Divezzamento e allergia alimentare

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Conclusioni

L’epoca di introduzione, la sequenza e il tipo di alimenti da assumere durante lo svezzamento seguono, oggi, schemi e raccomandazioni molto meno rigide rispetto al passato. Le evidenze attuali suggeriscono di non ritardare oltre il 6° mese l’introduzione di alimentazione complementare. Posticipare l’assunzione di arachidi, pesce o uovo non previene, e potrebbe perfino aumentare, il rischio di sviluppare l’allergia alimentare. Quale sia il reale ruolo protettivo della contemporanea presenza di latte materno o di componenti dietetiche specifiche quali i grassi polinsaturi è ancora oggetto di ricerca. Lo svezzamento può rappresentare, in alcuni casi, l’epoca di insorgenza della FPIES, mentre la ritardata assunzione di glutine non costituisce un fattore protettivo per l indirizzo per la corrispondenza: o sviluppo di celiachia.

 

Bibliografia

  1. WHO. Guiding principles for complementary feeding of the breastfed child. www.who.int/nutrition/en/
  2. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientifi c Opinion on the appropriate age for introduction of complementary feeding of infants. EFSA J. 2009; 7(12): 1423-61.
  3. Schiess SA, Grote V, Scaglioni S, et al. Introduction of complementary feeding in 5 European Countries. J Ped Gastroenterol Nutition. 2010; 50: 92–98.
  4. Agostoni C, Decsi T, Fewtrell M, et al. for ESPGHAN committee on Nutrition. Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition. JPGN 2008; 46: 99-110.
  5. Alvisi P, Brusa S, Alboresi S, et al. Recommendations on complementary feeding for healthy, full-term infants. Ital J Pediatr. 2015; 41: 36. Published online 2015 April 28.
  6. Zuccotti GV, Cassatella C, Morelli A, et al. Nutrient intake in italian infants and toddlers from North and South Italy: The Nutrintake 636 Study. Nutrients. 2014; 6(8): 3169- 3186.
  7. American Academy of Pediatrics. Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics 2000; 106 (2 Pt 1): 346-349.
  8. Muraro A, Dreborg S, Halken S, et al. Dietary prevention of allergic disease in infants and small children. Part III: critical review of published peer-reviewed observational and inteventional studies and fi nal recommendations. Pediatr Allergy Immunol 2004; 15: 291-307.
  9. Agostoni C, Laicini F. Early exposure to allergens: a new window of opportunity for non-communicable disease prevention in complementary feeding? Int J Food Sci Nutr 2014 ;65 :1-2.
  10. Greer FR, Sicherer SH, Burks AW, American Academy of Pediatrics Committee on Nutrition, American Academy of Pediatrics Section on Allergy and Immunology. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods and hydrolyzed formulas. Pediatrics 2008; 121: 183-191.
  11. Kull I, Bergström A, Lilja G, et al. Fish consumption during the fi rst year of life and development of allergic diseases during childhood. Allergy 2006; 61(8): 1009-1015.
  12. Nwaru BL Takkinen HM, Niemelä O, et al. Timing of infant feeding in relation to childhood asthma and allergic disease. J Allergy Clin Immunol 2013; 131: 78-86.
  13. Du Toit G, Roberts G, Sayre PH et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015; 372(9): 803-813.
  14. Prescott SL, Smith P, Tang M, et al. The importance of early complementary feeding in the development of oral tolerance: concerns and controversies. Pediatric Allergy and Immunology 2008; 19: 375-80.
  15. Grimshaw KEC, Maskell J, Oliver EM, et al Introduction of complementary foods and the relationship to food allergy. Pediatrics 2013; 132: e1529-e1538.
  16. Chan ES, Cummings C, Atkinson A, et al. Dietary exposures and allergy prevention in high-risk infants: a joint position statement of the Canadian Society of Allergy and Clinical Immunology and the Canadian Paediatric Society. Allergy Asthma Clin Immunol. 2014; 10(1): 45.
  17. Zutavern A, et al. Timing of solid food introduction in relation to eczema, asthma, allergic rhinitis, and food and inhalant sensitization at the age of 6 years: results from the prospective birth cohort study LISA. Pediatrics 2008; 121: e44-52.
  18. Poole JA, Barriga K, Leung DY, et al. Timing of initial exposure to cereal grains and the risk of wheat allergy. Pediatrics 2006; 117(6):2 175–2182.
  19. Koplin JJ, Osborne NJ, Wake M, et al. Can early introduction of egg prevent egg allergy in infants? A population-based study. J Allergy Clin Immunol 2010; 126(4): 807-813.
  20. de Silva D, Geromi M, Halken S, EAACI Food Allergy and Anaphylaxis Guidelines Group. Primary prevention of food allergy in children and adults: systematic review. Allergy. 2014; 69: 581:589.
  21. Ivarsson A, Hernell O, Stenlund H, Persson LA. Breast feeding protects against celiac disease. Am J Clin Nutr 2002; 75: 914-21.
  22. Størdal K, White R, Eggesbø M. Early feeding and risk of celiac disease in a prospective birth cohort. Pediatrics. 2013; 132: e 1202–9.
  23. Vriezinga N, Auricchio R, Bran E, et al. Randomized feeding intervention in infants at high risk for celiac disease N Engl J Med 2014; 371(14): 1304-15.
  24. Lionetti E, Castellaneta S, Francavilla R, et al. Introduction of gluten, HLA status and the risk of coeliac disease in children. N Engl J Med 2014; 371(14): 1295- 1303.
  25. Venter C, Groetch M. Nutritional management of food protein-induced enterocolitis syndrome. Curr Opin Allergy Clin Immunol. 2014; 14(3): 255-262.

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