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The Australasian Society of Clinical Immunology and Allergy position statement: summary of allergy prevention in children

Med J Aust 2005; 182 (9): 464-467.

Summary

  • A family history of allergy and asthma identifies children at high risk of allergic disease.

  • Dietary restrictions in pregnancy are not recommended.

  • Avoiding inhalant allergens during pregnancy has not been shown to reduce allergic disease, and is not recommended.

  • Breastfeeding should be recommended because of other beneficial effects, but if breast feeding is not possible, a hydrolysed formula is recommended (rather than conventional cow’s milk formulas) in high-risk infants only.

  • Maternal dietary restrictions during breastfeeding are not recommended.

  • Soy formulas and other formulas (eg, goat’s milk) are not recommended for reducing food allergy risk.

  • Complementary foods (including normal cow’s milk formulas) should be delayed until a child is aged at least 4–6 months, but a preventive effect from this measure has only been demonstrated in high-risk infants.

  • There is no evidence that an elimination diet after age 4–6 months has a protective effect, although this needs additional investigation.

  • Further research is needed to determine the relationship between house dust mite exposure at an early age and the development of sensitisation and disease; no recommendation can yet be made about avoidance measures for preventing allergic disease.

  • No recommendations can be made about exposure to pets in early life and the development of allergic disease. If a family already has pets it is not necessary to remove them, unless the child develops evidence of pet allergy (as assessed by an allergy specialist).

  • Women should be advised not to smoke while pregnant, and parents should be advised not to smoke.

  • No recommendations can be made on the use of probiotic supplements (or other microbial agents) for preventing allergic disease at this time.

  • Immunotherapy may be considered as a treatment option for children with allergic rhinitis, and may prevent the subsequent development of asthma.

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  • Susan L Prescott1
  • Mimi LK Tang2

  • 1 School of Paediatrics and Child Health Research, University of Western Australia, Perth, WA.
  • 2 Department of Immunology, Royal Children's Hospital, Melbourne, VIC.

Correspondence: 

Acknowledgements: 

We thank ASCIA members, particularly those involved in the Paediatric Interest Group, for their comments on this position statement when it was circulated for review.

Competing interests:

None identified.

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