The Prophylaxis of Allergic Disease in Infancy and Childhood1

Abstract

The late Dr. Joseph Breiinemaii (1872-1944, a distinguished pioneer in American pediatrics, was particularly known for his clinical studies of the nutrition of the newborn human infant. About twenty years ago he made the following statement (6): "The milk of every mammal is specific for its young. To this m a n i s no exception. (The italics are mine throughout.) There is, furthermore, evidence that the milk of one mammal is not only imperfectly adapted to the young of ohher mammals, but that there i s even something harmful in non-specific ,milk. The essential nature of this specificity is unknown. While it may eventually prove to be largely, or wholly, a matter of chemistry, there i s reason, to believe that there i s also a n intangible biologic factor."It is the thesis of this presentation that Brennemann's statement is correct and that the intangible biologic fact,or which he foresaw is allergy, and, moreover, that a practical application can be made of this knowledge which will go far towards alleviating the scourge of allergic disease, in the human infant aiid child. When I first began practice in 1929, it was the custom of many pediatriciaiis to start infants on raw egg yolk a t the age of three months. This method of feeding had been recently introduced because a t that time there was very widespread interest in rickets aiid anemia in infants and egg yolk was believed t o be a good prophylactic agent for both. It was' soon discovered in the feeding of raw egg yolk to infants three months of age or less that many developed rashes or other evidence of intolerance, and within a few years this practice was almost universally discontinued. Egg yolk subsequently was not introduced into the diet until the age of six t o nine months when it was conimonly tolerated without difficulty. T h i s observation suggested that during the interval between three months of age and six to nine months of age, the infant developed some type of protection against allergy to egg.

Human Milk as a Prophylaxis

“…7 Glaser 31 speculated in the 1930s that if a child were at high risk for developing allergy, prophylaxis should be able to change the outcome. Cord serum total IgE levels of greater than 100 U/mL are associated with five to ten times greater risk than lower levels.…”