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Exclusive breast feeding for 4-6 months may protect against the development of allergic diseases in early childhood and remains good advice. Convincing proof for the preventive effects of the delayed introduction of solid foods and hydrolyzed formula in formula-fed infants is lacking. There is some evidence to support a preventive effect of house dust mite allergen avoidance before sensitization occurs. The effect of exposure to animal allergen is uncertain, with some studies showing an increase in sensitization while others suggest a protective effect. Therefore, no evidence-based advice can be given at this stage regarding allergen avoidance measures to be adopted by families with infants at high risk of atopy, except perhaps to breast feed exclusively for at least 4 months. Data regarding the secondary prevention of allergic disease by allergen avoidance were more secure until the publication this year of two randomized controlled trials which suggest that mattress impermeable covers, the main dust mite allergen avoidance measure, may not work. Allergen avoidance, however, should remain an essential part of the management of allergic diseases, even if the benefit of mattress covers is in doubt.
Current Opinion in Allergy and Clinical Immunology – Wolters Kluwer Health
Published: Apr 1, 2004
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