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Infant Nutrition
Published in Praveen S. Goday, Cassandra L. S. Walia, Pediatric Nutrition for Dietitians, 2022
Olivia Mayer, Yasemin Cagil, John Kerner
It is common to add human milk or formula to a puree mixture to help with the consistency, add energy and protein, and provide a familiar taste. Traditionally, families started with iron-fortified infant rice cereal; however, many caregivers choose to start with pureed vegetables. Infants receiving human milk should be advised to start with iron- and zinc-containing foods along with vitamin C containing foods to aid with absorption of non-heme iron. Historically, the advice was to not introduce common allergenic foods such as eggs and peanuts until 12 months of age; however, there is no evidence to support prolonging an infant’s exposure will protect children from allergies. In fact, delayed introduction is now thought to be a risk factor for development of allergies for children with a first-degree relative with atopy (asthma, eczema, allergic rhinitis etc.). Early introduction of solids around 6 months of age, including foods considered allergenic, is now highly recommended by the AAP. Furthermore, based on the results from landmark studies it was concluded that introducing peanut-containing and egg-containing products to the diet of high-risk infants early (between 4 and 11 months) was very important in reducing future development of allergies to these foods (see Chapter 15). For healthy infants, it is recommended that a variety of foods, in developmentally appropriate textures, including highly allergenic foods be offered. Avoid giving honey, unpasteurized foods, and juice during infancy. Foods with added sugar and salt should also be avoided.
Allergy–Asthma Practice
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Mark Holbreich, Pudupakkam K Vedanthan, PA Mahesh, Sitesh Roy
Food allergies now affect up to 8% of US children and a similar percentage of adults. The most common allergies in children are cow’s milk, eggs, peanuts, tree nuts, wheat, soy, fish and shellfish. In adults the most common food allergy is shellfish. The current understanding is that food allergy develops when a food protein touches abnormal skin in an infant as in atopic dermatitis. Most childhood food allergies with the exception of peanuts, tree nuts, fish and shellfish will be outgrown. Following the publication of the Learning Early About Peanut (LEAP) trial in England it is now recommended that infants with atopic dermatitis begin eating peanuts at 6 months of life to induce tolerance. Currently the treatment for children who have a severe food allergy is avoidance of the food and carrying injectable epinephrine. It is expected that over the next few years treatment for food allergies will change dramatically with the introduction of programs for Oral Induction of Tolerance (OIT). The first product AR 101, which is purified peanut protein, will be commercially available in the near future.
Pesticides and Chronic Diseases
Published in William J. Rea, Kalpana D. Patel, Reversibility of Chronic Disease and Hypersensitivity, Volume 4, 2017
William J. Rea, Kalpana D. Patel
Chronic bronchitis in children: A single study investigated exposure to pesticides during pregnancy and the development of chronic bronchitis and cough, as well as asthma, hay fever and allergies in children of Ontario farm families.1194 No significant associations were reported between cough and bronchitis and prenatal exposure to agricultural pesticides. However, when stratified by sex, the risk of developing cough and bronchitis increased after exposure to insecticides, approaching significance for female offspring (OR = 2.29, 95% CI = 0.95–5.35). Similarly, the use of the herbicide dicamba (3,6-dichloro-2-methoxybenzoic acid) and the carbamate insecticide carbaryl increased the risk of developing cough and bronchitis when both sexes were analyzed together. Unfortunately, all data were collected retrospectively through the OFFHS, meaning that participants were asked to recall exposures that occurred in the past, and that information about the age of diagnosis of the children was not collected. These factors contributed to a relatively low quality score of 11 points out of 20.
Childhood overweight and obesity and abnormal birth anthropometric measures are associated with a higher prevalence of childhood asthma in preschool age
Published in Journal of Asthma, 2023
Eleni Pavlidou, Maria Mantzorou, Maria Tolia, Georgios Antasouras, Antigoni Poutsidi, Evmorfia Psara, Efthymios Poulios, Aristeidis Fasoulas, Georgios K. Vasios, Constantinos Giaginis
Additionally, childhood diabetes melittus type 1 and preterm birth (<37th week) were recorded from the mothers of the study children in the given questionnaire. Mothers’ answers concerning preterm birth were further cross-checked by their gynecologists’ or hospitals’ medical files for more precise records for the exact week of preterm birth to be obtained; however, we observed that there were several missing data concerning the exact week of preterm birth and several of them did not agree with the mothers’ answers and thus preterm birth was treated as binary outcome as before and after of 37th week of pregnancy. Childhood asthma was diagnosed by a specialized physician using questionnaires based on the International Study of Asthma and Allergies in Children (ISAAC) and report of asthma-specific medication and healthcare use (35). In fact, maternal reports of child wheeze from questionnaires – derived from the ISAAC were used. We considered wheeze to be present if the maternal answered “yes” to the question: “In the past 12 months, has your child ever had wheezing (or whistling in the chest)?” (35). In addition, asthma was furher defined as at least 3 episodes of wheeze in combination with treatment with inhaled glucocorticosteroids and/or signs of suspected hypereactivity without concurrent upper respiratory infection, and also if their child’ sleep been disturbed due to wheezing for at least one night per week in the last one 12 months (35).
The clinical evidence of second-generation H1-antihistamines in the treatment of allergic rhinitis and urticaria in children over 2 years with a special focus on rupatadine
Published in Expert Opinion on Pharmacotherapy, 2021
Antonio Nieto, María Nieto, Ángel Mazón
Lack of evidence in pediatric pharmacotherapy is common and has obvious and critical implications. Many reasons limit the development of pharmacologic studies in children, in particular ethical and practical issues in carrying out research on pediatric population. These obstacles also include the different pharmacokinetics at different ages, from the neonatal period to adolescence, so a single study in children is not likely to be enough to cover the entire pediatric age span. Additionally, regulatory agencies ask the pharmaceutical companies to stimulate the development of pediatric medicines and provide more information on their use, as a response to the lack of evidence and approval of medicines for children [3]. Therefore, the correct management of allergies in children according to guidelines is necessary, but it is also essential to have good efficacy, safety, and tolerability data from individual pharmacological agents in pediatric patients.
Which foods should a child with food allergy avoid? The role of parental knowledge in food avoidance appraisals
Published in Children's Health Care, 2021
Emily M. Steiner, Danielle Weiss Byrne, Lynnda M. Dahlquist, Amy L. Hahn, Mary Elizabeth Bollinger
Food allergies are becoming increasingly more common, as approximately 8% of children in the United States are diagnosed with at least one food allergy (Gupta et al., 2011). To manage food allergies properly, children must restrict their diet to avoid allergic reactions (American College of Allergy Asthma and Immunology, 2015b). However, since food is a major part of daily life and because many common allergens (e.g., traces of milk and peanuts) can be found in popular food items, avoidance of allergens can be challenging (Bollinger et al., 2006). This task has the potential to be particularly demanding for caregivers, especially those of young children, who are responsible for monitoring and making food choices for their children (Bollinger et al., 2006; Cohen, Noone, Muñoz-Furlong, & Sicherer, 2004; King, Knibb, & Hourihane, 2009; Muñoz-Furlong, 2003; Primeau et al., 2000; Rouf, White, & Evans, 2011). Parents vary in their ability to interpret and apply food recommendations from physicians. For example, some parents may fail to ensure avoidance of food items that could be harmful, thereby increasing their child’s risk of a severe allergic reaction. However, other parents may have their child avoid more foods than necessary, which needlessly limits their child’s access to safe foods.