Shaoul Ron, Pevzner Miri, Goldshtein Zehavit
Pediatric Gastroenterology Institute, Ruth Children's Hospital, Rambam Medical Center., Faculty of Medicine, Technion.
Clinical Division- Organization of Pharmacy in Israel.
Harefuah. 2021 Mar;160(3):161-166.
The effect of the pregnant mother's nutrition and the effect of the baby's nutrition during the first-year on the development of allergy and atopic disease in the baby have been studied extensively in recent years. Key recommendations for healthcare bodies in Europe and the United States include: • Allergy prevention in at-risk infants (parent or sibling with allergy): Currently, there is a consensus of healthcare organizations around the world that the recommended exclusive breastfeeding duration is the first 6 months of life for the overall health benefit of the baby. Allergy prevention in non-breastfed infants at risk: There are studies showing that fully hydrolyzed formula can reduce the risk of allergic reactions, especially atopic dermatitis, in high-risk non-breastfed babies. Some recommendations for high-risk non-breastfed infants support feeding up to 4 to 6 months with hydrolyzed formulas. Further research is needed on this subject. Soy formulas failed to prevent allergy in high-risk infants. • In case of cow's milk allergy symptoms in breastfed babies: Although a small amount of food allergens may be present in the milk, mothers should be encouraged to continue breastfeeding while avoiding consumption of cow's milk and products. • In case of cow's milk allergy symptoms in non-breastfed babies: Under six months of age, extensively hydrolyzed formula is suitable for most cases of cow's milk allergy, except for severe clinical conditions, which require amino acid formulas. Over six months, soy formulas can be considered. Exposure to solid foods: The current recommendations are to start on solids at the age of 4-6 months and there is no recommendation for avoiding known allergens, despite family history. Later introduction of peanut, fish or egg does not prevent, and may even increase, the risk of developing food allergy. In order to provide a professional and appropriate response to infants and parents, it is important to know the latest guidelines, based on research from recent years as clinical recommendations have changed over the past few decades.
近年来，人们广泛研究了孕期母亲的营养以及婴儿出生后第一年的营养对婴儿过敏和特应性疾病发展的影响。欧美医疗机构的主要建议包括：
高危婴儿（父母或兄弟姐妹有过敏史）的过敏预防：目前，全球医疗机构达成共识，为了婴儿的整体健康，建议纯母乳喂养至6个月。
非母乳喂养高危婴儿的过敏预防：有研究表明，深度水解配方奶粉可降低高危非母乳喂养婴儿发生过敏反应的风险，尤其是特应性皮炎。一些针对高危非母乳喂养婴儿的建议支持使用水解配方奶粉喂养4至6个月。对此主题还需要进一步研究。大豆配方奶粉未能预防高危婴儿过敏。
母乳喂养婴儿出现牛奶过敏症状的情况：尽管母乳中可能存在少量食物过敏原，但应鼓励母亲继续母乳喂养，同时避免食用牛奶及其制品。
非母乳喂养婴儿出现牛奶过敏症状的情况：6个月以下，除严重临床情况需要氨基酸配方奶粉外，深度水解配方奶粉适用于大多数牛奶过敏病例。6个月以上，可以考虑使用大豆配方奶粉。
固体食物接触：目前的建议是在4至6个月开始添加固体食物，尽管有家族病史，也没有避免已知过敏原的建议。较晚引入花生、鱼或鸡蛋并不能预防，甚至可能增加发生食物过敏的风险。为了给婴儿及其父母提供专业且合适的应对措施，了解基于近年来研究的最新指南非常重要，因为在过去几十年中临床建议已经发生了变化。
