂养，4个月时添加蛋黄，6个月时添加蛋清，此外不采取任何其他饮食回避措施。所有婴儿随访18个月。主要终点是特应性湿疹的发生情况。通过新鲜食物点刺试验或体外sIgE或Fx5E检测食物过敏。
在6个月、12个月和18个月时，干预组湿疹发生率分别为4.3%（1/23）、8.7%（2/23）和17.4%（4/23），与非干预组相比显著降低，非干预组湿疹发生率分别为26.1%（6/23）、34.8%（8/23）和39.1%（9/23）。通过皮肤点刺试验或sIgE检测，干预组食物过敏发生率为13.0%（3/23），非干预组为34.8%（9/23）。蛋清是最常见的致敏食物。
包括母乳喂养、延迟添加辅食、pHF喂养和避免高风险食物在内的早期饮食干预可降低特应性湿疹和食物过敏的发生风险，可能是针对特应性高危婴儿的一种有效的一级干预方法。
