Clinical Question
What can mothers do to prevent eczema or allergies in their infants?
Bottom line
Although this is not official policy or even a practice guideline, the American Academy of Pediatrics summarized the current evidence as lacking support for any dietary restrictions during pregnancy or breastfeeding as a means of preventing atopic disorders in children. Exclusive breastfeeding early in life, for a few months at least, decreases the likelihood of infant eczema in the first 2 years of life. Regarding infant feeding, holding off on foods associated with allergy until 6 months of age is not effective in preventing allergy, and the introduction of peanut products before then may prevent a peanut allergy from developing. 5
Reference
Study design: Practice guideline
Funding: Foundation
Setting: Various (guideline)
Synopsis
This is a clinical report from the American Academy of Pediatrics. It's not a policy statement, a guideline, or a review article. It's sort of a "trust-us-we're-the-experts" summary of available research in a nontransparent way. Pointing out the weak research evidence base, the group finds that the current evidence does not support a role for dietary restrictions during pregnancy and lactation. Exclusive breastfeeding for the first 3 months to 4 months of age is associated with a decreased likelihood of eczema in the first 2 years of life, but breastfeeding beyond that time is not. Breastfeeding for at least 3 months may protect against wheezing in the first 2 years of life, and longer may provide protection for up to age 5 years. Delaying introduction of peanuts, eggs, and fish until after the first 4 months to 6 months of life does not prevent atopic disease, and early peanut exposure may prevent peanut allergy.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA