How do I reduce the risk of Allergies for my Newborn
1 . Why is it important to know about risk of allergies in your newborn?
Allergy is an abnormal over-reaction of the body’s natural immune mechanism to substances that are normally not harmful to the human body. Many nations around the world are experiencing an alarming increase in allergic diseases such as eczema and asthma. About 35% of infants and children are having atopic diseases and this is one of the most important morbidity factors in industrialised countries. The incidence is also growing and in recent decades has roughly doubled in Western societies.
About 60% of all allergies appear during the first years of life, with food allergies being the earliest manifestations.Studies have shown that general food allergies occur in about 5-10% of the overall infant and small-child population. In most studies, cow’s milk protein allergy is the most common in young infant, with a 2% to 6% incidence.
Symptoms of cow milk protein allergies tend to be non-specific and difficult to recognise. Many infants (50%-60%) present with gastrointestinal or skin symptoms, 30% of infants have respiratory symptoms such as wheezing and cough. 75%-92% of infants with cow milk protein allergies have more than two organs systems involved. Recent studies have found that infant colic and gastroesophageal reflux may be caused by cow milk protein allergies.
Although most allergies first appear in childhood, it can develop in any person at any age. The course and presentation of allergic disease is variable and can manifest itself as different symptoms at a later age. Cow milk protein allergy is a significant but not an isolated phenomenon. It plays a role in the pathogenesis of other atopic diseases in infants and children such as other food allergies, rhinitis, asthma, or other atopic manifestations such as chronic, non-infectious otitis media.
There are multiple possible contributing factors for development of allergies in children which include:
(1) The genetic background of the child
(2) Western lifestyles (hygiene and change of gut flora)
(3) The inherent ability of certain food to trigger allergic reactions such as cow’s milk proteins
(4) The maturity of the digestive guts
(5) Age of the child when the offending food is first introduced
The genetic background of a child is one of the key factors in predicting the risk of allergies:
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Family History
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Risk of allergies in Children
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Both Parents without allergies
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5-15%
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One parent with allergies
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20-40%
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Both parents with allergies
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40-60%
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- What could I do to reduce the risk of allergies for my newborn?
- Breastfeeding has been shown to be protective against development of allergies in the newborn. It enhances immune functions and is hypoallergic and the overall composition helps to establish bifidogenic gut flora. In exclusively breast-fed infants, the incidence of cow milk protein allergy is about 0.5%-1.5%. However, about 20% of infants with increased risk of allergy will develop cow milk protein allergy during their first year of life if fed on cow’s milk protein.
- Use hydrolyzed formula (or better known as a hypoallergenic formula) if you could not breast feed. Studies have shown that newborn who is fed hydrolyzed formula or pasteurized human milk has a risk of 1.6% in developing cow milk protein allergy compared to 2.6% risk in newborns who were fed cow’s milk formula
- Delay weaning until 6 months old
- Introduction of good bacteria such as Lactobacilli & Bifidobacteria to the newborns. Recent studies have shown that lactobacilli may have the capacity to degrade cow’s milk protein and modify their immunomodulation activity. Thus, probiotics that favour the establishment of immunopositive lactobacilli and bifidobacteria may play a major role in future allergy-prevention programmes.
REFERENCES:
(1) Liptay S, Bauer CP, Grubl A et al. Natural History of Atopic disease in early childhood: is cord blood IGE a prognostic factor? A preliminary report. Clin Pediatr.1992; (4): 241-6.
(2) Malaysian Society of Allergy & Immunology. http://www.allergymsai.org
(3) Exl BM, Fritsche R. Cow’s Milk Protein Allergy and Possible Means for Its Prevention. Nutrition. 2001; 17:642-651
(4) Wold AE, Adlerberth I. Does breast-feeding affect the infant’s immune responsiveness? Acta Paediatr. 1998; 87:19
(5) Bock SA. Prospective appraisal of complaints of adverse reactions to foods in children during the first 3 years of life. Paediatrics. 1987;79:683.
(6) Hill DJ. Cow milk allergy in infancy and early childhood. Clin Exp Allergy. 1996; 26: 243
(7) Host A, Husby S, Osterballe O. A prospective study of cow’s milk allergy in exclusively breastfed infants. Incidence, pathogenic role of early inadvertent exposure to cow’s milk formula, and characterization of bovine milk protein in human milk. Acta Paediatr Scand. 1998;77:663
(8) Wold AE. The hygiene hypothesis revised: is the rising frequency of allergy due to changes in the intestinal flora? Allergy. 1998; 53:20
(9) Hill DJ, Hudson IL, Sheffield LJ et al. A low allergen diet is a significant intervention in infantile colic: result of a community based study. J Allergy Clin Immunol. 1995;96:886
(10) Jacono G, Carroccio A, Cavataio F et al. Gastroesophageal reflux and cow’s milk allergy in infants: a prospective study. J Allergy Clin Immunol. 1996; 97: 822.
