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The prophylaxis of allergic disease in infancy.

J. Glaser

Published 1962 in Pediatrics

ABSTRACT

Whatever the personal feelings of anyone regarding the method of prophylaxis of allergic disease just reviewed may be, its importance is such that it deserves rechecking by unprejudiced observers. Although these studies cover a period of over 25 years of personally observed patients, it should not take nearly that long to determine whether or not potentially allergic infants, as here defined and treated in the manner discussed, will show a lessened incidence of atopic dermatitis than a control series. It is not necessary to show that infants with atopic dermatitis are more likely to develop subsequent allergic disease than infants who have not had atopic dermatitis, as this is well documented and the verification of this portion of the study is not so urgently required. Practically speaking, the most desirable type of study can not well be done by a co-operative investigation involving many physicians and does not lend itself easily to a clinic study except possibly in one particularly organized for that purpose. The infants must be followed from birth by a pediatrician with a genuine interest in and knowledge of allergy. He should be particularly familiar with the differential diagnosis between atopic dermatitis, which is an allergic disease, and seborrheic dermatitis, which is not an allergic disease, although both are called lergic disease, although both are called eczema, since these are so frequently confused in early infancy. In conclusion, one may state that the pediatrician, through applied science, has solved the problem of adequate nutrition of the human infant and in addition the infant can now be successfully protected against many serious infectious diseases. However, in the light of present day knowledge this is not enough. The immunologic status of the infant with respect to allergy must also be considered. For this purpose human breast milk is doubtless the ideal food. If the trend away from breast feeding cannot be reversed, then the use of a well-tolerated nutritionally adequate substitute for the customary cow's milk feeding of the newborn infant, which has less serious consequences immunologically, must be considered. The increased cost of such feeding over cow's milk cannot be regarded as a legitimate reason for not doing this in view of the suffering and economic loss that may be incurred in some infants as a result of possible sensitization to cow's milk. At present soy bean milk appears to be a suitable and practical substitute, although it is possible that eventually other preparations yet to be discovered may prove to be equally or more satisfactory.

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