10 AAP Allergy 2019
10 AAP Allergy 2019
10 AAP Allergy 2019
This clinical report updates and replaces a 2008 clinical report from the abstract
American Academy of Pediatrics, which addressed the roles of maternal and a
Department of Pediatrics, School of Medicine and Public Health,
early infant diet on the prevention of atopic disease, including atopic University of Wisconsin-Madison, Madison, Wisconsin; bJaffe Food
dermatitis, asthma, and food allergy. As with the previous report, the available Allergy Institute, Division of Allergy and Immunology, Department of
data still limit the ability to draw firm conclusions about various aspects of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New
York; and cDepartment of Pediatrics, School of Medicine, University of
atopy prevention through early dietary interventions. Current evidence does North Carolina at Chapel Hill, Chapel Hill, North Carolina
not support a role for maternal dietary restrictions during pregnancy or
Drs Greer, Sicherer, and Burks contributed to identification,
lactation. Although there is evidence that exclusive breastfeeding for 3 to incorporation, and interpretation of the literature used to compose the
4 months decreases the incidence of eczema in the first 2 years of life, report; assisted in drafting, reviewing, and editing the manuscript;
and approved the final manuscript as submitted.
there are no short- or long-term advantages for exclusive breastfeeding
This document is copyrighted and is property of the American
beyond 3 to 4 months for prevention of atopic disease. The evidence Academy of Pediatrics and its Board of Directors. All authors have filed
now suggests that any duration of breastfeeding $3 to 4 months is protective conflict of interest statements with the American Academy of
Pediatrics. Any conflicts have been resolved through a process
against wheezing in the first 2 years of life, and some evidence suggests that approved by the Board of Directors. The American Academy of
Pediatrics has neither solicited nor accepted any commercial
longer duration of any breastfeeding protects against asthma even after involvement in the development of the content of this publication.
5 years of age. No conclusions can be made about the role of breastfeeding in
either preventing or delaying the onset of specific food allergies. There is To cite: Greer FR, Sicherer SH, Burks AW, AAP COMMITTEE
a lack of evidence that partially or extensively hydrolyzed formula prevents ON NUTRITION, AAP SECTION ON ALLERGY AND IMMUNOLOGY.
atopic disease. There is no evidence that delaying the introduction of The Effects of Early Nutritional Interventions on the
Development of Atopic Disease in Infants and Children:
allergenic foods, including peanuts, eggs, and fish, beyond 4 to 6 months The Role of Maternal Dietary Restriction, Breastfeeding,
prevents atopic disease. There is now evidence that early introduction of Hydrolyzed Formulas, and Timing of Introduction of
peanuts may prevent peanut allergy. Allergenic Complementary Foods. Pediatrics. 2019;143(4):
e20190281
Clinical reports from the American Academy of Pediatrics benefit from expertise and resources of liaisons and internal (AAP) and external reviewers. However,
clinical reports from the American Academy of Pediatrics may not reflect the views of the liaisons or the organizations or government agencies that they represent.
The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual
circumstances, may be appropriate.
All clinical reports from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before
that time.
DOI: https://doi.org/10.1542/peds.2019-0281
Address correspondence to Frank R. Greer, MD, FAAP. E-mail: frgreer@pediatrics.wisc.edu
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
Copyright © 2019 by the American Academy of Pediatrics
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
FUNDING: No external funding.
POTENTIAL CONFLICT OF INTEREST: Dr Sicherer received royalties from UpToDate and Johns Hopkins University Press; grants to his institution from HAL Allergy
Group, Food Allergy Research and Education, the Immune Tolerance Network, and the National Institute of Allergy and Infectious Diseases; and honoraria from the
American Academy of Allergy, Asthma, and Immunology (as an associate editor) and is a medical advisor to the Food Allergy Fund and the International Association
for Food Protein Enterocolitis. He was a member of the following sponsored expert panel: Guidelines for the Prevention of Peanut Allergy in the United States:
Summary of the National Institute of Allergy and Infectious Diseases; and Drs Greer and Burks have indicated they have no potential conflicts of interest to disclose.
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References This article cites 30 articles, 4 of which you can access for free at:
http://pediatrics.aappublications.org/content/early/2019/03/15/peds.2
019-0281#BIBL
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