Zuzana Abaffyová, Zuzana Rennerová, Miloš Jeseňák, Klára Kossárová
The prevalence of food allergy has been increasing. Food allergy in infants is often the first manifestation of allergic march with future development of allergic diseases – atopic eczema, allergic rhinitis, or bronchial asthma. For this reason prevention of food allergy is important for decreasing prevalence of allergic diseases. In last years maternal dietary restriction during pregnancy and lactation was recommended. In infants a delayed introduction of allergenic food (especially cow’s milk, hen’s eggs, nuts and fish) was also recommended. But is this really necessary? Recent studies have not confirmed a protective effect of maternal exclusion diet during the pregnancy and lactation period on development of atopic diseases in infants. Breast feeding is food of choice for infants for great number of reasons, but the evidence that it prevents allergic outcomes is contradictory. Delaying the introduction of foods into an infant’s diet (particularly of allergenic foods) is not beneficial and may even increase the risk of the developing allergic diseases. There is currently not enough evidence to support the use of probiotics for prevention of allergic disease. The studies of use of prebiotics has given hopeful results, which should be confirmed by further controlled studies. European Society of Pediatric Allergy and Clinical Immunology and European Society of Pediatric Gastroenterology, Hepatology and Nutrition give next recommendations: exclusive breastfeeding is recommended for 4-6 months for allergy prevention. High risk infants should be fed until four months with extensively hydrolyzed or partially hydrolyzed formulas or hypoallergenic formula if they are not breast fed. Solid foods should be introduced after the fourth month and avoidance or delayed introduction of allergenic foods is not further recommended.