Spilling the Beans on Allergy and Asthma

Today we take a closer look at allergy, atopy and asthma. This topic will mainly concentrate on little known ways of primary prevention that mothers need to know about and that have been shown to be effective.

Atopy is a propensity to generate IgE antibodies against common environmental allergens. Asthma, atopic dermatitis, and rhino-conjunctivitis are the known clinical manifestations of atopy. These medical problems are major causes of morbidity & mortality during childhood continuing into the adult life.

However, atopy is only one of many factors involved in the pathogenesis of these disorders. The contribution of atopy and atopy-related genes might vary with the disease in question.

For those who are affected attempts to successfully prevent the development of these diseases must take priority and that is mainly done through primary prevention.

As most of us know the onset of allergic manifestations is usually during early childhood and that is why primary prevention efforts have to commence soon after birth or preferably during pregnancy according to multiple research studies.

What to prevent/avoid?

Exposure to Environmental Tobacco Smoke (ETS), especially during pregnancy and early childhood, increases the risk of childhood wheeze and asthma, and so avoidance of exposure to it must be included in all preventive advice to expectant mothers and those with young children.

It is important to understand that maternal avoidance of allergenic foods during pregnancy does not work and could in fact be harmful. Having said that it is now known that maternal avoidance of allergenic foods during breast feeding might have some protective effect on reduction of cow’s milk allergy and atopic dermatitis in the new born. This should only be performed by highly motivated mothers with a high risk of allergy in the offspring and under strict dietary supervision by a nutritionist.

Breast-feeding for 4 to 6 months protects the new born baby from development of early childhood wheezing and atopic dermatitis; still there is no evidence of any long-term benefits. The evidence to support a preventive effect of HDM (house dust mite) allergen avoidance for the development of sensitization to HDM or respiratory allergy is not compelling and it might be that current methods of allergen reduction are not effective.

A strategy of combining food and aeroallergen avoidance seems effective in reducing early childhood wheeze and atopic dermatitis and later childhood asthma. It is also worth noting that there is evidence that probiotics might be useful in preventing atopic dermatitis.