The right foods stop the allergic march

Food can keep infants free of allergic disease. The right nutritional choices during the first four to six months of life can mean the difference between a healthy childhood and a progression of atopic disease that can lead to asthma.

"Breastfeeding remains the gold standard. But if breast milk is not sufficient, infants should be fed a hydrolyzed product," said Andrea von Berg, MD, head of the Research Institute for Prevention of Allergies and Respiratory Diseases at the Department in Pediatrics at Marien-Hospital in Wesel, Germany.

Dr. von Berg told a symposium audience Friday evening at the AAP 2004 National Conference and Exhibition that infants at normal risk of atopic disease should be given a partially hydrolyzed whey (pHF-W) product. Infants at high risk and those who have already developed atopic dermatitis or other atopic disease should be fed an extensively hydrolyzed casein (eHF-C) formula. Both formulations are available in the US.

Dr. von Berg based her recommendations on the German Infant Nutritional Intervention (GINI) study, which she coordinated. The randomized trial of more than 2,200 newborns found that infants who received pHF-W and eHF-C showed a significantly lower rate of atopic disease during the first three years of life than those who were not fed such formulas.

Among infants who did not have a family history of atopic disease (AD), pHF-W was associated with the lowest rate of infant atopic disease. For infants who did have a family history of AD, eHF-C showed the strongest association with a lower rate of atopic disease in infants. GINI compared cow's milk formula to pHF-W, eHF-C, and extensively hydrolyzed whey formula. Other interventions, including maternal allergen avoidance diets, maternal and infant diets supplemented with probiotics, and delayed introduction of solid foods, had little or no effect on AD rates in early life.