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Relationship between the appearance of atopic dermatitis in childhood and the consumption of probiotics during the neonatal period in premature patients. Proc Nutr Soc 2022. [DOI: 10.1017/s0029665122002336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Kalach N, Bellaïche M, Elias-Billon I, Dupont C. Family history of atopy in infants with cow's milk protein allergy: A French population-based study. Arch Pediatr 2019; 26:226-231. [PMID: 30885604 DOI: 10.1016/j.arcped.2019.02.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/07/2018] [Accepted: 02/16/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This French multicenter, cross-sectional, observational study aimed to describe the family history of atopy in infants with cow's milk protein allergy (CMPA), and the related diagnostic approaches used by specialists in a real-life ambulatory setting. PATIENTS AND METHODS In total, 1674 infants with suspected CMPA [median age 4.5 months (range: 0.1-18.0), males 54%] were enrolled in the study by 466 private physicians (pediatricians: 97%). Family history of atopy was defined as a known history of atopy in at least one first- (father, mother, and/or sibling) and/or second-degree relative (grandparents, uncles, and aunts), as reported by parents to physicians. RESULTS Atopy in a first-degree relative was more common among infants with documented or high probability of CMPA (in 84% and 80% of cases, respectively, vs. the other subgroups, P=0.005). Most infants experienced digestive (92%) and skin (61%) symptoms suggestive of CMPA. Delayed reactions were reported in 64% of infants. According to a post-classification based on the results of previous diagnostic tests and procedures, 1133 infants (68%) had highly probable (52%) or documented CMPA (16%). In these infants, a history of atopy was reported in first- and/or second-degree relative(s) in 86% of cases (81% in first-degree relatives). Whatever the family history of atopy, the characteristics of the infants were similar, except for fewer pets in the case of negative family atopy (14% vs. 25%, P<0.001). Atopy in a parent was more frequent in infants who presented with the first signs suggestive of CMPA within the first 6 months of life vs. those with later first symptoms (75% vs. 65%, P=0.063). CONCLUSION This French study confirms the high rate of family history of atopy in first-degree relatives of infants with probable or documented CMPA.
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Affiliation(s)
- N Kalach
- Clinique pédiatrique Saint-Antoine, hôpital Saint-Vincent-de-Paul, groupement des hôpitaux de l'institut catholique de Lille (GHICL), boulevard de Belfort, 59020 Lille cedex, France.
| | - M Bellaïche
- Service de gastroentérologie pédiatrique, hôpital Robert-Debré, AP-HP, 75019 Paris, France
| | - I Elias-Billon
- Medical department, nutrition hygiène santé, 94150 Rungis, France
| | - C Dupont
- Service de gastroentérologie pédiatrique, université Paris V - René Descartes, hôpital Necker-Enfants-malades, AP-HP, 75015 Paris, France
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Immunomodulatory effects of probiotics: Can they be used to treat allergies and autoimmune diseases? Maturitas 2018; 119:25-38. [PMID: 30502748 DOI: 10.1016/j.maturitas.2018.11.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/06/2018] [Accepted: 11/08/2018] [Indexed: 12/12/2022]
Abstract
As a person ages, physiological, immunological and gut microbiome changes collectively result in an array of chronic conditions. According to the 'hygiene hypothesis' the increasing prevalence of immune-mediated disorders may be related to intestinal dysbiosis, leading to immune dysfunction and associated conditions such as eczema, asthma, allergies and autoimmune diseases. Beneficial probiotic bacteria can be utilized by increasing their abundance within the gastrointestinal lumen, which in turn will modulate immune cells, such as, T helper (Th)-1, Th2, Th17, regulatory T (Treg) cells and B cells, which have direct relevance to human health and the pathogenesis of immune disorders. Here, we describe the cross-talk between probiotics and the gastrointestinal immune system, and their effects in relation to inflammatory bowel disease, multiple sclerosis, allergies and atopic dermatitis.
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Rouelle C, Arion A, Prevost V. [Management and prevention of cow's milk protein allergy: Contribution of community pharmacists]. ANNALES PHARMACEUTIQUES FRANÇAISES 2017; 75:236-244. [PMID: 28187880 DOI: 10.1016/j.pharma.2017.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 01/09/2017] [Accepted: 01/10/2017] [Indexed: 10/20/2022]
Abstract
Cow's milk protein allergy (CMPA) is a public health issue in children whose quality of life is strongly affected. The objective of this article is to review the present state of knowledge on the CMPA, and highlight some emerging alternatives in its management and in its prevention. Good knowledge in the appropriate infant formula, exclusion diets, the handling of the emergency treatment thanks to the use of epinephrine auto-injector pens, the use of personalized care project and accessibility to allergic patients' association are factors that secure the management. Breastfeeding and appropriate dietary diversification are for their part major preventive measures. The use of probiotics and desensitization immunotherapy are interesting emerging tracks. The role of community pharmacists in all these steps is discussed. It is indeed a nearby health professional involved both in improving prevention and in the optimization of the management. Its educational posture is crucial in assisting patients to help them better understand the CMPA and its treatment; as part of its new tasks, he can be integrated into therapeutic education programs to help allergic children and their families in a multidisciplinary context to better manage their daily life.
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Affiliation(s)
- C Rouelle
- Pharmacie Clémenceau, 14000 Caen, France.
| | - A Arion
- Pédiatrie médicale, CHU de Caen, 14000 Caen, France
| | - V Prevost
- UFR des sciences pharmaceutiques, université de Caen Normandie, 14000 Caen, France; UMR 1086 Inserm « cancers et préventions », centre François-Baclesse, avenue du général-Harris, 14076 Caen cedex 05, France
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Banti T, Carsin A, Chabrol B, Reynaud R, Fabre A. [Infant food diversification. Assessment of practices in relation to French recommendations in pediatricians and pediatric residents in southern France]. Arch Pediatr 2016; 23:1018-1027. [PMID: 27642151 DOI: 10.1016/j.arcped.2016.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 07/05/2016] [Accepted: 07/07/2016] [Indexed: 11/28/2022]
Abstract
Infant food diversification has undergone a rapid succession of good practice recommendations in France, but there has been no assessment of pediatrician practices on food diversification. OBJECTIVE To assess the practices of pediatricians in relation to current recommendations of the French Society of Pediatrics on infant food diversification. METHODS This was an observational study conducted from 1 November 2014 to 31 March 2015. The study population consisted of 97 pediatricians in the Var department and 84 pediatric residents assigned to the University of Aix-Marseille in France. A questionnaire was sent by email or post to determine physician characteristics, food diversification methods in healthy children and those at atopic risk, and how the pediatric consultation was conducted. The expected answers were based on the most recent recommendations of the French Society of Pediatrics published in 2008, updated from 2003. In summary, breastfeeding is recommended up to 6 months. Food diversification can be started between 4 and 6 months in children with no allergy risk. Gluten, honey, legumes and cow's milk are introduced between 4 and 7 months, after 12 months and after 36 months, respectively. In atopic children, food diversification is delayed until after 6 months and the most allergenic foods (nuts, exotic fruits, peanuts, and shellfish) are introduced after the age of 12 months. RESULTS Eighty-four responses were obtained (51%): 50 pediatricians and 34 pediatric residents. Sixteen items were classified depending on whether or not an update after 2003 existed. Over 80% of the physicians responded as recommended for the recently updated items for the age of introduction of "solid food in healthy children", "gluten", "cow's milk protein hydrolysates", and "the time until introduction of cow's milk in the atopic child". At best, 65% of physicians responded in accordance with recommendations for items without a recent update, age of introduction of "cow's milk", "milk desserts", "animal proteins", "fats", "vegetables", "use of a hypoallergenic infant formula", and "breastfeeding extension with atopic child". Pediatric residents had the same responses as pediatricians. Seventy-two physicians did not consider the allergenic status of the children to delay the introduction of the most allergenic foods. The lack of complete updating the introduction of solid foods schedule could explain the differences between pediatrician practices and recommendations. Moreover, old recommendations on allergenic food eviction are still available. CONCLUSION Pediatricians and pediatric residents partially applied the current recommendations on the introduction of solid food.
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Affiliation(s)
- T Banti
- Unité de pédiatrie multidisciplinaire, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - A Carsin
- Unité de pneumologie et médecine infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - B Chabrol
- Unité de pneumologie et médecine infantile, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - R Reynaud
- Unité de pédiatrie multidisciplinaire, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - A Fabre
- Unité de pédiatrie multidisciplinaire, CHU Timone-Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Banti T, Carsin A, Chabrol B, Fabre A. Diversification alimentaire : l’information disponible sur Internet est-elle en accord avec les recommandations des sociétés savantes ? Arch Pediatr 2016; 23:706-13. [DOI: 10.1016/j.arcped.2016.04.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 04/25/2016] [Indexed: 11/25/2022]
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Chouraqui JP, Simeoni U, Tohier C, Nguyen F, Kempf C, Beck L, Lachambre E. [Screening for the risk of allergy and prevention in French maternity units: A survey]. Arch Pediatr 2015; 22:943-50. [PMID: 26251054 DOI: 10.1016/j.arcped.2015.06.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 05/04/2015] [Accepted: 06/17/2015] [Indexed: 01/28/2023]
Abstract
Allergy has been on the rise for half a century and concerns nearly 30% of children; it has now become a real public health problem. The guidelines on prevention of allergy set up by the French Society of Paediatrics (SFP) and the European Society of Paediatric Allergology and Clinical Immunology (ESPACI) are based on screening children at risk through a systematic search of the family history and recommend, for children at risk, exclusive breastfeeding whenever possible or otherwise utilization of hypoallergenic infant formula, which has demonstrated efficacy. The AllerNaiss practice survey assessed the modes of screening and prevention of allergy in French maternity units in 2012. The SFP guidelines are known by 82% of the maternity units that took part in the survey, and the ESPACI guidelines by 55% of them. A screening strategy is in place in 59% of the participating maternity wards, based on local consensus for 36% of them, 13% of the units having a written screening procedure. Screening is based on the search for a history of allergy in first-degree relatives (99%) during pregnancy (51%), in the delivery room (50%), and after delivery (89%). A mode of prevention of the risk of allergy exists in 62% of the maternity units, most often in writing (49%). A hypoallergenic infant formula is prescribed for non-breastfed children in 90% of the units. The survey shows that there is a real need for formalization of allergy risk screening and prevention of allergy in newborns in French maternity units.
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Affiliation(s)
- J-P Chouraqui
- Service de gastro-entérologie, hépatologie et nutrition pédiatriques, hôpital couple-enfant, CHU de Grenoble, avenue du Maquis-du-Grésivaudant, 38700 La Tronche, France
| | - U Simeoni
- Service de pédiatrie, CHUV/UNIL, 46, rue du Bugnon, 1011 Lausanne, Suisse
| | - C Tohier
- Policlinique l'Atlantique, avenue Claude-Bernard, BP 40419, 44819 Saint-Herblain cedex, France
| | - F Nguyen
- École des sages-femmes de Paris Baudelocque, hôpital Saint-Vincent-de-Paul, 76, avenue Denfert-Rochereau, 75014 Paris, France
| | - C Kempf
- CKConsulting, 6, rue Birkenfels, 67530 Ottrott, France
| | - L Beck
- Nestlé France, 77446 Noisiel, France.
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Diversification alimentaire et risque allergique. Arch Pediatr 2014; 21:1392-5. [DOI: 10.1016/j.arcped.2014.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 06/27/2014] [Accepted: 07/04/2014] [Indexed: 11/21/2022]
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Ibuprofen Concentrations in Human Mature Milk—First Data About Pharmacokinetics Study in Breast Milk With AOR-10127 “Antalait” Study. Ther Drug Monit 2014; 36:590-6. [DOI: 10.1097/ftd.0000000000000058] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lodge CJ, Allen KJ, Lowe AJ, Dharmage SC. Overview of evidence in prevention and aetiology of food allergy: a review of systematic reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:5781-806. [PMID: 24192789 PMCID: PMC3863871 DOI: 10.3390/ijerph10115781] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 10/24/2013] [Accepted: 10/25/2013] [Indexed: 12/12/2022]
Abstract
The worldwide prevalence of food allergy appears to be increasing. Early life environmental factors are implicated in the aetiology of this global epidemic. The largest burden of disease is in early childhood, where research efforts aimed at prevention have been focused. Evidence synthesis from good quality systematic reviews is needed. We performed an overview of systematic reviews concerning the prevention and aetiology of food allergy, retrieving 14 systematic reviews, which covered three broad topics: formula (hydrolysed or soy) for the prevention of food allergy or food sensitization; maternal and infant diet and dietary supplements for the prevention of food allergy or food sensitization and hygiene hypothesis-related interventions. Using the AMSTAR criteria for assessment of methodological quality, we found five reviews to be of high quality, seven of medium quality and two of low quality. Overall we found no compelling evidence that any of the interventions that had been systematically reviewed were related to the risk of food allergy. Updating of existing reviews, and production of new systematic reviews, are needed in areas where evidence is emerging for interventions and environmental associations. Furthermore, additional primary studies, with greater numbers of participants and objective food allergy definitions are urgently required.
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Affiliation(s)
- Caroline J. Lodge
- Centre for MEGA Epidemiology, the University of Melbourne, 207 Bouverie Street, Melbourne, Victoria 2010, Australia; E-Mails: (C.J.L.); (A.J.L.)
| | - Katrina J. Allen
- Murdoch Children’s Research Institute, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia; E-Mail:
- Department of Allergy and Immunology, Royal Childrens Hospital, 50 Flemington Road, Parkville, Victoria 3052 Australia
| | - Adrian J. Lowe
- Centre for MEGA Epidemiology, the University of Melbourne, 207 Bouverie Street, Melbourne, Victoria 2010, Australia; E-Mails: (C.J.L.); (A.J.L.)
- Murdoch Children’s Research Institute, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia; E-Mail:
| | - Shyamali C. Dharmage
- Centre for MEGA Epidemiology, the University of Melbourne, 207 Bouverie Street, Melbourne, Victoria 2010, Australia; E-Mails: (C.J.L.); (A.J.L.)
- Murdoch Children’s Research Institute, Royal Children’s Hospital, 50 Flemington Road, Parkville, Victoria 3052, Australia; E-Mail:
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Betoko A, Charles MA, Hankard R, Forhan A, Bonet M, Regnault N, Botton J, Saurel-Cubizolles MJ, de Lauzon-Guillain B. Determinants of infant formula use and relation with growth in the first 4 months. MATERNAL AND CHILD NUTRITION 2012; 10:267-79. [PMID: 22642271 DOI: 10.1111/j.1740-8709.2012.00415.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The wide variety of infant formula available on the market can be confusing for parents and physicians. We aimed to determine associations between predominant type of formula used from birth to 4 months and parental and child characteristics and type of physician consulted, and then to describe relations between type of formula used and growth. Our analyses included 1349 infants from the EDEN mother-child cohort. Infant's feeding mode and type of formula used were assessed at 4 months by maternal self-report. Infant's weight and height from birth to 4 months, measured in routine follow-up, were documented by health professionals in the infant's personal health record. Anthropometric z-scores were calculated by using World Health Organization growth standards. Multinomial logistic regression was used to identify factors associated with the type of formula predominantly used; relations with growth were analysed by linear regressions. Partially hydrolysed formulas were more likely to be used by primiparous women (P < 0.001), those breastfeeding longer (P < 0.001) and for infants with family history of allergies (P = 0.002). Thickened formulas were more often used by mothers returning to employment in the first 4 months (P = 0.05) and breastfeeding shortly (P < 0.001). No significant relation was found between infant's growth and type of formula (P > 0.20). Infants breastfed shorter showed higher weight-for-age (P < 0.001) and length-for-age (P = 0.001) z-score changes between birth and 4 months. The use of a specific type of infant formula seems to be mainly related to parental characteristics. Infant's growth in the first 4 months is related to other factors than to the type of formula used.
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Affiliation(s)
- Aisha Betoko
- INSERM, CESP, Centre for Research in Epidemiology and Population Health, U1018, Epidemiology of Diabetes, Obesity and Chronic Kidney Disease Over the Life Course, Villejuif, France Paris Sud 11 University, UMRS 1018, Villejuif, France INSERM, CIC 0802, Clinical Investigation Centre, University hospital, Poitiers, France INSERM, UMRS 953, Epidemiological Research Unit on Perinatal Health and Women's and Children's Health, Villejuif, France UPMC, Paris 06 University, Paris, France
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Su J, Prescott S, Sinn J, Tang M, Smith P, Heine RG, Spieldenner J, Iskedjian M. Cost-effectiveness of partially-hydrolyzed formula for prevention of atopic dermatitis in Australia. J Med Econ 2012; 15:1064-77. [PMID: 22630113 DOI: 10.3111/13696998.2012.697085] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To perform an economic evaluation of a specific brand of partially hydrolyzed infant formula (PHF-W) in the prevention of atopic dermatitis (AD) among Australian infants. METHODS A cost-effectiveness analysis was undertaken from the perspectives of the Department of Health and Aging (DHA), of the family of the affected subject and of society as a whole in Australia, based on a decision-analytic model following a hypothetical representative cohort of Australian newborns who are not exclusively breastfed and who have a familial history of allergic disease (i.e., are deemed 'at risk'). Costs, consequences, and incremental cost-effectiveness ratios (ICER) were calculated for PHF-W vs standard cow's milk based infant formula (SF), and, in a secondary analysis, vs extensively hydrolyzed infant formula (EHF-Whey), when the latter was used for the prevention of AD. RESULTS From a representative starting cohort of 87,724 'at risk' newborns in Australia in 2009, the expected ICERs for PHF-W vs SF were AU$496 from the perspective of the DHA and savings of AUD1739 and AU$1243 from the family and societal perspectives, respectively. When compared to EHF-Whey, PHF-W was associated with savings for the cohort of AU$5,183,474 and AU$6,736,513 from the DHA and societal perspectives. LIMITATIONS The generalizability and transferability of results to other settings, populations, or brands of infant formula should be made with caution. Whenever possible, a conservative approach directing bias against PHF-W rather than its comparators was applied in the base case analysis. Assumptions were verified in one-way and probabilistic sensitivity analyses, which confirmed the robustness of the model. CONCLUSIONS PHF-W appears to be cost-effective when compared to SF from the DHA perspective, dominant over SF from the other perspectives, and dominant over EHF-Whey from all perspectives, in the prevention of AD in 'at risk' infants not exclusively breastfed, in Australia.
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Affiliation(s)
- John Su
- Department of Dermatology, Royal Children's Hospital, University of Melbourne, Melbourne, Australia; Monash University, Melbourne, Australia
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Dietary treatment of cows' milk protein allergy in childhood: a commentary by the Committee on Nutrition of the French Society of Paediatrics. Br J Nutr 2011; 107:325-38. [DOI: 10.1017/s0007114511004831] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The diagnosis of cows' milk protein allergy (CMPA) requires first the suspicion of diagnosis based on symptoms described in the medical history, and, second, the elimination of cows' milk proteins (CMP) from the infant's diet. Without such rigorous analysis, the elimination of CMP is unjustified, and sometimes harmful. The elimination diet should be strictly followed, at least until 9–12 months of age. If the child is not breast fed or the mother cannot or no longer wishes to breast feed, the first choice is an extensively hydrolysed formula (eHF) of CMP, the efficacy of which has been demonstrated by scientifically sound studies. If it is not tolerated, an amino acid-based formula is warranted. A rice protein-based eHF can be an alternative to a CMP-based eHF. Soya protein-based infant formulae are also a suitable alternative for infants >6 months, after establishing tolerance to soya protein by clinical challenge. CMPA usually resolves during the first 2–3 years. However, the age of recovery varies depending on the child and the type of CMPA, especially whether it is IgE-mediated or not, with the former being more persistent. Once the child reaches the age of 9–12 months, an oral food challenge is carried out in the hospital ward to assess the development of tolerance and, if possible, to allow for the continued reintroduction of CMP at home. Some children with CMPA will tolerate only a limited daily amount of CMP. The current therapeutic options are designed to accelerate the acquisition of tolerance thereof, which seems to be facilitated by repeated exposure to CMP.
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Langhendries JP, Maton P, François A, Marguglio A, Marion W, Smeets S, Philippet P. [Implementation of the intestinal micro flora in the early stage and adequate immunity later on]. Arch Pediatr 2011; 17 Suppl 3:S110-8. [PMID: 20728810 DOI: 10.1016/s0929-693x(10)70910-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The pre and postnatal development of human immunity are remarkably continuous. The feto-placental unit builds up to promote a climate of immune tolerance specifically driven in this way by the maternal immunity. The process of birth triggers the development of the infant's postnatal immunity, in first place through the bacterial colonisation of a sterile intestinal mucosa. The progressive immune response stabilisation at the sub-mucosa level during the first year of life will arise from the interface between the host and its microflora. It will take place progressively and will occur thanks to a variety of successive and complementary very complex immune mechanisms, under the influence of a rich and diversified intestinal microbiotia. Solid scientific arguments allow hypothesising that immune deviances later in life could be the consequence of an inadequate bacterial pressure on the intestinal mucosa at the early stage. A variety of epigenetic modifications taking place in this early stage could account for the deviant programming of later immunity. Each health care provider should acknowledge that some therapeutic and nutritional interventions during the first year of life may interfere with this complex immune development, giving rise to a risk of increasing immune deviancies later on.
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Affiliation(s)
- J-P Langhendries
- CHC-Site St Vincent, NICU, Rue François Lefèbvre 207, Liège-Rocourt, Belgique.
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Prise en charge diététique de l’allergie aux protéines du lait de vache. Arch Pediatr 2011; 18:79-94. [DOI: 10.1016/j.arcped.2010.08.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Accepted: 08/08/2010] [Indexed: 01/28/2023]
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Alimentation des premiers mois de vie du nourrisson et prévention de l’allergie : réponse des auteurs. Arch Pediatr 2009; 16:1191-3. [DOI: 10.1016/j.arcped.2009.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2009] [Accepted: 04/25/2009] [Indexed: 11/21/2022]
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Abstract
AIM This article explores the role of breastfeeding in different aspects of vaccination in the first 6 months when infants are still developing: (1) pain management; (2) immunomodulation of infants' vaccine responses; (3) metabolism of thimerosal. METHODS Major databases were searched for studies that addressed outcomes of related issues. RESULTS Studies reveal that breastfeeding can: (1) help mothers and infants to cope with the stressful situations that accompany parenteral vaccines; (2) improve response to vaccines in the still maturing immunologic and enterohepatic systems of infants; (3) influence physiologic parameters that can change metabolism of ethylmercury derived from some vaccines. CONCLUSION Health promotion that supports vaccinations should also emphasize early initiation and maintenance of exclusive breastfeeding up until 6 months for maximum protection of the infants with a possible beneficial effect on the vaccine response. Paediatric professionals should inform mothers of the proven benefits of breastfeeding and its importance in complementing vaccination and lowering stress and the risk of untoward reactions on susceptible infants.
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Affiliation(s)
- Josè G Dòrea
- Department of Nutrition, Universidade de Brasília, 70919-970 Brasília, DF, Brazil.
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Current World Literature. Curr Opin Allergy Clin Immunol 2009; 9:284-90. [DOI: 10.1097/aci.0b013e32832c00ee] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Alimentation de la mère et de l’enfant les premiers mois de vie et prévention de l’allergie. Arch Pediatr 2009; 16:385-6. [DOI: 10.1016/j.arcped.2008.12.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 12/16/2008] [Indexed: 11/21/2022]
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Rancé F, Bidat E, Dutau G. La prévention primaire des maladies allergiques : le point de vue des pédiatres allergologues. REVUE FRANCAISE D ALLERGOLOGIE 2009. [DOI: 10.1016/j.reval.2008.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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