A review by the American Academy of Pediatrics of the evidence about the development of atopic disease (atopic dermatitis, asthma, food allergy) in early life related to the diet of babies, and of mothers during pregnancy and lactation, has been published. As has been previously reported, the benefits of a nutritional intervention that may prevent or delay the onset of atopic disease are largely limited to infants at high risk of developing allergy, i.e. those with a family history. The current evidence does not support a major role for dietary restrictions during pregnancy or lactation. However, there is evidence that breastfeeding for at least four months, compared with feeding infant formula made with intact cow’s milk protein, prevents or delays the occurrence of atopic dermatitis, cow’s milk allergy, and wheezing in early childhood.

For infants at high risk of developing atopic disease, there is evidence that exclusive breastfeeding for at least four months, compared with feeding intact cow’s milk protein formula, decreases the cumulative incidence of atopic dermatitis and cow’s milk allergy in the first two years of life. There is evidence that exclusive breastfeeding for at least three months protects against wheezing in early life. For infants at high risk of atopy who are not exclusively breastfed for four to six months, there is modest evidence that the onset of atopic disease may be delayed or prevented by the use of hydrolyzed formulas, compared with formula made with intact cow’s milk protein, particularly for atopic dermatitis. The report states that there is little evidence that delaying the introduction of complementary foods beyond “4 to 6 months” is effective at preventing atopic disease but does not examine differences across this age range. It should be noted that the authors reflect that the current body of evidence is lacking and this limits their ability to reach firm conclusions.

Greer et al. (2008) Effects of early nutritional interventions on the development of atopic disease in infants and children. PEDIATRICS; 121 (1): 183-191