Early life exposures and allergy risk

Do exposures in infancy play a role in the later development of allergies and asthma? There are two recent studies that help answer this question in terms of infant feeding practices and use of antibiotics.

There has long been an idea that limiting the number of food exposures in a young child or delaying various foods could decrease the likelihood of developing food allergy or eczema. However, several studies over the last decade have suggested that the exact opposite may be the case. A recent study from Europe in the Journal of Allergy and Clinical Immunology (2014;133:1056-1064) showed that children with a more diverse diet in the first year of life are actually at lower risk for allergic diseases, including asthma, nasal allergies, and food allergies. In a study looking at antibiotic use in infancy (Annals of Allergy, Asthma, and Immunology. 2014; 112:441-445), with each course of antibiotic exposure, there was an increased risk of developing asthma. So, in addition to the other problems with overuse of antibiotics, including increased risk for allergic reactions to the drug and development of bacterial resistance, association with early use of antibiotics and asthma is another reason to limit their use. The likely mechanism to explain this effect is that the antibiotics disrupt the normal bacteria in our body that help prevent allergies. These are important considerations for parents of young children, and we at BVAAC are happy to discuss these issues with our patients’ families.