Food allergies during the first 1000 days have critical nutritional implications such as nutrient deficiencies especially in cases of milk allergy among infants and children. However, food allergies can be prevented through dietary interventions and lifestyle strategies from the start of pregnancy to decrease the risk of children developing allergies. Based on the Philippine Guidelines on Dietary primary prevention of allergic diseases in children, here are some of the evidence-based recommendations on how to prevent allergic diseases during the first 1000 days:

1. Mothers should not avoid allergenic foods during pregnancy to prevent allergy in the child. Unless the mother is truly diagnosed with a food allergy, there is no need for food avoidance for an otherwise healthy pregnant woman. Recent studies have challenged the older prevention strategy of avoiding allergenic foods such as milk, eggs, peanuts, nuts, wheat, soy and seafood because new studies have shown that eating these foods in pregnancy could help the infant tolerate these food items and help protect against atopic dermatitis or asthma in the first 18 months of infancy. Moreover, dietary restriction during pregnancy may lead to nutritional deficiencies which can affect the developing fetus.

2. Exclusive breastfeeding for the first 6 months of the baby’s life is recommended to prevent asthma. Cow’s milk allergy is one of the most common food allergies among infants which may lead to digestive system problems such as vomiting and diarrhea. Breast milk has proteins that are most suitable for human infant consumption as compared to cow’s milk which contains proteins which may trigger allergies. Moreover, several meta-analyses have shown that breastfeeding for the first 6 months is associated with a decreased risk for asthma at 0 - 2 years old.

3. Delaying complementary feeding beyond the age of 6 months for all infants is not recommended. Studies have shown that delaying food introduction beyond 6 months has no protective effect against the development of allergies. By 6 months, breastfeeding can still be continued but breastmilk may be deficient in some nutrients that are needed for the increased growth of the infant. This is why complementary feeding with iron-rich foods is recommended during this time to “complement” the lacking nutrients from breast milk. This is also the period when the infant is introduced to new food items gradually as they develop tolerance to common food.

4. Early introduction of highly allergenic foods as complementary food for infants to prevent allergic diseases is recommended. A prospective cohort study shows that introduction of highly allergenic foods such as wheat, egg and fish, to infants is related to a decreased risk of asthma, allergic rhinitis, and allergy development. Introducing fish at 9 months or less is related to a decreased risk for allergic rhinitis. Another population-based cross-sectional study showed that early introduction of eggs in the cooked form (hardboiled, fried or scrambled) is related to a lower risk of developing egg allergy as compared to introducing it at 10–12 months or later.

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References:

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