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Allergy Prevention Children

pdfASCIA PCC_Allergy_prevention in children 2015299.64 KB

Allergic disorders are often life long, and although treatable, there is currently no cure. It therefore makes sense to try to prevent allergic diseases in children, if possible.

Allergic disorders are very common in children

Up to 40% of children in Australia and New Zealand are affected by allergic disorders some time during life, with 20% having current symptoms. Allergic diseases have approximately doubled in western countries over the last 25 years. The most common allergic conditions in children are food allergies, eczema, asthma and hay fever (allergic rhinitis). 

Symptoms range from mild to potentially life-threatening

Allergic diseases are caused by abnormal immune responses to otherwise harmless substances in the environment. For example, hay fever is commonly caused by an immune response in the nose and eyes to grass pollens and/or house dust mites. Some allergic conditions (such as mild allergic rhinitis) may cause only mild symptoms. For others (such as moderate/severe allergic rhinitis, asthma), symptoms can be debilitating, disturb sleep and impact on learning and behaviour. Poorly controlled bad asthma, stinging insect allergy or severe food allergies can even be life threatening.

Why and how should we prevent children from developing allergic disease?

Although effective treatments are available, there are currently no cures for allergic conditions.  Therefore it makes sense to try to prevent these conditions, if possible, in infants and children. 

Allergy prevention in infants and children is an active area of research but so far, we only have some answers.  Recent research has identified some "risk factors" that appear to increase the risk of developing allergic disease. Other studies are examining whether avoiding these factors will reduce the risk.

At present the optimal approach to prevent children from developing allergies is to:

A. Identify infants that have an increased risk of developing allergic disease
B. Practise allergy prevention in the children who are identified as being at high risk of developing allergic disease. 


Which infants are at risk of developing allergic disease?

A number of factors appear to increase the risk of developing allergic disorders.  We have no control over some risk factors such as family history, whilst there are other environmental factors that we might be able to influence. Identified risk factors for developing allergic disease include:

  • Family history of allergic disease in a parent or sibling (family history of allergic disease in both parents OR a parent and a sibling is associated with a further increased risk)
  • Introduction of cow's milk or soy milk formula before 3 - 4 months of age (an increased risk for eczema and food allergy)
  • Introduction of solid foods before 3-4 months of age (an increased risk for eczema and food allergy)
  • Birth in Spring - a risk for hay fever (seasonal allergic rhinitis)
  • Passive exposure to cigarette smoke (a risk for increased respiratory symptoms)

Practical suggestions for preventing allergic conditions in children

If your child is identified as being at increased risk of developing allergic disease, it is sensible to try to reduce the risk by following the recommendations outlined below. 

It should be emphasised that even if you follow these suggestions, there is still a chance that a child at high risk may develop allergic disease, and that taking measures to reduce one type of allergy such as eczema, may have no effect on whether the child develops asthma or allergic rhinitis.


  • Do not smoke during pregnancy
  • Do not smoke in the presence of the child, or in enclosed spaces where the child sleeps or plays.


  • Where possible, breast feed your child for at least 6 months. Breastfeeding provides a nutritious and balanced food source for your baby, reduces the risk of gastrointestinal tract infections and may also reduce the risk of developing allergic disease in early life.


  • Where possible, delay the introduction of formula feeds until the child is 4-6 months of age.
  • If it is not possible to breast feed, use a partially hydrolysed (hypo-allergenic) cow's milk formula in the first 4-6 months of life, commonly referred to as ‘HA' formula. It is important to note that these formulae should not be used if your child already has cow's milk allergy (confirmed by a doctor). Ask your doctor for more information.
  • Delay the introduction of solid foods until the child is 4-6 months of age. Thereafter, foods can be introduced, with a new food introduced every 2-3 days. Introduce one new food at a time so that any reactions can be readily identified.
  • There is no evidence that delayed introduction of allergenic foods like egg, milk, peanut, tree nuts, or seafood beyond the first 4-6 months of life reduces the risk of food allergy and eczema. Some studies suggest that delayed introduction of foods beyond 6 months may even lead to an increased risk of food allergy, although further research is required to confirm this.

ASCIA Infant Feeding Advice is available on the ASCIA website.    

Research into allergy prevention is important

Although allergy prevention in children is an active area of research, our understanding of why allergic diseases develop and why they are increasing in our society is incomplete. We therefore encourage you to support and participate in studies on the development and prevention of allergic disease. 

Some common questions regarding allergy prevention in infants and children are available here.

pdfASCIA PCC Allergy_prevention_FAQs 2015189.1 KB

Allergy prevention in children - summary


 Stop smoking  Yes  


 Stop smoking  Yes  
 Probiotics  No  Await further research studies. 
 Dietary Restrictions  No  
 Fish oil Supplements   No  


 Breast-Feeding Yes Exclusively for 4-6 months. Continue breastfeeding while introducing new foods if possible.
 Partial breast-feeding   Supplement with a partially hydrolysed cow’s milk formula (commonly referred to as ‘HA’ formula) for the first 4-6 months (unless infant is already cow’s milk allergic). 
 Soy formula   For some forms of cow’s milk allergy (seek medical advice). 
 Weaning   Avoid introduction of solids until aged 4-6 months. Thereafter, introduce a new food every 2-3 days according to developmental readiness and what the family eats. Introduce one new food at a time so that any reactions can be readily identified. 
Diet restrictions No Introduce foods from 4-6 months.  
Removal of pets No Only if family member is already allergic to pets. 
Dust mite avoidance No Await further research studies. 

Avoid environmental irritants

Avoid exposure to tobacco smoke, unflued  indoor gas heaters, remove sources of mould and dampness where possible. 


 Immunotherapy No Useful to treat established allergies - await further studies regarding its role in prevention. 

Further reading

Dunstan J, Mori TA, Barden A, Beilin LJ, Taylor A, Holt PG, et al. Fish oil supplementation in pregnancy modifies neonatal allergen-specific immune responses and clinical outcomes in infants at high risk of atopy: a randomised controlled trial. J Allergy Clin Immunol 2003; 112:1178-84.

Möller C, Dreborg S, Ferdousi HA, Halken S, Host A, Jacobsen L, et al. Pollen immunotherapy reduces the development of asthma in children with seasonal rhinoconjunctivitis (the PAT-study). J Allergy Clin Immunol 2002; 109:251-6.

Kalliomäki M, Salminen S, Poussa T, Arvilommi H, Isolauri E. Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet 2003; 361:1869-71.

Apelberg BJ, Aoki Y, Jaakkola JJ. Systematic review: Exposure to pets and risk of asthma and asthma-like symptoms. J Allergy Clin Immunol 2001; 107:455-60.

Stick SM, Burton PR, Gurrin L, Sly PD, LeSouef PN. Effects of maternal smoking during pregnancy and a family history of asthma on respiratory function in newborn infants. Lancet 1996; 348:1060-64.

Kramer MS. Maternal antigen avoidance during pregnancy for preventing atopic disease in infants of women at high risk. Cochrane Database Syst Rev 2000; 2.

Osborn DA, Sinn J.  Formulas containing hydrolysed protein for prevention of allergy and foodintolerance in infants. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD003664.

Arshad SH, Bateman B, Sadeghnejad A, Gant C, Matthews SM. Prevention of allergic disease during childhood by allergen avoidance: the Isle of Wight prevention study. J Allergy Clin Immunol. 2007 Feb;119(2):307-13.

The Australasian Society of Clinical Immunology and Allergy Position Statement: summary of allergy prevention in children. MJA Practice Essentials. Australasian Medical Publishing Company, Sydney 2007.

Osborn DA, Sinn JK. Probiotics in infants for prevention of allergic disease and food hypersensitivity (Review). Cochrane Database of Systematic Reviews 2007, Issue 4. Art. No.: CD006475. DOI: 10.1002/14651858.CD006475.pub2.

© ASCIA 2010

The Australasian Society of Clinical Immunology and Allergy (ASCIA) is the peak professional body of Clinical Immunologists and Allergists in Australia and New Zealand

Website: www.allergy.org.au 

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Postal address: PO Box 450 Balgowlah NSW 2093 Australia


This document has been developed and peer reviewed by ASCIA members and is based on expert opinion and the available published literature at the time of review.  Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner. The development of this document is not funded by any commercial sources and is not influenced by commercial organisations.  


Content Updated May 2014

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