Cochrane in context: Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child

McGill University, Faculty of Medicine, 1020 Pine Avenue West, Montreal, Quebec, Canada H3A 1A2.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 02/2006; 9(3):CD000133. DOI: 10.1002/14651858.CD000133.pub2
Source: PubMed


Evidence is inadequate to advise women to avoid specific foods during pregnancy or breastfeeding to protect their children from allergic diseases like eczema and asthma. We included five trials, involving 952 participants. Trials of mothers' avoidance of milk, eggs, and other potentially 'antigenic' foods during pregnancy or breastfeeding, or both, provide inadequate evidence about whether such avoidance helps prevent atopic eczema or asthma in the child. Women who avoided eating these foods gained significantly less weight during pregnancy in the one trial reporting on this outcome, raising the possibility of adverse nutritional effects on the mother or fetus. Finally, one small trial reported an inconclusive response of breastfed infants with atopic eczema when their mothers avoided consumption of cow milk and egg.

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    • "It has long been proposed that the mother should avoid such foods containing potential allergens during pregnancy and lactation to prevent food sensitization in the child. However, recent studies suggest that allergen exposure may be necessary to induce tolerance, and moreover, a balanced diet prevents malnutrition of both mother and child [82]. Furthermore, alterations of the maternal diet, that is, avoidance of milk and egg consumption during pregnancy did not seem to lower the risk of sensitization in the child [83,84]. "
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    ABSTRACT: Asthma and allergic disorders can affect the course and outcome of pregnancy. Pregnancy itself may also affect the course of asthma and related diseases. Optimal management of these disorders during pregnancy is vital to ensure the welfare of the mother and the baby. Specific pharmacological agents for treatment of asthma or allergic diseases must be cautiously selected and are discussed here with respect to safety considerations in pregnancy. Although most drugs do not harm the fetus, this knowledge is incomplete. Any drug may carry a small risk that must be balanced against the benefits of keeping the mother and baby healthy. The goals and principles of management for acute and chronic asthma, rhinitis, and dermatologic disorders are the same during pregnancy as those for asthma in the general population. Diagnosis of allergy during pregnancy should mainly consist of the patient's history and in vitro testing. The assured and well-evaluated risk factors revealed for sensitization in mother and child are very limited, to date, and include alcohol consumption, exposure to tobacco smoke, maternal diet and diet of the newborn, drug usage, and insufficient exposure to environmental bacteria. Consequently, the recommendations for primary and secondary preventive measures are also very limited in number and verification.
    World Allergy Organization Journal 03/2009; 2(3):26-36. DOI:10.1097/WOX.0b013e31819b0a86
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    • "We focus on the following key areas: maternal pre-and postnatal antigen avoidance, breastfeeding, choice of infant formula supplementation, timing of solid food introduction, and fatty acid intake (in breastfeeding mothers and in infants). General antigen avoidance (milk, soy, eggs, tree nuts, peanuts, shellfish) for the population as a whole is not supported by current data [70]. In families at highest risk (parents or siblings who have significant atopic history), "
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    ABSTRACT: The use of complementary and alternative medical (CAM) therapies is increasing among well children and adolescents and in those children who have special health care needs. Integrative pediatrics, a holistic practice that includes an examined integration of CAM and conventional therapies, is ideally suited for primary care. This article describes how to integrate evidence-based CAM therapies for colic, atopy, ADHD, eating disorders, and other conditions commonly seen in primary care practice.
    Pediatric Clinics of North America 01/2008; 54(6):837-58; ix. DOI:10.1016/j.pcl.2007.09.007 · 2.12 Impact Factor
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