Dietary prevention of allergic diseases in infants and small children

Part I: Immunologic background and criteria for hypoallergenicity*


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    An extensive review by an expert group set up by the Section on Pediatrics, European Academy of Allergology and Clinical Immunology.

Antonella Muraro MD PhD, Department of Pediatrics, University of Padua, Via Giustiniani 3, 35128 Padua, Italy
Tel.: +39 049 8213505-06, +39 049 8212538
Fax: +39 049 8213509


The role of primary prevention of allergic diseases has been a matter of debate for the last 40 years. In order to shed some light into this issue, a group of experts of the Section of Pediatrics EAACI critically reviewed the existing literature on the subject. In this paper, the immunology of the fetus and newborn is reviewed as well as the post-natal development of the immune system. The influence of post-natal environment and breastfeeding on tolerance induction and sensitization are examined. Allergic diseases result from a strong relationship between genetic and environmental factors. Sensitization to food allergens occurs in the first year of life and cow's milk allergy is the first food allergy to appear in the susceptible infants. Hypoallergenicity of food formulas to be used is a critical issue both for treatment of cow's milk-allergic children and for prevention. Methods to document hypoallergenicity are discussed and evaluated in the preclinical and clinical steps.