Sansotta N, Piacentini G L, Mazzei F, Minniti F, Boner A L, Peroni D G
Paediatric Department, University of Verona, Verona, Italy.
Allergol Immunopathol (Madr). 2013 Sep-Oct;41(5):337-45. doi: 10.1016/j.aller.2012.08.012. Epub 2012 Dec 31.
Strategies to prevent or reduce the risk of allergic diseases are needed. The time of exclusive breastfeeding and introduction of solid foods is a key factor that may influence the development of allergy. For this reason, the aim of this review was to examine the association between exposure to solid foods in the infant's diet and the development of allergic diseases in children. Classical prophylactic feeding guidelines recommended a delayed introduction of solids for the prevention of atopic diseases. Is it really true that a delayed introduction of solids (after the 4th or 6th month) is protective against the development of eczema, asthma, allergic rhinitis and food or inhalant sensitisation? In recent years, many authors have found that there is no statistically significant association between delayed introduction of solids and protection for the development of allergic diseases. Furthermore, late introduction of solid foods could be associated with increased risk of allergic sensitisation to foods, inhalant allergens and celiac disease in children. Tolerance may be driven by the contact of the mucosal immune system with the allergen at the right time of life; the protective effects seem to be enhanced by the practice of the breastfeeding at the same time when weaning is started. Therefore, recent guidelines propose a "window" approach for weaning practice starting at the 17th week and introducing almost all foods within the 27th week of life to reduce the risk of chronic diseases such as allergic ones and the celiac disease. Guidelines emphasize the role of breastfeeding during the weaning practice.
需要采取预防或降低过敏性疾病风险的策略。纯母乳喂养及引入固体食物的时间是可能影响过敏症发展的关键因素。因此，本综述的目的是研究婴儿饮食中固体食物的摄入与儿童过敏性疾病发展之间的关联。传统的预防性喂养指南建议延迟引入固体食物以预防特应性疾病。延迟引入固体食物（在第4或6个月之后）真的能预防湿疹、哮喘、过敏性鼻炎以及食物或吸入性致敏吗？近年来，许多作者发现延迟引入固体食物与预防过敏性疾病发展之间不存在统计学上的显著关联。此外，延迟引入固体食物可能会增加儿童对食物、吸入性过敏原和乳糜泻过敏致敏的风险。耐受性可能由黏膜免疫系统在生命的适当时间与过敏原接触所驱动；在开始断奶的同时进行母乳喂养似乎会增强保护作用。因此，最近的指南提出了一种“窗口期”断奶方法，从第17周开始，在生命的第27周内引入几乎所有食物，以降低诸如过敏性疾病和乳糜泻等慢性疾病的风险。指南强调了断奶过程中母乳喂养的作用。
