Only You can Prevent Childhood Allergy
Jarungchit Ngamphaiboon MD*
Affiliation : * Department of Pediatrics, Faculty of Medicine, Chulalongkorn University
One can consider an allergy to be an aggressive and overflowing immune response to allergen that
are normally tolerated and harmless. However, in recent decades, the incidence of allergic disorders has
increased sharply in countries with a western lifestyle and today has reached about 30-40% among children
and teenagers. Family history of atopy has found to be the strong risk factor. Furthermore, it seems possible
that prenatal or very early life environmental factors influences the development of allergic diseases. It has
also been suggested that intrauterine risk factors may act differently if mother suffer from allergic disease.
Maternal diet during pregnancy has possible effect on the development of atopic sensitizations in children,
especially cow milk. Cow milk protein allergy is the first clinical allergic diseases of allergic march in young
children.The potential of hydrolyzed formula [HA] to reduce the risks of allergic disease have been recom-
mended in high risk infants. We have studied to determine the efficacy of secondary prevention of hypoallergenic
formula (HA) compared with cow milk [CM] and breast feeding [BF] in unselected population and the
correlation between atopic risk score and allergic diseases in children under 5 years old.
Results : 3,502 children are included in the study: exclusively BF in the first 4 mo, CM formula and HA formula
are 970 [27.7%], 2,106 [60.1%] and 426 [12.2%] respectively. The average age of diagnosis allergic diseases
is 14.7 months [2 weeks - 5 years]. The most clinical presentation in the first year of life is atopic dermatitis.
Male has greater risk than female [OR 1.5; 95% CI 1.300-1.719]. The incidence of allergic manifestation is
significantly reduced by using HA compared with BF [OR 0.23; 95% CI 0.160-0.314] and increased by using
CM compared with BF [OR 1.66; 95% CI 1.396-1.957] when adjusted for sex and family history of atopy.
Family history of atopic diseases is a significantly risk factor.
Conclusions : Primary prevention for intrauterine sensitization can start by avoidance of cow milk intake
during pregnancy in high risk mothers. Secondary prevention is breast feeding (BF) for at least 4-6 month.
Hydrolyzed formula [HA] has been recommended in high risk infants to reduce the risks of allergic diseases.
There is a higher incidence of atopic disease in children with male sex. Positive family history is the strong risk
factor for the development of atopic disease in children. In high-risk infants [atopic risk score = 2], using HA
formula as a BF substitute during the first 4 months reduces the risk of atopy during the first year of life. The
new generation hydrolyzed infant formula (NAN HA) is nutritionally complete and has hypoallergenic,
tolerogenic, and bifidogenic effects that help to balance infants’ immune responses toward tolerance. This can
be an alternative feeding option for high risk infants to prevent allergic diseases. Breast milk is the best for all
babies. Professional advises should be recommended before using an infant formula and proper use of an
infant formula is important to the infant’s health.
Keywords : Allergy, Childhood
