Complementary Foods and the Development of Food Allergy

Berthold Koletzko, MD

PEDIATRICS Vol. 106 No. 5 Supplement November 2000, pp. 1285


The prevalence of allergic diseases in children is increasing in Western Europe and other developed countries. Allergic reactions to food components are of particular concern in infants and young children. In prospective studies the incidence of cows’ milk protein allergy in infancy has been estimated at about 2% to 3%. Allergic reactions are also frequently observed against egg white, fish, cereals, nuts, peanuts, and soybean and thus against complementary food products. In infants with documented allergy against complementary foods, the basic treatment is complete avoidance of the causal protein.

In view of the high and rising prevalence of food allergies, strategies for prevention are appealing. Exclusive breastfeeding with exclusion of cows’ milk formulas and complementary foods during the first 4 to 6 months is presumed to have a preventive effect against the occurrence of allergic symptoms, extending beyond the period of breastfeeding. However, the size of the effect remains controversial.6-8 Scientifically rigorous evidence is not available because infants cannot ethically be randomly assigned to breast or formula feeding to exclude securely the effect of confounding factors, which may highly influence the results of published studies. However, one study from Finland suggested a long-term protective effect of breastfeeding. In a prospective study on unselected newborns followed up until the age of 17 years, exclusive breastfeeding was associated with lower rates of eczema and food allergy at 1 and 3 years of age, and a lower score of respiratory allergy up to 17 years, when compared with the early feeding of cows’ milk formula.

A cikk a Pediatrics oldalán olvasható.