Gastrointestinal Manifestations of Food Allergy

Shereen M. Reda

Disclosures

Pediatr Health. 2009;3(3):217-229. 

In This Article

Prevention

Approaches to delay or prevent food allergy is a subject of research. Recently, the 2008 report of the American Academy of Pediatrics Committee on Nutrition stated that in high-risk infants, there is evidence that exclusive breastfeeding for at least 4 months and delaying complementary foods until 4-6 months, prevents development of allergy.[56,57] There is some evidence that supplementing hydrolyzed formulas in high-risk infants may delay or prevent allergic disease. There is no convincing evidence that maternal manipulation of diet during pregnancy or lactation, use of soy products, or infant dietary restrictions of solid food, including highly allergic food such as fish, egg and foods containing peanut protein, beyond 4-6 months has any effect on the development of atopic disease.

Recently, two studies raised a new concept and approaches to the induction of immune tolerance.[58,59] In these studies, no effect of maternal peanut consumption during pregnancy or lactation was observed,[58] which supports the hypothesis that peanut sensitization occurs as a result of environmental exposure. Furthermore, they have suggested that a high level of environmental exposure (non-oral) to peanuts during infancy appears to promote sensitization, whereas low levels (oral) may be protective in atopic children.[59] The implication of the new concept is that avoiding consumption of peanut prevents the development of oral tolerance and increases the risk of hypersensitivity through cutaneous exposure. It appears that in addition to the genetic determinants of atopy, there are several other factors, such as the age at exposure, route and dose of exposure to peanut, and the nature of peanut in food (raw, boiled or roasted), that together, all contribute to the induction of tolerance to peanut.[60]

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