Maternal intake of vitamin D during pregnancy and risk of recurrent wheeze in children at 3 y of age. Prenatal Vitamin D Supplementation and Child Respiratory Health: A Randomised Controlled Trial Consumption of Artificially-Sweetened Soft Drinks in Pregnancy and Risk of Child Asthma and Allergic Rhinitis Asthma prevalence in Melbourne schoolchildren: have we reached the peak? Increased intake of oily fish in pregnancy: effects on neonatal immune responses and on clinical outcomes in infants at 6 mo. Fish oil intake compared with olive oil intake in late pregnancy and asthma in the offspring: 16 y of registry-based follow-up from a randomized controlled trial. Effect of maternal dietary exclusion on breast fed infants with eczema: two controlled studies. Maternal diet during pregnancy in relation to eczema and allergic sensitization in the offspring at 2 y of age. Maternal B vitamin intake during pregnancy and wheeze and eczema in Japanese infants aged 16-24 months: the Osaka Maternal and Child Health Study. Consumption of fish, butter and margarine during pregnancy and development of allergic sensitizations in the offspring: role of maternal atopy. Maternal vitamin D status during pregnancy and child outcomes Maternal fat consumption during pregnancy and risk of wheeze and eczema in Japanese infants aged 16–24 months: the Osaka Maternal and Child Health Study Bronchial reactivity and dietary antioxidants. Effect of allergen avoidance in infancy on allergic manifestations at age two years. Immune response of the atopic woman and foetus: effects of high‐ and low‐dose food allergen intake during late pregnancy Effect of maternal egg consumption on breast milk ovalbumin concentration Dairy food, calcium and vitamin D intake in pregnancy, and wheeze and eczema in infants The relation of breastfeeding and body mass index to asthma and atopy in children: a prospective cohort study to age 6 years. Maternal dietary pattern during pregnancy is not associated with recurrent wheeze in children. The development and prediction of atopy in high-risk children: follow-up at age seven years in a prospective randomized study of combined maternal and infant food allergen avoidance. Effect of allergen avoidance on development of allergic disorders in infancy Serum ovalbumin‐specific immunoglobulin G responses during pregnancy reflect maternal intake of dietary egg and relate to the development of allergy in early infancy Effect of n-3 long chain polyunsaturated fatty acid supplementation in pregnancy on infants’ allergies in first year of life: randomised controlled trial The immunological and long-term atopic outcome of infants born to women following a milk-free diet during late pregnancy and lactation: a pilot study. Prospective study on the atopy preventive effect of maternal avoidance of milk and eggs during pregnancy and lactation Allergy prevention by maternal elimination diet during late pregnancy--a 5-year follow-up of a randomized study. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys Maternal fish consumption during pregnancy and risks of wheezing and eczema in childhood: The Generation R Study Effects of maternal diet during late pregnancy and lactation on the development of atopic diseases in infants up to 18 months of age—in‐vivo results Prevention of allergic disease during childhood by allergen avoidance: the Isle of Wight prevention study. Do early intake of fish and fish oil protect against eczema and doctor-diagnosed asthma at 2 years of age? A cohort study Maternal meat and fat consumption during pregnancy and suspected atopic eczema in Japanese infants aged 3-4 months: the Osaka Maternal and Child Health Study. Maternal abstention from cow milk and egg in allergy risk pregnancies Development of atopic disease in babies whose mothers were receiving exclusion diet during pregnancy--a randomized study. Maternal consumption of dairy products during pregnancy and lactation, and the development of cow's milk antibodies in the offspring. Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomized, controlled trial. Dietary factors influencing levels of food antibodies and antigens in breast milk Allergen avoidance in infancy and allergy at 4 years of age Effect of combined maternal and infant food-allergen avoidance on development of atopy in early infancy: a randomized study. Maternal dietary patterns during pregnancy and risk of wheeze and eczema in Japanese infants aged 16-24 months: the Osaka Maternal and Child Health Study.
BACKGROUND Vitamin D deficiency and asthma are common at higher latitudes . Although vitamin D has important immunologic effects , its relation with asthma is unknown . OBJECTIVE We hypothesized that a higher maternal intake of vitamin D during pregnancy is associated with a lower risk of  recurrent wheeze in children at 3 y of age . DESIGN The participants were 1194 mother-child pairs in Project Viva-a prospect i ve prebirth cohort study in Massachusetts . We assessed the maternal intake of vitamin D during pregnancy from a vali date d food-frequency question naire . The primary outcome was recurrent wheeze , ie , a positive asthma predictive index ( > or=2 wheezing attacks among children with a personal diagnosis of eczema or a parental history of asthma ) . RESULTS The mean ( + /-SD ) total vitamin D intake during pregnancy was 548 + /- 167 IU/d . By age 3 y , 186 children ( 16 % ) had recurrent wheeze . Compared with mothers in the lowest quartile of daily intake ( median : 356 IU ) , those in the highest quartile ( 724 IU ) had a lower risk of having a child with recurrent wheeze [ odds ratio ( OR ) : 0.39 ; 95 % CI : 0.25 , 0.62 ; P for trend < 0.001 ] . A 100-IU increase in vitamin D intake was associated with lower risk ( OR : 0.81 ; 95 % CI : 0.74 , 0.89 ) , regardless of whether vitamin D was from the diet ( OR : 0.81 ; 95 % CI : 0.69 , 0.96 ) or supplements ( OR : 0.82 ; 95 % CI : 0.73 , 0.92 ) . Adjustment for 12 potential confounders , including maternal intake of other dietary factors , did not change the results . CONCLUSION In the northeastern United States , a higher maternal intake of vitamin D during pregnancy may decrease the risk of recurrent wheeze in early childhood Background Observational studies suggest high prenatal vitamin D intake may be associated with reduced childhood wheezing .  We examined the effect of prenatal vitamin D on childhood wheezing  in an interventional study . Methods We r and omised 180 pregnant women at 27 weeks gestation to either  no vitamin D , 800 IU ergocalciferol daily until delivery or single oral bolus of 200,000 IU cholecalciferol  , in an ethnically stratified , r and omised controlled trial . Supplementation improved but did not optimise vitamin D status . Research ers blind to allocation assessed offspring at 3 years . Primary outcome was any history of wheeze assessed by vali date d question naire . Secondary outcomes included atopy , respiratory infection , impulse oscillometry and exhaled nitric oxide . Primary analyses used logistic and linear regression . Results We evaluated 158 of 180 ( 88 % ) offspring at age 3 years for the primary outcome . Atopy was assessed by skin test for 95 children ( 53 % ) , serum IgE for 86 ( 48 % ) , exhaled nitric oxide for 62 ( 34 % ) and impulse oscillometry of acceptable quality for 51 ( 28 % ) . We found no difference between supplemented and control groups in risk of wheeze  [ no vitamin D : 14/50 ( 28 % ) ; any vitamin D : 26/108 ( 24 % ) ( risk ratio 0.86 ; 95 % confidence interval 0.49 , 1.50 ; P = 0.69 ) ] . There was no significant difference in atopy , eczema risk , lung function or exhaled nitric oxide between supplemented groups and controls . Conclusion Prenatal vitamin D supplementation in late pregnancy that had a modest effect on cord blood vitamin D level , was not associated with decreased wheezing in offspring at age three years . Trial Registration Controlled-Trials.com IS RCT Background Past evidence has suggested a role of artificial sweeteners in allergic disease ; yet , the evidence has been inconsistent and unclear . Objective To examine relation of intake of artificially-sweetened beverages during pregnancy with  child asthma and allergic rhinitis  at 18 months and 7 years . Methods We analyzed data from 60,466 women enrolled during pregnancy in the prospect i ve longitudinal Danish National Birth Cohort between 1996 and 2003 . At the 25th week of gestation we administered a vali date d Food Frequency Question naire which asked in detail about intake of artificially-sweetened soft drinks . At 18 months , we evaluated child asthma using interview data . We also assessed asthma and allergic rhinitis through a question naire at age 7 and by using national registries . Current asthma was defined as self-reported asthma diagnosis and wheeze in the past 12 months . We examined the relation between intake of artificially-sweetened soft drinks and child allergic disease outcomes and present here odds ratios with 95 % CI comparing daily vs. no intake . Results At 18 months , we found that mothers who consumed more artificially-sweetened non-carbonated soft drinks were 1.23 ( 95 % CI : 1.13 , 1.33 ) times more likely to report a child asthma diagnosis compared to non-consumers . Similar results were found for child wheeze . Consumers of artificially-sweetened carbonated drinks were more likely to have a child asthma diagnosis in the patient ( 1.30 , 95 % CI : 1.01 , 1.66 ) and medication ( 1.13 , 95 % CI : 0.98 , 1.29 ) registry , as well as self-reported allergic rhinitis ( 1.31 , 95 % CI : 0.98 , 1.74 ) during the first 7 years of follow-up . We found no associations for sugar-sweetened soft drinks . Conclusion Carbonated artificially-sweetened soft drinks were associated with registry-based asthma and self-reported allergic rhinitis , while early childhood outcomes were related to non-carbonated soft drinks . These results suggest that consumption of artificially-sweetened soft drinks during pregnancy may play a role in offspring allergic disease development OBJECTIVE To determine the change in prevalence of  asthma , eczema and allergic rhinitis in Australian schoolchildren between 1993 and 2002 . DESIGN Question naire based survey , using the protocol of the International Study of Asthma and Allergy in Childhood . SETTING Metropolitan Melbourne primary schools within a 20 km radius of the GPO in 1993 and 2002 . SUBJECTS All children in school years 1 and 2 ( ages 6 and 7 ) attending a r and om sample of 84 schools in 1993 and 63 schools in 2002 . MAIN OUTCOME MEASURES Parent-reported symptoms of atopic disease ; treatment for asthma ; country of birth . RESULTS There was a 26 % reduction in the 12-month period prevalence of reported wheeze , from 27.2 % in 1993 to 20.0 % in 2002 . The magnitude of reduction was similar for boys ( 27 % ) and girls ( 25 % ) . The 12-month period prevalence of reported eczema increased from 11.1 % in 1993 to 17.2 % in 2002 , and rhinitis increased from 9.7 % to 12.7 % . There were reductions in the proportion of children attending an emergency department for asthma in the previous year ( 3.6 % to 2.3 % ) , the proportion admitted to hospital ( 1.7 % to 1.1 % ) and the proportion taking asthma medication ( 18.5 % to 13.4 % ) . Of those who reported frequent wheeze , there was an increase in the proportion taking regular inhaled steroids ( 34.5 % to 40.9 % ) . CONCLUSION There has been a significant reduction in the prevalence of reported asthma in Melbourne schoolchildren , whereas the prevalence of eczema and allergic rhinitis has continued to increase BACKGROUND Long-chain n-3 PUFAs found in oily fish may have a role in lowering the risk of allergic disease . OBJECTIVE The objective was to assess whether an increased intake of oily fish in pregnancy modifies neonatal immune responses and early markers of atopy . DESIGN Women ( n = 123 ) were r and omly assigned to continue their habitual diet , which was low in oily fish , or to consume 2 portions of salmon per week ( providing 3.45 g EPA plus DHA ) from 20 wk gestation until delivery . In umbilical cord blood sample s ( n = 101 ) , we measured n-3 fatty acids , IgE concentrations , and immunologic responses . Infants were clinical ly evaluated at age 6 mo ( n = 86 ) . RESULTS Cord blood mononuclear cell ( C BMC ) production of interleukin (IL)-2 , IL-4 , IL-5 , IL-10 , and tumor necrosis factor-α in response to phytohemagglutinin ( PHA ) and of IL-2 in response to Dermatophagoides pteronyssinus allergen 1 ( Derp1 ) was lower in the salmon group ( all P ≤ 0.03 ) . In the subgroup of C BMC s in which an allergic phenotype was confirmed in the mother or father , IL-10 production in response to Toll-like receptor 2 , 3 , and 4 agonists , ovalbumin , salmon parvalbumin , or Derp1 and prostagl and in E(2 ) production in response to lipopolysaccharide or PHA was lower in the salmon group ( all P ≤ 0.045 ) . Total IgE at birth and total IgE , incidence and severity of atopic dermatitis , and skin-prick-test positivity at 6 mo of age were not different between the 2 groups . CONCLUSION Oily fish intervention in pregnancy modifies neonatal immune responses but may not affect markers of infant atopy assessed at 6 mo of age . This trial is registered at clinical trials.gov as NCT00801502 BACKGROUND Evidence suggests that asthma is rooted in the intrauterine environment and that intake of marine n-3 polyunsaturated fatty acids ( n-3 PUFAs ) in pregnancy may have immunomodulatory effects on the child . OBJECTIVE Our aim was to examine whether increasing maternal intake of n-3 PUFAs in pregnancy may affect offspring risk of asthma . DESIGN In 1990 , a population -based sample of 533 women with normal pregnancies were r and omly assigned 2:1:1 to receive four 1-g gelatin capsules/d with fish oil providing 2.7 g n-3 PUFAs ( n = 266 ) ; four 1-g , similar-looking capsules/d with olive oil ( n = 136 ) ; or no oil capsules ( n = 131 ) . Women were recruited and r and omly assigned around gestation week 30 and asked to take capsules until delivery . Among 531 live-born children , 528 were identified in registries and 523 were still alive by August 2006 .  Diagnoses from the International Coding of Diseases version 10 were extracted from a m and atory registry that recorded diagnoses reported from hospital contacts . RESULTS During the 16 y that passed since childbirth , 19 children from the fish oil  and  olive oil groups had received an asthma-related diagnosis ; 10 had received the diagnosis allergic asthma . The hazard rate of asthma was reduced by 63 % ( 95 % CI : 8 % , 85 % ; P = 0.03 ) , whereas the hazard rate of allergic asthma was reduced by 87 % ( 95 % CI : 40 % , 97 % ; P = 0.01 ) in the fish oil compared with the olive oil group . CONCLUSION Under the assumption that intake of olive oil in the dose provided here was inert , our results support that increasing n-3 PUFAs in late pregnancy may carry an important prophylactic potential in relation to offspring asthma Thirty seven breast fed infants with eczema were studied to see whether changes in their mothers ' diets affected their skin condition .  Nineteen mothers and babies took part in a double blind crossover trial of exclusion of egg and cows ' milk , and 18 took part in open exclusion of 11 foods  followed by double blind challenge to those mothers whose infants seemed to respond . Babies were examined at the beginning and end of each dietary period , and the extent and severity of the rash were given a numerical score . The eczema improved in six infants when their mothers avoided egg and cows ' milk and worsened again when these were reintroduced . Two infants suffered gastrointestinal reactions after maternal ingestion of egg and cows ' milk , one developing colitis . Maternal dietary exclusion seems to benefit some breast fed babies with eczema BACKGROUND Maternal diet during pregnancy might be one of the factors that influences fetal immune responses associated with childhood allergy . OBJECTIVE We analyzed the association between maternal diet during the last 4 wk of pregnancy and allergic sensitization and eczema in the offspring at 2 y of age . DESIGN Data from 2641 children at 2 y of age were analyzed within a German prospect i ve birth cohort study ( LISA ) . Maternal diet during the last 4 wk of pregnancy was assessed with a semiquantitative food-frequency question naire , which was administered shortly after childbirth . RESULTS High maternal intake of margarine [ adjusted odds ratio ( aOR ) : 1 . 49 ; 95 % CI : 1.08 , 2.04 ] and vegetable oils ( aOR : 1.48 ; 95 % CI : 1.14 , 1.91 ) during the last 4 wk of pregnancy was positively associated and high maternal fish intake ( aOR : 0.75 ; 95 % CI : 0.57 , 0.98 ) was inversely associated with eczema during the first 2 y in the offspring . High celery ( aOR : 1.85 ; 95 % CI : 1.18 , 2.89 ) and citrus fruit ( aOR : 1.73 ; 95 % CI : 1.18 , 2.53 ) intakes increased the risk of sensitization against food allergens . In turn , sensitization against inhalant allergens was positively related to a high maternal intake of deep-frying vegetable fat ( aOR : 1.61 ; 95 % CI : 1.02 , 2.54 ) , raw sweet pepper ( aOR : 2.16 ; 95 % CI : 1.20 , 3.90 ) , and citrus fruit ( aOR : 1.72 ; 95 % CI : 1.02 , 2.92 ) . CONCLUSIONS We suggest that the intake of allergenic foods and foods rich in n-6 polyunsaturated fatty acids during pregnancy may increase and foods rich in n-3 polyunsaturated fatty acids may decrease the risk of allergic diseases in the offspring It is uncertain whether B group vitamins are risk or preventive factors for allergic disorders . We prospect ively investigated the association between maternal intake of folate and vitamins B(12 ) , B(6 ) , and B(2 ) during pregnancy and the risk of wheeze and eczema in the infants aged 16 - 24 months . Subjects were 763 Japanese mother-child pairs . Data on maternal intake during pregnancy were assessed with a  diet history question naire ( DHQ ) . Symptoms of wheeze and eczema were based on criteria of the International Study of Asthma and Allergies in Childhood . Among 763 infants , 169 ( 22.1 % ) and 142 ( 18.6 % ) had symptoms of wheeze and eczema  , respectively . There were no evident relationships between maternal consumption  of folate , vitamin B(12 ) , vitamin B(6 ) , and vitamin B(2 ) during pregnancy and the risk of wheeze or eczema in the offspring after adjustment for maternal age , gestation at baseline , residential municipality at baseline , family income , maternal and paternal education , maternal and paternal history of asthma , atopic eczema , and allergic rhinitis , changes in maternal diet in the previous 1 month , season when data at baseline were collected , maternal smoking during pregnancy , baby 's older siblings , baby 's sex , baby 's birth weight , household smoking in the same room as the infant , breastfeeding duration , age at which solid foods were introduced , age of infant at the third survey , and maternal intake of docosahexaenoic acid , n-6 polyunsaturated fatty acids , vitamin D , calcium , vitamin E , and β-carotene during pregnancy . Further investigation is warranted to draw conclusions as to the question of whether maternal B vitamin intake during pregnancy is related to the risk of childhood allergic disorders It has been suggested that changes in dietary habits , particularly increased consumption of omega-6 polyunsaturated fatty acids ( PUFA ) and decreased consumption of omega-3 PUFAs may explain the increase in atopic disease seen in recent years . Furthermore , it seems possible that it is mainly prenatal or very early life environmental factors that influence the development of allergic diseases . It has also been suggested that intrauterine risk factors may act differently if mother themselves suffer from allergic disease . The aim of this study was to investigate whether the consumption of fish , butter and margarine during pregnancy might influence the development of allergic sensitizations in the offspring . The study population was divided into the offspring of allergic and non-allergic mothers . This was a retrospective cohort study enrolling 295 offspring of allergic mothers and 693 of non-allergic mothers . Information regarding maternal intake of fish , butter and margarine during pregnancy as well as other prenatal and perinatal confounding factors were retrospectively assessed by parental report via a st and ardized question naire . Atopy was determined by skin-prick tests ( SPT ) to eight prevalent inhalant allergens and two foods . In the allergic mothers ' group there is no clear correlation between maternal intakes of fish , butter and margarine  and sensitizations to food or inhalants . In the non-allergic mothers ' group there was no correlation between butter and margarine  intake and food or inhalant sensitizations . On the contrary , a protective effect of fish intake on SPT positivity was observed . In particular , frequent maternal intake ( ' 2 - 3 times/wk or more ' ) of fish reduced the risk of food sensitizations by over a third ( aOR 0.23 ; 95 % CI : 0.08 - 0.69 ) . A similar trend , even if not significant , was found for inhalants . Finally , even in the whole study population , i.e. allergic group plus non-allergic group , there was a similar trend between increased consumption of fish and decreased prevalence of SPT positivity for foods . This study shows that frequent intake of fish during pregnancy may contrast the development of SPT sensitizations for foods in the offspring of mothers without atopic disease . Therefore , larger prospect i ve studies are needed , enrolling mothers with and without allergic disease , to confirm these results Objective : To investigate whether exposure to high maternal concentrations of 25(OH)-vitamin D in pregnancy poses any risk to the child . Design : Prospect i ve study . Setting : Princess Anne Maternity Hospital , Southampton , UK.Subjects : A group of 596 pregnant women were recruited . A total of 466 ( 78 % ) children were examined at birth , 440 ( 74 % ) at age 9 months and 178 ( 30 % ) at age 9 years . Methods :  Maternal 25 (OH)-vitamin D concentrations  were measured in late pregnancy . Anthropometry of the child was recorded at birth , 9 months and 9 years . At 9 months , atopic eczema was assessed . At 9 years , children had an echocardiogram and a dual energy x-ray absorptiometry scan , blood pressure , arterial compliance and carotid intima-media thickness were measured and intelligence and psychological function assessed . Results : There were no associations between maternal 25(OH)-vitamin D concentrations and the child 's body size or measures of the child 's intelligence , psychological health or cardiovascular system . Children whose mothers had a 25(OH)-vitamin D concentration in pregnancy > 75 nmol/l had an increased risk of eczema on examination at 9 months ( OR 3.26 , 95 % CI 1.15–9.29 , P=0.025 ) and asthma at age 9 years ( OR 5.40 , 95 % CI , 1.09–26.65 , P=0.038 ) compared to children whose mothers had a concentration of < 30 nmol/l . Conclusion : Exposure to maternal concentrations of 25(OH)-vitamin D in pregnancy in excess of 75 nmol/l does not appear to influence the child 's intelligence , psychological health or cardiovascular system ; there could be an increased risk of atopic disorders , but this needs confirmation in other studies .Sponsorship : The study was supported by the Medical Research Council and WellChild ( previously known as Children Nationwide ) Background : One factor capable of modulating antenatal immune responses is diet . This prospect i ve study examined the association between maternal intake of specific types of fatty acids , cholesterol , fish and meat during pregnancy and the risk of wheeze and eczema in the offspring . Methods : Subjects were 763 mother-child pairs . Data on maternal intake during pregnancy were assessed with a diet history question naire . Data on wheeze and eczema based on criteria of the International Study of Asthma and Allergies in Childhood were obtained from a question naire completed by mothers 16–24 months postpartum . Results : Higher maternal intake of α-linolenic acid and docosahexaenoic acid during pregnancy was independently associated with a reduced risk of wheeze , but not eczema , in the offspring ( adjusted odds ratios ( ORs ) between extreme quartiles 0.52 ( 95 % CI 0.28 to 0.97 ) and 0.37 ( 95 % CI 0.15 to 0.91 ) , respectively ) . Higher maternal intake of n-6 polyunsaturated fatty acids and linoleic acid during pregnancy was independently related to an increased risk of infantile eczema but not wheeze ( adjusted ORs 2.25 ( 95 % CI 1.13 to 4.54 ) and 2.11 ( 95 % CI 1.06 to 4.26 ) , respectively ) . No significant exposure-response relationships were observed between maternal consumption of total fat , saturated fatty acids , monounsaturated fatty acids , eicosapentaenoic acid , arachidonic acid , cholesterol , meat and fish and the ratio of n-3 to n-6 polyunsaturated fatty acid consumption during pregnancy and infantile wheeze or eczema . Conclusions : Maternal intake of α-linolenic acid and docosahexaenoic acid during pregnancy may be preventive against infantile wheeze . Maternal intake of n-6 polyunsaturated fatty acids , especially linoleic acid , during pregnancy may increase the risk of childhood eczema BACKGROUND : It has been postulated that dietary antioxidants may influence the expression of allergic diseases and asthma . To test this hypothesis a case-control study was performed , nested in a cross sectional study of a r and om sample of adults , to investigate the relationship between allergic disease and dietary antioxidants . METHODS : The study was performed in rural general practice s in Grampian , Scotl and . A vali date d dietary question naire was used to measure food intake of cases , defined , firstly , as people with seasonal allergic-type symptoms and , secondly , those with bronchial hyperreactivity confirmed by methacholine challenge , and of controls without allergic symptoms or bronchial reactivity . RESULTS : Cases with seasonal symptoms did not differ from controls except with respect to the presence of atopy and an increased risk of symptoms associated with the lowest intake of zinc . The lowest intakes of vitamin C and manganese were associated with more than fivefold increased risks of bronchial reactivity . Decreasing intakes of magnesium were also significantly associated with an increased risk of hyperreactivity . CONCLUSIONS : This study provides evidence that diet may have a modulatory effect on bronchial reactivity , and is consistent with the hypothesis that the observed reduction in antioxidant intake in the British diet over the last 25 years has been a factor in the increase in the prevalence of asthma over this period BACKGROUND One hundred twenty children , identified before birth as being at high risk for atopy , were prenatally assigned to prophylactic or control groups . METHODS The infants in the prophylactic group either received breast milk from mothers on an exclusion diet or an extensively hydrolyzed formula . Their bedrooms and living rooms were treated repeatedly with an acaricide , and they used polyvinyl-covered mattresses with vented head areas . The infants in the control group were fed conventionally , and no environmental control was recommended . RESULTS A significant advantage , first demonstrated at 1 year of age , persists for children in the prophylactic group . They have less of any allergy or eczema , but the reduced prevalence of asthma is no longer significant . Only three children in the prophylactic group had positive skin prick test results compared with 16 in the control group , suggesting a significant reduction in sensitization . CONCLUSION A dual approach to allergen avoidance , focusing on foods and aeroallergens , appears to be beneficial in selected high-risk infants . Avoidance of potent allergens in early life increases the threshold for sensitization in these high-risk infants . Whether sensitization has been avoided or merely deferred has yet to be proved The influence of the mother 's consumption of cows ’ milk and hens ’ egg on the immune response ( IgE , IgG ) in the mother and foetus was studied in 165 pregnant women with atopical respiratory disease with an allergy to pollen and /or animal d and er . The women were r and omly allocated to four diets ranging from a diet free from hens ’ egg and cows ’ milk to a diet containing intake of one egg and one litre of milk daily during the third trimester . No significant differences in cord blood IgE levels were noted in spite of differences in maternal diet , and no specific IgE antibodies to ovalbumin , ovomucoid and betalactoglobulin were found in the cord blood . The mother 's IgG antibody concentrations to ovalbumin , ovomucoid and betalactoglobulin were influenced by her diet , but cord blood IgG antibody levels to the selected food allergens were unaffected . The data presented on the IgE and IgG antibody levels to ovalbumin , ovomucoid and betalactoglobulin in cord blood suggest that changes in maternal diet during the last trimester of pregnancy in order to prevent atopic sensitization in utero are less likely to affect the foetus than previously supposed Background Maternal dietary avoidance of egg has been recommended to treat egg allergy in breastfed infants . However , only one of three r and omized controlled trials have produced evidence in favour of this recommendation The present prospect i ve study examined the association between maternal consumption of dairy products , calcium , and vitamin D during pregnancy and the  risk of wheeze and eczema in the infants aged 16–24 months . Subjects were 763 Japanese mother – child pairs . Data on maternal intake during pregnancy were assessed with a diet history question naire . Symptoms of wheeze and eczema were based on criteria of the International Study of Asthma and Allergies in Childhood . Higher maternal intake of total dairy products , milk , cheese and calcium during pregnancy was significantly related to a decreased risk of infantile wheeze , but not eczema ( adjusted ORs ( 95 % CI ) between extreme quartiles were 0.45 ( 0.25−0.79 ) , 0.50 ( 0.28−0.87 ) , 0.51 ( 0.31−0.85 ) , and 0.57 ( 0.32−0.99 ) , respectively ) . When  maternal vitamin D consumption during pregnancy was categorised into two groups using a cut-off point at the 25th percentile , children whose mothers had consumed ≥4.309 μg·day−1 had a significantly reduced risk of wheeze and eczema ( adjusted ORs ( 95 % CI ) were 0.64 ( 0.43−0.97 ) and 0.63 ( 0.41−0.98 ) , respectively ) . Higher consumption of calcium and dairy foods other than yoghurt during pregnancy may reduce the risk of infantile wheeze .  Higher vitamin D intake during pregnancy may be protective against childhood wheeze and eczema OBJECTIVES We investigated the relationship between  breastfeeding  ,  asthma and atopy , and  child body mass index ( BMI ) . METHODS From a prospect i ve birth cohort ( n = 2860 ) in Perth , Western Australia , 2195 children were followed up to age 6 years . Asthma was defined as doctor-diagnosed asthma and wheeze in the last year , and atopy was determined by skin prick test of 1596 children .  Breastfeeding , BMI , asthma , and atopy were regressed allowing for confounders and the propensity score for overweight . RESULTS Using fractional polynomials , we found no association between breastfeeding and overweight . Less exclusive breastfeeding was associated with increased asthma and atopy , and BMI increased with asthma . CONCLUSIONS Less exclusive breastfeeding leads to increases in  child asthma and atopy and a higher BMI is a risk factor for asthma BACKGROUND The rise in asthma prevalence over the last few decades may be a result of changes in prenatal or early-life environment , including maternal diet during pregnancy . Previous studies have found associations between individual foods or nutrients consumed during pregnancy and  asthma or wheeze in children , but these may be confounded by overall dietary pattern . OBJECTIVE To determine whether overall maternal dietary pattern during pregnancy is associated with  recurrent wheeze in children . METHODS A total of 1376 mother-infant pairs from Project Viva , a longitudinal prebirth cohort , who had responses for food frequency question naires in the first and second trimester and outcome data at 3 years of age were included .  Multivariable logistic regression was used to look at associations between dietary pattern and the primary outcome of recurrent wheeze at 3 years . Overall  dietary  pattern was examined by using  Mediterranean diet score , Alternate Healthy Eating Index modified for pregnancy ( AHEI-P ) , and principal components analysis to look at Western and Prudent diets . RESULTS None of these dietary patterns was associated with the primary outcome of recurrent wheeze in children in either the crude or the multivariable model ( multivariable model , odds ratio per 1-point increase in Mediterranean diet , 0.98 [ 95 % CI , 0.89 - 1.08 ] ; AHEI-P , 1.07 [ 0.87 - 1.30 ] ; Prudent , 1.02 [ 0.83 - 1.26 ] ; Western , 0.98 [ 0.81 - 1.19 ] ) . CONCLUSION Overall dietary pattern during pregnancy is not associated with recurrent wheeze in this cohort . Maternal intake of individual nutrients may be more important determinants of offspring wheeze-associated illness than is dietary pattern BACKGROUND The natural history of allergic disease and its potential for prevention merit close examination because of the explosive worldwide increase in the prevalence and morbidity of atopic disorders . This study examines the development of atopy at age 7 years in 165 children in a high-risk cohort , previously reported from birth to age 4 years . METHODS In this prospect i ve , r and omized , controlled study of food allergen avoidance in infancy , the prophylactic-treated group consisted of infants whose mothers avoided cow 's milk , egg , and peanut during the last trimester of pregnancy and lactation and who , themselves ,  avoided cow 's milk until age 1 year ( casein hydrolysate supplementation before age 1 ) , egg until age 2 years , and peanut and fish until age 3 years . The control group consisted of maternal/infant pairs who followed st and ard feeding practice s. RESULTS Despite a significant reduction in food allergy and milk sensitization before age 2 years , none of the following differed between the groups at age 7 years : food allergy , atopic dermatitis , allergic rhinitis , asthma , any atopic disease , lung function , food or aeroallergen sensitization , serum IgE level , or presence of nasal eosinophils or nasal basophilic cells .  Children with food allergy by 4 years evidence d higher 7-year ( current ) prevalences of allergic rhinitis and asthma ( p < 0.01 ) . Atopic diseases/parameters at age 7 years were shown , by multivariate analysis ( p < 0.05 ) , to be associated with several genetic and environmental risk factors ( male gender , maternal nonwhite ethnicity and asthma , and household smoking ) , as well as predictive atopic markers during infancy ( elevated serum IgE level ; egg , cow 's milk , and peanut sensitization ; and nasal eosinophils and nasal basophilic cells ) . CONCLUSIONS These findings help to : ( 1 ) eluci date the natural history of atopic disease in high-risk children ; ( 2 ) document the progression of allergy from atopic dermatitis , food allergy , and food sensitization to respiratory allergy and aeroallergen sensitization despite food allergy prevention in infancy ; ( 3 ) identify allergy predictive markers ; and ( 4 ) exp and our appreciation of the interactions of genetic and environmental factors in the development of atopy There is much evidence that the development of allergic disorders may be related to early exposure of allergens , including those in breastmilk . We have tried to find out whether avoidance of food and inhaled allergens in infancy protects against the development of  allergic disorders in high-risk infants . In a prenatally r and omised , controlled study 120 infants with family history of atopy and high ( greater than 0.5 kU/l ) cord-blood concentrations of total IgE were allocated r and omly to prophylactic and control groups . In the prophylactic group ( n = 58 ) , lactating mothers  avoided allergenic foods ( milk , egg , fish , and nuts ) and avoided feeding their infants these foods and soya , wheat , and orange  up to the age of 12 months ; the infants ' bedrooms and living rooms were treated with an acaricidal powder and foam every 3 months , and concentrations of Dermatophagoides pteronyssinus antigen(Der p l ) in dust sample s were measured by enzyme-linked immunosorbent assay . In the control group ( n = 62 ) , the diet of mothers and infants was unrestricted ; no acaricidal treatment was done and Der p l concentrations were measured at birth and at 9 months . A paediatric allergy specialist unaware of group assignment examined the infants for allergic disorders at 10 - 12 months . Odds ratios were calculated by logistic regression analysis for various factors with control for other confounding variables . At 12 months , allergic disorders had developed in 25 ( 40 % ) control infants and in 8 ( 13 % ) of the prophylactic group ( odds ratio 6.34 , 95 % confidence intervals 2.0 - 20.1 ) . The prevalences at 12 months of asthma ( 4.13 , 1.1 - 15.5 ) and eczema ( 3.6 , 1.0 - 12.5 ) were also significantly greater in the control group .  Parental smoking was a significant risk factor for total allergy at 12 months whether only one parent smoked ( 3.97 , 1.2 - 13.6 ) or both parents smoked ( 4.72 , 1.2 - 18.2 ) Background The value of allergen elimination diets during pregnancy for primary prevention of infant allergy has been question ed . However , dietary compliance may influence effectiveness Objective To determine whether dietary n-3 long chain polyunsaturated fatty acid ( LCPUFA ) supplementation of pregnant women with a fetus at high risk of allergic disease reduces immunoglobulin E associated eczema or food allergy at 1 year of age . Design Follow-up of infants at high hereditary risk of allergic disease in the Docosahexaenoic Acid to Optimise Mother Infant Outcome ( DOMInO ) r and omised controlled trial . Setting Adelaide , South Australia . Participants 706 infants at high hereditary risk of developing allergic disease whose mothers were participating in the DOMInO trial . Interventions The intervention group ( n=368 ) was r and omly allocated to receive fish oil capsules ( providing 900 mg of n-3 LCPUFA daily ) from 21 weeks ’ gestation until birth ; the control group ( n=338 ) received matched vegetable oil capsules without n-3 LCPUFA . Main outcome measure Immunoglobulin E associated allergic disease ( eczema or food allergy with sensitisation ) at 1 year of age . Results No differences were seen in the overall percentage of infants with immunoglobulin E associated allergic disease between the n-3 LCPUFA and control groups ( 32/368 ( 9 % ) v 43/338 ( 13 % ) ; unadjusted relative risk 0.68 , 95 % confidence interval 0.43 to 1.05 , P=0.08 ; adjusted relative risk 0.70 , 0.45 to 1.09 , P=0.12 ) , although the percentage of infants diagnosed as having atopic eczema ( that is , eczema with associated sensitisation ) was lower in the n-3 LCPUFA group ( 26/368 ( 7 % ) v 39/338 ( 12 % ) ; unadjusted relative risk 0.61 , 0.38 to 0.98 , P=0.04 ; adjusted relative risk 0.64 , 0.40 to 1.02 , P=0.06 ) . Fewer infants were sensitised to egg in the n-3 LCPUFA group ( 34/368 ( 9 % ) v 52/338 ( 15 % ) ; unadjusted relative risk 0.61 , 0.40 to 0.91 , P=0.02 ; adjusted relative risk 0.62 , 0.41 to 0.93 , P=0.02 ) , but no difference between groups in immunoglobulin E associated food allergy was seen . Conclusion n-3 LCPUFA supplementation in pregnancy did not reduce the overall incidence of immunoglobulin E associated allergies in the first year of life , although atopic eczema and egg sensitisation were lower . Longer term follow-up is needed to determine if supplementation has an effect on respiratory allergic diseases and aeroallergen sensitisation in childhood . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12610000735055 ( DOMInO trial : ACTRN12605000569606 ) Infants born to atopic parents have been found to be at high risk of allergy development . The present study investigated the effect of a maternal milk-free diet during late pregnancy and lactation on the immune response and allergy incidence in at-risk and control infants . Atopic mothers were r and omly allocated into an intervention group ( n 12 ) or an unrestricted-diet group ( n14 ) and compared with  non-atopic mothers following an unrestricted diet ( n 12 ) . The intervention involved a maternal milk-free diet during late pregnancy and lactation . Infants were followed up for 18 months postnatally . A significant fall in maternal serum beta-lactoglobulin (beta-Lg)-immunoglobulin G ( IgG ) antibody levels ( P < 0.05 ) was observed after a 7-week milk-exclusion diet . In maternal and cord serum sample s the levels of beta-Lg-IgG and alpha-casein-IgG antibodies were significantly correlated ( r 0.89 , P < 0.0001 and r 0.71 , P < 0.001 respectively ) . Higher levels of beta-Lg-IgG ( P < 0.05 ) were observed in the cord serum sample s compared with paired maternal serum sample s. Single-blind allergy assessment by a paediatrician at 12 and 18 months showed that the infants born in the non-atopic group had a significantly lower allergy incidence compared with the infants born in the atopic group following an unrestricted diet ( P < 0.008 and P < 0.02 respectively ) . The allergy incidence in the infants born in the atopic diet group was significantly lower compared with that of the atopic group following an unrestricted diet ( P < 0.04 ) . It was observed that the atopic nature of the parents significantly affected the allergy incidence in their children . A trend towards a beneficial effect of a maternal milk-free diet during late pregnancy and lactation was also observed in infants born to atopic parents Abstract The preventive effect of maternal avoidance of cow 's milk and eggs on the development of atopic dermatitis and sensitization to food allergens was studied in a prospect i ve trial with families at high risk for atopy . intervention included encouraging exclusive breast feeding for at least 3 months and delaying the controlled introduction of solid foods . In addition , one group received a maternal diet with the complete avoidance of milk and eggs in the last trimester of pregnancy and during the period of exclusive breast feeding , another group had the same diet starting after delivery , and mothers of the third group had no dietary restrictions . The period prevalences of atopic dermatitis as well as the rates of specific sensitization to eggs and milk at 6 and 12 months were not significantly different between groups . We were unable to demonstrate a significant preventive effect of maternal diet . Conclusion While breast feeding should be promoted for children at risk for atopy , mothers can be encouraged to stay on normal diet during pregnancy and the breast feeding period The 209 mothers to be , enrolled in a r and omized , prospect i ve , allergy-prevention study from allergy-prone families , totally abstained from cow 's milk and egg  from gestational week 28 to delivery . This article presents the development of allergic disease at 5 years of age in their children , compared with the development of allergic disease in the children of the control mothers who took normal food throughout pregnancy . The prevalence of allergic disease could be evaluated in 198 children ( 95 % ) .  Allergic disease was monitored with  question naires , skin prick testing , serum-IgE determinations , and physical examination . Eczema , allergic rhinoconjunctivitis , and asthma was equally common in the groups . Persistent food intolerance to egg was significantly more common in children of the mothers receiving the diet . This long-term follow-up confirms our previous findings that maternal elimination diet during late pregnancy does not prevent the development of allergic disease in the genetically predisposed child BACKGROUND Data for trends in prevalence of asthma , allergic rhinoconjunctivitis , and eczema over time are scarce . We repeated the International Study of Asthma and Allergies in Childhood ( ISAAC ) at least 5 years after Phase One , to examine changes in the prevalence of symptoms of these disorders . METHODS For the ISAAC Phase Three study , between 2002 and 2003 , we did a  cross-sectional question naire survey of 193,404 children aged 6 - 7 years from 66 centres in 37 countries , and 304,679 children aged 13 - 14 years from 106 centres in 56 countries , chosen from a r and om sample of schools in a defined geographical area . FINDINGS Phase Three was completed a mean of 7 years after Phase One . Most centres showed a change in prevalence of 1 or more SE for at least one disorder , with increases being twice as common as decreases , and increases being more common in the 6 - 7 year age-group than in the 13 - 14 year age-group , and at most levels of mean prevalence . An exception was asthma symptoms in the older age-group , in which decreases were more common at high prevalence . For both age-groups , more centres showed increases in all three disorders more often than showing decreases , but most centres had mixed changes . INTERPRETATION The rise in prevalence of symptoms in many centres is concerning , but the absence of increases in prevalence of asthma symptoms for centres with existing high prevalence in the older age-group is reassuring . The divergent trends in prevalence of symptoms of allergic diseases form the basis for further research into the causes of such disorders Background / Objectives : Maternal fish consumption during pregnancy might influence the fetal immune system through anti-inflammatory effects of omega-3 fatty acids , and might affect the risks of childhood asthma and atopy . In Generation R , a prospect i ve cohort study in the Netherl and s , we examined the associations of first trimester fish consumption with childhood wheezing and eczema in the first 4 years of life . Methods : In total , 2976 mothers completed a 293-item semiquantitative food frequency question naire covering dietary intake in the first trimester . The occurrence of wheezing and eczema was yearly assessed by question naires . Results : Median weekly fish consumption was 83 ( 95 % range 0–316 ) grams per week . We observed no consistent associations of maternal total- , lean- or fatty-fish consumption during pregnancy with the risks of childhood wheezing . Maternal shellfish consumption of 1–13 g per week was associated with overall increased risks of childhood wheezing and eczema ( OR 1.20 ( 1.04 , 1.40 ) and OR 1.18 ( 1.01 , 1.37 ) , respectively ) . Maternal fatty fish consumption of 35–69 g per week was associated with increased overall risks of childhood eczema ( OR 1.17 ( 1.00 , 1.38 ) ) , but maternal total- or lean-fish consumption was not . Conclusions : During pregnancy , shellfish consumption was associated with increased risks of wheezing and eczema , while fatty fish consumption was associated with a higher risk of eczema only . Maternal total fish or lean fish consumption were not associated with wheezing or eczema . Further studies are needed to replicate these findings and to explore underlying mechanisms One hundred and sixty‐two women with respiratory allergy to animal d and ers and /or pollens were r and omly allocated to a diet consisting of either a very low ingestion of hens ' egg and cows ' milk or a daily ingestion of one hens ' egg and about 11 of cows ' milk during the last 3 months of pregnancy .  One hundred and sixty‐three infants were followed prospect ively up to 18 months of age when the cumulated incidence of atopic disease in each child was evaluated blindly . No significant differences in the distribution of atopic disease were found among the infants in relation to the maternal diet during late pregnancy . The numbers of skin‐prick tests positive to ovalbumin , ovomucoid , β‐lactoglobulin and cows ' milk were likewise not influenced by differences in the maternal diet during late pregnancy . Genetic factors rather than maternal diet during the perinatal period probably have a greater effect on the incidence of atopic diseases during early infancy BACKGROUND Early life allergen exposure may increase the risk of childhood allergy , but the protective effect of reduction in allergen exposure remains uncertain . OBJECTIVE To evaluate the effect of reduction in food and house dust mite ( HDM ) allergen exposure in infancy in preventing asthma and allergy . METHODS Infants , at higher risk because of family predisposition , were recruited prenatally and r and omized to prophylactic ( n = 58 ) and control ( n = 62 ) groups . Prophylactic group infants were either breast-fed with mother on a low allergen diet or given an extensively hydrolyzed formula . Exposure to HDM was reduced by the use of an acaricide and mattress covers . The control group followed st and ard advice .  Development of allergic diseases and sensitization to common allergens ( atopy ) was assessed blindly at ages 1 , 2 , 4 , and 8 years in all 120 children . RESULTS Repeated measurement analysis , adjusted for all relevant confounding variables , confirmed a preventive effect on asthma : adjusted odds ratio ( OR ) , 0.24 ; 95 % CI , 0.09 - 0.66 ; P = .005 ; atopic dermatitis , OR , 0.23 ; CI , 0.08 - 0.64 ; P = .005 ; rhinitis , OR , 0.42 ; CI , 0.19 - 0.92 ; P = .03 ; and atopy , OR , 0.13 ; CI , 0.05 - 0.32 ; P < .001 . The protective effect was primarily observed in the subgroup of children with persistent disease ( symptoms at all visits ) and in those with evidence of allergic sensitization . CONCLUSION Allergic diseases can be reduced , for at least the first 8 years of life , by combined food and HDM allergen avoidance in infancy . CLINICAL IMPLICATION S Strict food and HDM allergen avoidance should be considered for prevention of allergy in high-risk infants Background There are ambiguous results regarding the role n-3 polyunsaturated fatty acids and fish might play in primary prevention of allergic diseases .  The aim was to investigate the association between cod liver oil and fish consumption during pregnancy and in the first year of life and  asthma and eczema  at 2 years of age . Methods From the Prevention of Allergy among Children in Trondheim study , a prospect i ve birth cohort study in primary healthcare in Trondheim , Norway , 3086 children were followed prospect ively from 1 year to approximately 2 years of age . The primary outcome variable was parental reported asthma and eczema at 2 years . Results The mean age for introducing fish in the diet was 9.1 months . Excluding children with incident eczema before 1 year , a reduced risk of developing eczema was found if the child was eating fish once a week or more , adjusted OR ( aOR ) for any kind of fish 0.62 ( 95 % CI 0.42 to 0.91 p=0.02 ) , for oily fish aOR 0.21 ( 95 % CI 0.05 to 0.86 p=0.03 ) and for lean fish aOR 0.67 ( 95 % CI 0.41 to 1.08 p=0.10 ) . The associations between maternal diet and eczema at 2 years and between the dietary factors and doctor-diagnosed asthma were all insignificant . Conclusions Fish consumption in infancy was more important than maternal fish intake during pregnancy in preventing eczema in childhood . The intake of fish per se , not specifically n-3 polyunsaturated fatty acids , was most important in preventing eczema Interest has increased in the possibility that maternal dietary intake during pregnancy might influence the development of allergic disorders in children . The present prospect i ve study examined the association of maternal intake of selected foods high in fatty acids and specific types of fatty acids during pregnancy with the risk of suspected atopic eczema among Japanese infants aged 3 - 4 months . Subjects were 771 mother-child pairs . Information on maternal dietary intake during pregnancy was assessed with a vali date d self-administered diet history question naire . The term ' suspected atopic eczema ' was used to define an outcome based on results of our question naire completed by mothers 3 - 4 months postpartum . The risk of suspected atopic eczema was 8.4 % ( n = 65 ) . Higher maternal intake of  meat  during pregnancy was significantly associated with an increased risk of suspected atopic eczema in the offspring : the multivariate odds ratio ( OR ) for the highest vs. lowest quartile was 2.59 [ 95 % confidence interval ( CI ) : 1.15 - 6.17 , p for trend = 0.01 ] . The positive association was strengthened when the definition of the outcome was confined to a definite physician 's diagnosis of atopic eczema ( n = 35 ) : the multivariate OR between extreme quartiles was 3.53 ( 95 % CI : 1.19 - 12.23 , p for trend = 0.02 ) . No material exposure-response relationships were observed between maternal intake of eggs , dairy products , fish , total fat , saturated fatty acids , monounsaturated fatty acids , n-3 polyunsaturated fatty acids , alpha-linolenic acid , eicosapentaenoic acid , docosahexaenoic acid , n-6 polyunsaturated fatty acids , linoleic acid , arachidonic acid and cholesterol and the ratio of n-3 to n-6 polyunsaturated fatty acid consumption and the risk of suspected atopic eczema . Higher maternal meat intake may increase the risk of infantile atopic eczema , whereas we found no evidence that maternal intake of fish and n-3 polyunsaturated fatty acids are preventive against infantile atopic eczema To study the possibility of intrauterine sensitization , 212 women were enrolled on a voluntary basis into a prospect i ve , r and omized study , comparing the effects of an elimination diet and normal food during late pregnancy . The diet group took no cow milk and no egg from week 28 to delivery , and extra calcium and casein hydrolysate ( Nutramigen ® ) supplement was given to fill the nutritional needs of mother and child . The control group took normal food , including approximately 1/2 liter of milk/day and 3–5 eggs/week . All families had a history of allergy in mother , father , or sibling . Maternal weight gain during pregnancy was significantly lower in the diet group . Birth weights showed no significant difference between the two main groups , but smokers in the elimination diet group had significantly smaller babies . IgE antibodies to cow milk and egg were significantly higher in atopic than in non‐atopic women before the trial . The diet caused a significant fall in IgG‐antibodies to cow milk and egg in both atopic and non‐atopic subjects . Cord blood IgE determination revealed no significant difference between the groups . No IgE antibodies to cow milk or egg were detected in any of the cord sera . The participating babies are being followed up until 18 months of age In a prospect i ve , r and omized study , we have monitored the effect of maternal abstention from cow 's milk and egg on the development of  atopy in babies . Two hundred twelve women were followed from midpregnancy . We report the occurrences of allergies in their babies up to 18 months of age , as assessed by skin prick testing , determination of serum IgE , question naires , and blinded physical examination by a pediatric allergist . Whatever the method that was used , there was no statistically significant difference between babies whose mothers received the " diet " or the " nondiet . " Other factors known to influence the risk of atopy like heredity , sex , month of birth , breast-feeding , and exposure to tobacco smoke , animal d and ruff , and solid food did not differ between the groups . The mothers receiving the exclusion diet , by their own choice , had diminished their intake of milk and egg during lactation also , and therefore , their babies were significantly less exposed to cow 's milk before 6 months . Still , atopy was equally abundant among their children . Thus , maternal elimination diet during late pregnancy did not protect the baby against allergy OBJECTIVE To assess whether the maternal consumption of milk and milk products affects development of cow 's milk ( CM ) antibodies in infants . DESIGN A r and omized pilot trial using food frequency question naires ( mothers ) and food records ( infants ) . SETTING Families with a newborn infant with increased HLA-DQB1-conferred risk of type 1 diabetes and at least one first-degree relative affected by type 1 diabetes from 16 hospitals in Finl and between April 1995 and November 1997 . SUBJECTS AND INTERVENTION Infants r and omized to receive a hydrolysed formula when breast milk was not available during their first 6 - 8 mo ( n=112 ) . Of these , 13 dropped out by the age of 3 mo and two were excluded due to incomplete CM antibody data . RESULTS Maternal milk protein intake from cheese during pregnancy was inversely related to IgA-class antibody titres to beta-lactoglobulin ( BLG ) and casein ( CAS ) at 3 mo , and to IgA antibody titres to BLG at 6 mo . Maternal consumption of raw milk products during lactation was positively related to the development of IgA antibody titres to CAS at 6 mo , and inversely correlated to IgG antibody titres to bovine serum albumin ( BSA ) and IgA antibody titres to CAS at 2 y. Maternal cheese consumption was inversely related to the IgG antibody titres to CM formula and CAS and to the IgA antibody titres to CAS in early infancy . CONCLUSIONS Few associations were established between maternal CM protein intake and CM protein antibody levels in the infants . The milk and milk products taken by the mother differed in their impact on the emerging CM antibody response in the offspring BACKGROUND There is growing interest in the potential role of anti-inflammatory n-3 polyunsaturated fatty acids ( n-3 PUFAs ) in the prevention of allergic disease . OBJECTIVE We sought to determine whether maternal dietary supplementation with n-3 PUFAs during pregnancy could modify immune responses in infants . METHODS In a r and omized , controlled trial 98 atopic , pregnant women received fish oil ( 3.7 g n-3 PUFAs per day ) or placebo from 20 weeks ' gestation until delivery . Neonatal PUFA levels and immunologic response to allergens were measured at birth . RESULTS Eighty-three women completed the study .  Fish oil supplementation ( n = 40 ) achieved significantly higher proportions of n-3 PUFAs in neonatal erythrocyte membranes ( mean + /- SD , 17.75 % + /- 1.85 % as a percentage of total fatty acids ) compared with the control group ( n = 43 , 13.69 % + /- 1.22 % , P < .001 ) . All neonatal cytokine ( IL-5 , IL-13 , IL-10 , and IFN-gamma ) responses ( to all allergens ) tended to be lower in the fish oil group ( statistically significant only for IL-10 in response to cat ) . Although this study was not design ed to examine clinical effects , we noted that infants in the fish oil group were 3 times less likely to have a positive skin prick test to egg at 1 year of age ( odds ratio , 0.34 ; 95 % confidence interval , 0.11 to 1.02 ; P = .055 ) . Although there was no difference in the frequency of atopic dermatitis at 1 year of age , infants in the fish oil group also had significantly less severe disease ( odds ratio , 0.09 ; 95 % confidence interval , 0.01 to 0.94 ; P = .045 ) . CONCLUSIONS These data suggest a potential reduction in subsequent infant allergy after maternal PUFA supplementation . More detailed follow-up studies are required in larger cohorts to establish the robustness of these findings and to ascertain their significance in relation to longer-term modification of allergic disease in children The effect of a milk‐free diet during late pregnancy and lactation , on levels of cows’milk specific antibodies and antigens in breast milk , was examined . Women with an allergic condition ( defined as atopic ) were r and omly allocated to a milk‐free diet ( n= 10 ) or an unrestricted diet ( n= 12 ) . Twelve non‐atopic women followed an unrestricted diet . A significant reduction ( p < 0.001 ) in β‐lactoglobulin‐specific immunoglobulin A and α‐casein‐specific immunoglobulin A levels was observed over the first 5 days in all groups . The mean level of β‐lactoglobulin antigens in breast milk from women who adhered strictly to the milk‐free diet was significantly lower than the levels of the atopic group on the unrestricted diet ( p < 0.02 ) . The allergy incidence in the infants born in the atopic diet group was significantly lower compared with that of the atopic group on the unrestricted diet In an attempt to prevent or reduce the manifestations of atopic disease , a group of infants considered to be genetically at high risk of atopy was entered in a prenatally r and omized , controlled study . A prophylactic group ( n= 58 ) was either breast‐fed with their mothers excluding foods regarded as highly antigenic from their diets , or given an extensively hydrolysed formula . In addition , strenuous efforts were made to reduce exposure to the house‐dust mite by application of acaricide to the bedroom and living room carpets and upholstered furniture . A control group ( n= 62 )  was fed conventionally by breast or on formula , and no specific environmental measures were taken . The results ( previously reported ) after 1 year showed significantly less total allergy , asthma , and eczema in the prophylactic group . Similar results were obtained at 2 years although the reduction in asthma no longer achieved statistical significance . However , there was significantly less sensitization , as shown by a battery of skin prick tests ( SPTs ) , to both dietary allergens and aeroallergens in the prophylactic group . A11 the children have now been review ed at the age of 4 years , and SPTs to a wide range of dietary allergens and aeroallergens have been performed . The control group continues to show more total allergy ( odds ratio [ OR ] 2.73 , 95 % confidence interval [ CI ] 1.21–6.13 , P<0.02 ) , definite allergy ( allergic symptoms plus positive SPT ) ( OR 5.6 , CI 1.8–17.9 , P<0.005 ) , and eczema ( OR 3.4 , CI 1.2–10.1 , P<0.05 ) . More control children have positive SPTs ( OR 3.7 , CI 1.3–10.0 , P<0.02 ) . A dual approach to the prevention of allergic disease , avoiding as far as possible sensitization to food and aeroallergens , significantly reduces the risk of atopic disease . This should be reserved for infants considered at very high risk of atopy , and close medical and dietetic supervision must be available The effect of maternal and infant avoidance of allergenic foods on food allergy was examined in a prenatally r and omized , controlled trial of infants of atopic parents . The diet of the prophylactic-treated group ( N = 103 ) included ( 1 ) maternal avoidance of cow 's milk , egg , and peanut during the third trimester of pregnancy and lactation and ( 2 ) infant use of casein hydrolysate ( Nutramigen ) for supplementation or weaning , and avoidance of solid foods for 6 months ; cow 's milk , corn , soy , citrus , and wheat , for 12 months ; and egg , peanut , and fish , for 24 months . In the control group ( N = 185 ) , mothers had unrestricted diets , and infants followed American Academy of Pediatrics feeding guidelines . The cumulative prevalence of atopy was lower at 12 months in the prophylactic-treated ( 16.2 % ) compared to the control ( 27.1 % ) group ( p = 0.039 ) , result ing from reduced food-associated atopic dermatitis , urticaria and /or gastrointestinal disease by 12 months ( 5.1 % versus 16.4 % ; p = 0.007 ) , and any positive food skin test by 24 months ( 16.5 % versus 29.4 % ; p = 0.019 ) , caused primarily by fewer positive milk skin tests ( 1 % versus 12.4 % ; p = 0.001 ) . The prevalences of allergic rhinitis , asthma , and inhalant skin tests were unaffected . Serum IgE levels in the prophylactic-treated group were marginally lower only at 4 months . Thus , reduced exposure of infants to allergenic foods appeared to reduce food sensitization and allergy primarily during the first year of life BACKGROUND Maternal diet during pregnancy might influence the development of childhood allergic disorders . AIMS This prospect i ve study examined the relationship between  maternal dietary patterns during pregnancy and the  risk of wheeze and eczema in the offspring aged 16 - 24 months . MATERIAL S & METHODS Subjects were 763 mother-child pairs . Data on maternal intake during pregnancy were assessed with a diet history question naire . Dietary patterns were derived from factor analysis of 33 predefined food groups . Symptoms of wheeze and eczema were based on criteria of the International Study of Asthma and Allergies in Childhood . Adjustment was made for maternal age , gestation , residential municipality , family income , maternal and paternal education , maternal and paternal history of allergic disorders , changes in maternal diet in pregnancy , season at baseline , maternal smoking during pregnancy , baby 's older siblings , sex , birth weight , age at the third survey , household smoking , and breastfeeding duration . RESULTS Three dietary patterns were identified : ' healthy ' , characterized by high intake of green and yellow vegetables , seaweed , mushrooms , white vegetables , pulses , potatoes , fish , sea products , fruit , and shellfish ; ' Western ' , characterized by high intake of vegetable oil , salt-containing seasonings , beef and pork , processed meat , eggs , chicken , and white vegetables ; and ' Japanese ' , characterized by high intake of rice , miso soup , sea products , and fish . There was a tendency for an inverse exposure-response relationship between the maternal Western pattern during pregnancy and the risk of childhood wheeze by crude analysis . After adjustment for the confounding factors under study , the inverse relationship was strengthened : the adjusted OR between extreme quartiles was 0.59 ( 95 % CI : 0.35 - 0.98 , p for trend = 0.02 ) . No such inverse association was observed for childhood eczema . Neither the maternal healthy pattern nor the Japanese pattern during pregnancy was related to childhood wheeze or eczema . CONCLUSION The maternal Western pattern during pregnancy may be preventive against wheeze  in the offspring
OBJECTIVES The aim of this study was to investigate the relationship between  maternal diet during pregnancy and lactation and development of  atopic disorders in childhood .