Allergy prevention - Current recommendations and new insights.

BACKGROUND: The prevalence of allergic disease has increased considerably in recent decades and Australia has one of the highest rates of allergic disease in the world. As there is currently no cure for allergic diseases, prevention offers a logical approach to addressing the rising burden of disease. The factors responsible for this escalation in prevalence remain unclear, and strategies for allergy prevention remain limited. OBJECTIVE: This article discusses current recommendations for allergy prevention and highlights new insights into allergic disease. DISCUSSION: History of allergic disease in a first degree relative is currently the only useful indicator for increased risk of developing allergic disease in a child. Prevention strategies should be directed to these high risk individuals. Currently, maternal dietary restriction during pregnancy or lactation and aeroallergen avoidance are not recommended. Breastfeeding is recommended, and where not possible or insufficient, a partially hydrolysed formula should be used in high risk infants. Introduction of solids should be delayed to 4-6 months of age. There is no evidence that delaying solids beyond this age is of benefit. There is currently insufficient evidence to recommend the addition of probiotics for allergy prevention.