Pediatric Nutrition in Practice

2 Nutrition of Healthy Infants, Children and Adolescents

Key Words

Tolerance induction · Sensitization · Allergen

avoidance · Breastfeeding · Atopic dermatitis

Key Messages

• Allergen contact during the first months of life
  modulates the induction of tolerance and sensitiza-
  tion to food antigens


• Nutritional intervention can reduce the risk of aller-
  gic manifestations, particularly of atopic dermatitis
  and cow’s milk protein allergy, during the first year of
  life in children with a positive family history of allergy


• Exclusive breastfeeding for the first 4 months of life,
  with gradual introduction of solid foods with a high
  diversity during continuous breastfeeding from the
  5th month onward, is strongly recommended for all
  healthy infants, regardless of allergy risk


• Maternal exclusion diets during pregnancy and/or
  lactation do not reduce allergy risks for the off-
  spring and are not recommended. Fish in the ma-
  ternal diet seems to reduce the risk of allergic dis-
  eases in the offspring


• Delaying the introduction of certain allergens be-
  yond the 7th month of life has no preventive effect
  and is not recommended. Fish should be intro-
  duced during the second half-year of life


• There is some evidence that certain probiotics giv-
  en to the mother and/or infant and some prebiotic
  mixtures as supplements to infant formulae may re-
  duce the risk of allergy, and particularly of eczema,

in children. Due to the heterogeneity of products,

study designs, target groups, applications and the

timing and duration of supplementation, no gen-

eral recommendations can be made

© 2015 S. Karger AG, Basel

Introduction

Contact with food allergens in early infancy mod-

ulates the development of tolerance to food aller-

gens, but also of sensitization and allergic mani-

festations. Nutritional intervention aiming at a

reduction in allergy risk should be started early in

infancy, and potentially even with the maternal

diet during the last weeks of pregnancy. Data on

alimentary allergy prevention were obtained in

observational cohort studies, which describe as-

sociations and can generate hypotheses, and in

controlled intervention studies, which can dem-

onstrate causal relationships. The available data

do not support the conclusion that maternal

elimination diets during pregnancy and lactation

provide a benefit for allergy risk reduction in the

infant. Data on breastfeeding effects on allergy

point to a beneficial impact of exclusive breast-

feeding during the first 4 months of life, with con-

tinued breastfeeding while solid foods are being

Koletzko B, et al. (eds): Pediatric Nutrition in Practice. World Rev Nutr Diet. Basel, Karger, 2015, vol 113, pp 113–117
DOI: 10.1159/000360328

2.5 Allergy Prevention through Early Nutrition

Sibylle Koletzko

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