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Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children

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

PEDIATRICS Vol. 121 No. 1 January 2008, pp. 183-191

Abstract

This clinical report reviews the nutritional options during pregnancy, lactation, and the first year of life that may affect the development of atopic disease (atopic dermatitis, asthma, food allergy) in early life. It replaces an earlier policy statement from the American Academy of Pediatrics that addressed the use of hypoallergenic infant formulas and included provisional recommendations for dietary management for the prevention of atopic disease. The documented benefits of nutritional intervention that may prevent or delay the onset of atopic disease are largely limited to infants at high risk of developing allergy (ie, infants with at least 1 first-degree relative [parent or sibling] with allergic disease).
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Outcomes of Breastfeeding versus Formula Feeding

A csecsemőtáplálás módjának a csecsemő és az anya egészségére gyakorlt hatásával kapcsolatos kutatási eredmények jól áttekinthető összefoglalása.

Letölthető a La leche League International oldaláról.
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Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries

Stanley Ip, M.D., Mei Chung, M.P.H., Gowri Raman, M.D., Priscilla Chew, M.P.H., Nombulelo Magula, M.D., Deirdre DeVine, M.Litt., Thomas Trikalinos, M.D., Ph.D., Joseph Lau, M.D.

Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, April 2007

Structured Abstract

Objectives: We reviewed the evidence on the effects of breastfeeding on short- and long-term infant and maternal health outcomes in developed countries.

Data Sources: We searched MEDLINE®, CINAHL, and the Cochrane Library in November of 2005. Supplemental searches on selected outcomes were searched through May of 2006. We also identified additional studies in bibliographies of selected reviews and by suggestions from technical experts.
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Food allergy and the introduction of solid foods to infants: a consensus document

Alessandro Fiocchi MD; Amal Assa’ad MD; Sami Bahna MD

Annals of Allergy, Asthma and Immunology 2006, vol. 97, no. 1, pp. 10 – 21

Abstract

Objective: To make recommendations based on a critical review of the evidence for the timing of the introduction of solid foods and its possible role in the development of food allergy.

Data Sources: MEDLINE searches using the following search algorithm: [weaning AND infant AND allergy]/[food allergy AND sensitization]/[dietary prevention AND food allergy OR allergens]/[Jan 1980-Feb 2006].

Study Selection: Using the authors’ clinical experience and research expertise, 52 studies were retrieved that satisfied the following conditions: English language, journal impact factor above 1 or scientific society, expert, or institutional publication, and appraisable using the World Health Organization categories of evidence.
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Vitamin C in breast milk may reduce the risk of atopy in the infant

U Hoppu, M Rinne, P Salo-Väänänen, A-M Lampi, V Piironen and E Isolauri

European Journal of Clinical Nutrition (2005) 59, 123−128

Abstract

Objective: To assess the effects of maternal dietary and supplement intake of vitamins C and E on breast milk antioxidant composition (vitamin C, alpha-tocopherol and beta-carotene) and their protective potential against the development of atopy in the infant.

Design, subjects and methods: Mothers with atopic disease were recruited at the end of gestation and maternal sensitization was assessed by skin-prick testing. The 4-day food records of the mothers and breast milk samples were collected at the infants’ age of 1 month.
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The association of prolonged breastfeeding and allergic disease in poor urban children

C. C. Obihara, B. J. Marais, R. P. Gie1, P. Potter, E. D. Bateman, C. J. Lombard, N. Beyers and J. L. L. Kimpen

Eur Respir J 2005; 25:970-977

The fact that breastfeeding may protect against allergic disease remains controversial, with hardly any reports from developing countries. This study investigated the association between allergic disease in children and prolonged breastfeeding.

Data were collected from a 15% random sample of households from two poor suburbs of Cape Town, South Africa. Parents completed a validated International Study on Asthma and Allergies in Childhood questionnaire on allergic diseases for children aged 6–14 yrs. Other questions included breastfeeding duration, maternal smoking and parental allergy.
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TGF-β in human milk is associated with wheeze in infancy

Oddy WH, Halonen M, Martinez FD, Lohman IC, Stern DA, Kurzius-Spencer M, Guerra S, Wright AL.
J Allergy Clin Immunol. 2003 Oct;112(4):723-8.

Abstract

BACKGROUND: Cytokines secreted in human milk might play important roles in newborn health and in the development of infant immune responses. We investigated the relationship of the concentration and dose of cytokines in human milk to infant wheeze at 1 year of age.

OBJECTIVE: Our objective was to test whether the cytokines in milk could account for some of the apparent protective effect of breast-feeding against wheeze in the first year of life.

METHODS: Data on breast-feeding and infant wheeze were collected prospectively from birth to 1 year from 243 mothers participating in the Infant Immune Study in Tucson, Arizona.
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Infant growth and health outcomes associated with 3 compared with 6 mo of exclusive breastfeeding

Michael S Kramer, Tong Guo, Robert W Platt, Zinaida Sevkovskaya, Irina Dzikovich, Jean-Paul Collet, Stanley Shapiro, Beverley Chalmers, Ellen Hodnett, Irina Vanilovich, Irina Mezen, Thierry Ducruet, George Shishko and Natalia Bogdanovich

American Journal of Clinical Nutrition, Vol. 78, No. 2, 291-295, August 2003

Abstract

Background: Opinions and recommendations about the optimal duration of exclusive breastfeeding have been strongly divided, but few published studies have provided direct evidence on the relative risks and benefits of different breastfeeding durations in recipient infants.

Objective: We examined the effects on infant growth and health of 3 compared with 6 mo of exclusive breastfeeding.

Design: We conducted an observational cohort study nested within a large randomized trial in Belarus by comparing 2862 infants exclusively breastfed for 3 mo (with continued mixed breastfeeding through >= 6 mo) with 621 infants who were exclusively breastfed for >= 6 mo.
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The effects of respiratory infections, atopy, and breastfeeding on childhood asthma

W.H. Oddy, N.H. de Klerk, P.D. Sly, P.G. Holt
Eur Respir J 2002; 19:899-905

Abstract

The objectives of the present study were to quantify the association of atopy and respiratory infections with asthma, and exclusive breastfeeding with respiratory illness, atopy and asthma in children.

A cohort study of 2,602 children enrolled prior to birth and followed prospectively, provided data on respiratory illness, the method of feeding in the first year of life, as reported on a prospective diary card, and current asthma at the age of 6 yrs (defined as doctor-diagnosed asthma with wheeze in the last year or cough without a cold, and currently taking either preventer or reliever asthma medication), as reported by parental questionnaire.
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Promotion of Breastfeeding Intervention Trial (PROBIT): A Randomized Trial in the Republic of Belarus

Michael S. Kramer et al.
JAMA. 2001;285:413-420.

Abstract

Context Current evidence that breastfeeding is beneficial for infant and child health is based exclusively on observational studies. Potential sources of bias in such studies have led to doubts about the magnitude of these health benefits in industrialized countries.

Objective To assess the effects of breastfeeding promotion on breastfeeding duration and exclusivity and gastrointestinal and respiratory infection and atopic eczema among infants.

Design The Promotion of Breastfeeding Intervention Trial (PROBIT), a cluster-randomized trial conducted June 1996–December 1997 with a 1-year follow-up.

Setting Thirty-one maternity hospitals and polyclinics in the Republic of Belarus.

Participants A total of 17 046 mother-infant pairs consisting of full-term singleton infants weighing at least 2500 g and their healthy mothers who intended to breastfeed, 16491 (96.7%) of which completed the entire 12 months of follow-up.
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