Alamo Asthma & Allergy Associates
Drs. Michael and Adrianne Vaughn
115 Gallery Circle
San Antonio, TX 78258
(Stone Oak MRI/Urgent Care Bldg.)
Prenatal guidelines to reduce the incidence of allergic diseases
in children of allergic parents
(Based on available scientific studies)
The childhood risk of developing allergic diseases such as eczema (Atopic dermatitis), hay fever (allergic rhinitis), and asthma may be modified by the mother's dietary habits both prior to and following the child's birth.
- Recent scientific evidence has suggested that maternal diets high in n-3 poly-unsaturated fatty acids, especially DHA (docosahexaenoic acid) may influence the immune system of the developing fetus and decrease allergic responses to both foods and airborne allergens after delivery. Similar beneficial effects have also been described if mothers continue n-3 PUFA (fish-oil) supplements while nursing.
- Food antigens consumed by nursing mothers can cross from the blood stream into breast milk and can lead to food allergy in infants. Highly allergenic foods such as egg, shellfish, peanut, tree nuts, and cows' milk (and related products) should be avoided, beginning in the last trimester and continued thru the period of breast feeding (3 months recommended, 6 months if possible).
- Children born by C-section, those without older siblings, those who do not attend daycare and those raised in westernized (hygienic) urban environments (vs. farms) all have an elevated risk for developing allergic diseases. This is most likely due to delayed colonization of the gastrointestinal (GI) tract with "normal" bacterial flora. These bacteria mature the GI tract and help digest and process consumed foods. "Probiotics" are commercially available bacterial cultures of normal flora that have been shown to be beneficial when consumed to specifically colonize the GI tract. This approach has been found to decrease the risk of developing infant eczema/atop√É¬≠c dermatitis (AD) and may help to improve this condition in children who have already developed this disease. Infants of mothers who take Probiotics beginning in the 3rd trimester and while nursing also have a decreased risk for developing allergic diseases.
- Infants at risk for developing allergies should not be fed solid foods until 6 months old. They should not be given cows' milk, wheat, soy, corn, or citrus until age 1, and no egg, until age 2. Peanut, tree nuts and fish should not be given until 3.
- If parents or siblings of an infant have allergic diseases or asthma, "Nutramigen" is the formula of choice for infants not being exclusively breastfed.
Probiotic bacteria. Since Pro-biotics are known to be safe in children as well as adults, we recommend their use in all children with AD and in all children who have parents or siblings with a history of AD, nasal allergies, or asthma. Not all Probiotics contain the same bacterial species. In one recently reported study, which examined the effects of Pro-biotics in infants with allergy to cow's milk formula, it was found that a mixture of various bacteria did not perform as well as a Probiotic containing a pure culture of Lactobacillus rhamnosus - strain GG (previously known as Lactobacillus casei). Lactobacillus rhamnosus - strain GG is available in the USA only in a product called Culturelle-DS. It can be purchased over the internet at www.culturelle.com. It is also carried by many Walgreen's stores.
* For infants and children give 1/2 to 1 capsule per day for one month. Capsules can be opened and mixed into foods, drinks, infant formula or pump-collected breast milk. Dosing should be repeated following any course of antibiotics.
n-3 Omega PUFA supplements can be purchased at most health food stores and at least 3 grams are recommended daily beginning at 20 months gestation and should be continued while nursing.