Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas
Effects of early nutritional interventions on the development of atopic disease in infants and children: The role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods, and hydrolyzed formulas
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DOI：
10.1542/peds.2007-3022
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发表时间：
2008-01-01
期刊：
影响因子：
8
通讯作者：
Burks, A. Wesley
中科院分区：
文献类型：
--
作者：
Greer, Frank R.;Sicherer, Scott H.;Burks, A. Wesley
本临床报告回顾了妊娠期、哺乳期和出生后第一年的营养选择，这些选择可能会影响生命早期特应性疾病（特应性皮炎、哮喘、食物过敏）的发展。它取代了美国儿科学会之前的一份政策声明，该声明涉及低过敏性婴儿配方奶粉的使用，并包括预防特应性疾病的饮食管理临时建议。营养干预可预防或延缓特应性疾病发作的已记录的益处主要限于发生过敏的高风险婴儿（即至少有 1 名一级亲属[父母或兄弟姐妹]患有过敏性疾病的婴儿）。目前的证据并不支持母亲在怀孕或哺乳期间饮食限制的主要作用。有证据表明，与使用完整牛奶蛋白制成的配方奶粉相比，母乳喂养至少 4 个月可以预防或延缓儿童早期特应性皮炎、牛奶过敏和喘息的发生。在对特应性高风险婴儿且未纯母乳喂养 4 至 6 个月的婴儿进行的研究中，有适度的证据表明，与使用完整牛奶蛋白制成的配方奶粉相比，使用水解配方奶粉可以延迟或预防特应性疾病的发作，特别是对于特应性皮炎。对各种水解配方奶粉的比较研究还表明，并非所有配方奶粉都具有相同的保护功效。也几乎没有证据表明，将添加辅食的时间推迟到 4 至 6 个月大之后可以预防特应性疾病的发生。目前，没有足够的数据证明任何 4 至 6 个月大的饮食干预对特应性疾病的发展具有保护作用。
This clinical report reviews the nutritional options during pregnancy, lactation, and the first year of life that may affect the development of atopic disease (atopic dermatitis, asthma, food allergy) in early life. It replaces an earlier policy statement from the American Academy of Pediatrics that addressed the use of hypoallergenic infant formulas and included provisional recommendations for dietary management for the prevention of atopic disease. The documented benefits of nutritional intervention that may prevent or delay the onset of atopic disease are largely limited to infants at high risk of developing allergy (ie, infants with at least 1 first-degree relative [parent or sibling] with allergic disease). Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation. There is evidence that breastfeeding for at least 4 months, compared with feeding formula made with intact cow milk protein, prevents or delays the occurrence of atopic dermatitis, cow milk allergy, and wheezing in early childhood. In studies of infants at high risk of atopy and who are not exclusively breastfed for 4 to 6 months, there is modest evidence that the onset of atopic disease may be delayed or prevented by the use of hydrolyzed formulas compared with formula made with intact cow milk protein, particularly for atopic dermatitis. Comparative studies of the various hydrolyzed formulas also indicate that not all formulas have the same protective benefit. There is also little evidence that delaying the timing of the introduction of complementary foods beyond 4 to 6 months of age prevents the occurrence of atopic disease. At present, there are insufficient data to document a protective effect of any dietary intervention beyond 4 to 6 months of age for the development of atopic disease.