Ferreira Manuela, Coelho Raquel, Trindade J Costa
Departamento de Pediatria, Hospital Fernando Fonseca, Amadora.
Acta Med Port. 2007 May-Jun;20(3):215-9. Epub 2007 Jul 2.
Allergic diseases are a major public health problem. It is essential to develop prevention strategies applied to it. A number of risk factors have been identified, but some are still under contradictory. Changing the dietary pattern of the at-risk infant may prevent food allergy. Evidence suggests that exclusive breast-feeding for the first 4-months seems to protect against atopic dermatitis in infants and early childhood wheezing. Breast-feeding should be encouraged for all infants because of all its well known benefits. Hydrolyzed formulas cannot substitute breast milk on the prevention of allergic diseases. Extensively hydrolysed formulas should be encouraged as a supplement to breast milk in high-risk infants whenever necessary. Partially hydrolysed formulas may be a reasonable substitute, but more studies are necessary. There is no evidence that avoiding allergenic foods during pregnancy will reduce the incidence of allergenic diseases in child. Avoidance food and aeroallergen seems effective in reducing early childhood wheeze, atopic dermatitis and asthma. Maternal avoidance of allergenic foods during lactation should only be undertaken under medical supervision by highly motivated mothers with a high risk of allergy in the offspring.
过敏性疾病是一个重大的公共卫生问题。制定针对该疾病的预防策略至关重要。已确定了一些风险因素,但有些仍存在争议。改变高危婴儿的饮食模式可能预防食物过敏。有证据表明,前4个月纯母乳喂养似乎可预防婴儿期的特应性皮炎和幼儿期喘息。由于母乳喂养有诸多众所周知的益处,应鼓励所有婴儿进行母乳喂养。水解配方奶粉在预防过敏性疾病方面不能替代母乳。必要时,应鼓励使用深度水解配方奶粉作为高危婴儿母乳的补充。部分水解配方奶粉可能是一种合理的替代品,但还需要更多研究。没有证据表明孕期避免食用致敏食物会降低儿童过敏性疾病的发病率。避免食用食物和吸入性变应原似乎对减少幼儿喘息、特应性皮炎和哮喘有效。母亲在哺乳期避免食用致敏食物仅应在有强烈意愿且后代过敏风险高的母亲在医疗监督下进行。