Bejegyzés

Hydrolysed formula and risk of allergic or autoimmune disease: systematic review and meta-analysis

Boyle RJ et al.
BMJ 2016; 352 :i974

Abstract

OBJECTIVE: To determine whether feeding infants with hydrolysed formula reduces their risk of allergic or autoimmune disease.

DESIGN: Systematic review and meta-analysis, as part of a series of systematic reviews commissioned by the UK Food Standards Agency to inform guidelines on infant feeding. Two authors selected studies by consensus, independently extracted data, and assessed the quality of included studies using the Cochrane risk of bias tool.

DATA SOURCES: Medline, Embase, Web of Science, CENTRAL, and LILACS searched between January 1946 and April 2015.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective intervention trials of hydrolysed cows’ milk formula compared with another hydrolysed formula, human breast milk, or a standard cows’ milk formula, which reported on allergic or autoimmune disease or allergic sensitisation.
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Immunological programming by breast milk creates an anti-inflammatory cytokine milieu in breast-fed infants compared to formula-fed infants

Kainonen E, Rautava S, Isolauri E.
Br J Nutr. 2012 Oct 30:1-9.

Abstract

Breast milk provides important maturational stimuli to an infant’s developing immune system. However, data concerning the role of breast-feeding in reducing the risk of allergic disease remain contradictory. Previous studies have centred on comparative analyses of breast milk and formula compositions. We chose a slightly different angle, whereby we focused on the effects of the chosen diet on the infant himself, comparing the immune development of formula-fed and breast-fed children. The objective of the present study was to determine how the mode of feeding affects infant immunology. Altogether, eighteen formula-fed infants with limited breast-feeding for < 3 months and twenty-nine infants who were exclusively breast-fed for >3 months were included in the study.
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Valóban meg kell-e kezdeni a hozzátáplálást 6 hónapos kor előtt?

A La Leche Liga angliai szervezetének válasza a British Medical Journal című orvosi szaklapban 2011 januárjában megjelent cikkre, amely megkérdőjelezi a hozzátáplálás nem korábban, mint 6 hónapos korban való elkezdésére vonatkozó eddigi ajánlásokat

A La Leche Liga már több mint 50 éve nyújt információt és támogatást azoknak a szülőknek, akik szoptatni szeretnék gyermeküket. Munkája során osztja a WHO, az Egészségügyi Minisztérium és más mértékadó szervezetek azon nézeteit, miszerint a csecsemők optimális növekedését, fejlődését és egészségét az szolgálja legjobban, ha életük első 6 hónapjában kizárólag szopnak. Ezután pedig a szoptatást kiegészítve kapjanak a kisbabák megfelelő minőségű ételeket, hogy növekvő, változó táplálékigényüket kielégíthessék.
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Clinical practice: Breastfeeding and the prevention of allergy

Kneepkens CM, Brand PL.
Eur J Pediatr. 2010 Aug;169(8):911-7.

Abstract

The increase in allergic disease prevalence has led to heightened interest in the factors determining allergy risk, fueled by the hope that by influencing these factors one could reduce the prevalence of allergic conditions. The most important modifiable risk factors for allergy are maternal smoking behaviour and the type of feeding.

A smoke-free environment for the child (to be), exclusive breastfeeding for 4-6 months and the postponement of supplementary feeding (solids) until 4 months of age are the main measures considered effective. There is no place for restricted diets during pregnancy or lactation.
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Chronic disease and infant nutrition: is it significant to public health?

Smith JP, Harvey PJ.
Public Health Nutr. 2010 Jul 13:1-11.

Abstract

OBJECTIVE: To assess the public health significance of premature weaning of infants from breast milk on later-life risk of chronic illness.

DESIGN: A review and summary of recent meta-analyses of studies linking premature weaning from breast milk with later-life chronic disease risk is presented followed by an estimation of the approximate exposure in a developed Western country, based on historical breast-feeding prevalence data for Australia since 1927. The population-attributable proportion of chronic disease associated with current patterns of artificial feeding in infancy is estimated.

RESULTS: After adjustment for major confounding variables, current research suggests that the risks of chronic disease are 30-200 % higher in those who were not breast-fed compared to those who were breast-fed in infancy.
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Breast-feeding in relation to asthma, lung function, and sensitization in young schoolchildren

Kull I, Melen E, Alm J, Hallberg J, Svartengren M, van Hage M, Pershagen G, Wickman M, Bergström A.
J Allergy Clin Immunol. 2010 May;125(5):1013-9.

Abstract

Background The evidence from previous studies on beneficial effects of breast-feeding in relation to development of asthma is conflicting.

ObjectiveTo investigate the relation between breast-feeding and asthma and/or sensitization during the first 8 years of life.

Method In a birth cohort, children were followed up to 8 years by questionnaires at ages 2 months and 1, 2, 4, and 8 years to collect information on exposures and health effects. Determination of serum IgE antibodies to common inhalant and food allergens was performed at 4 and 8 years.
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Breastfeeding and atopic dermatitis: protective or harmful? facts and controversies

Alan M. Dattner MD
Clinics in Dermatology Volume 28, Issue 1, January 2010, Pages 34-37

Abstract

Conventional wisdom posits that breastfeeding during the first 4 months of life generally reduces the incidence of atopic dermatitis in the child. Recent studies question this truism, especially in cases when the mother herself is allergic.

Studies about maternal dietary allergens in breast milk and their influence on atopic dermatitis have been questioned as well. There is evidence that probiotic and essential fatty acid supplementation, along with an allergen-avoidance diet, may reduce the chance of maternal dietary allergens provoking atopic dermatitis in the infant. Evidence on both sides of the controversy is presented in an effort to produce meaningful guidelines for breastfeeding infants at risk for atopic dermatitis.
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Breastfeeding and the prevalence of allergic diseases in schoolchildren: Does reverse causation matter?

Kusunoki T, Morimoto T, Nishikomori R, Yasumi T, Heike T, Mukaida K, Fujii T, Nakahata T.
Pediatr Allergy Immunol. 2010 Jan 14.

Abstract

Infants at higher risk of allergic diseases might be breastfed for longer periods compared with infants at lower risk in the hope that breastfeeding might reduce the risk of atopic disorders. Therefore, this intention could manifest as an apparent allergy-promoting effect of breastfeeding or reverse causation.

To analyze the effect of breast feeding on the prevalence of allergic diseases at school age, a large questionnaire survey was administered to the parents of schoolchildren aged 7–15 yrs. 13,215 parents responded (response rate, 90.1%).
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Infant feeding and allergy prevention: a review of current knowledge and recommendations. A EuroPrevall state of the art paper

Grimshaw KE et al.
Allergy. 2009 Oct;64(10):1407-16.

Abstract

The relationship between infant feeding patterns and the later development of food allergies has been the focus of much debate and research over the last decade. National recommendations have been made by many countries on how to feed infants to reduce the risk of food allergy but due to the lack of firm evidence the recommendations differ widely. This review has been developed as part of EuroPrevall, a European multicentre research project funded by the European Union, to document the differing feeding recommendations made across Europe, to investigate the current evidence base for any allergy prevention feeding recommendations and to identify areas where further research is needed.
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A korai táplálkozás hatása a csecsemő-és gyermekkori atópiás megbetegedések kialakulására

Az anyai diéta, a szoptatás, a hidrolizált tápszerek, és a kiegészítő táplálékok bevezetése időpontjának szerepe

Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas

Frank R. Greer, MD, Scott H. Sicherer, MD, A. Wesley Burks, MD and the Committee on Nutrition and Section on Allergy and Immunology

http://pediatrics.aappublications.org/cgi/content/full/121/1/183

Bevezetés

Az elmúlt néhány évtizedben drasztikusan megnőtt az atópiás betegségek előfordulása. A 4 év alatti gyermekek körében az aszthma előfordulása 160%-kal nőtt, az atópiás dermatitisz pedig 2-3-szorosára.1 Az elmúlt évtizedben a földimogyoró allergiások száma megduplázódott.
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