The Myth Of Preventing Asthma

Here we take a closer look at allergy, atopy and asthma. This topic will mainly concentrate on little known ways of primary prevention that mothers need to learn about and that have been shown to be effective.

Atopy is a propensity to generate antibodies against common environmental allergens. Asthma, atopic dermatitis, and rhino-conjunctivitis are the known clinical manifestations of atopy. These medical problems are major causes of morbidity & mortality during childhood continuing into the adult life. However, atopy is only one of many factors involved in the pathogenesis of these disorders. The contribution of atopy and atopy-related genes might vary with the disease in question.

For those who are affected attempts to successfully prevent the development of these diseases must take priority in heir lives and that is mainly done through primary prevention.

As most of us know the onset of allergic manifestations is usually during early childhood and that is why primary prevention efforts have to commence soon after birth or preferably during pregnancy according to multiple research studies.

What to prevent/avoid?

Exposure to Environmental Tobacco Smoke (ETS), especially during pregnancy and early childhood, increases the risk of childhood wheezing and asthma, and so avoidance of exposure to it must be included in all preventive advice to expectant mothers and those with young children.

It is important to understand that maternal avoidance of allergenic foods during pregnancy does not work and could in fact be harmful. Having said that it is now known that maternal avoidance of allergenic foods during breast feeding might have some protective effect on reduction of problems like cow’s milk allergy and atopic dermatitis in the new born. This should only be performed by highly motivated mothers with a known elevated risk of allergy in the offspring and under strict dietary supervision by a nutritionist.

A common question these days is to breast feed or not to breast feed? Breast-feeding for 4 to 6 months has been shown to protect the new born baby from development of early childhood asthma/ wheezing and atopic dermatitis; still there is no evidence of any long-term benefits.

The evidence to support a preventive effect of HDM (house dust mite) allergen avoidance for the development of sensitization to HDM or respiratory allergy is not compelling and it might be that current methods of allergen reduction are just not effective and require more tweaking for results to be seen.

A strategy of combining food and aeroallergen avoidance seems to be effective in reducing early childhood wheeze and atopic dermatitis and later childhood asthma. It is also worth noting that there is evidence that probiotics might be useful in preventing atopic dermatitis.(J of allergy, clnl immunology 2005; Hasan Arshad)

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