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Allergy

What is an allergy ?

Allergy is due to a hypersensitive immune system overreacting to substances that we normally shouldn’t react to because they are harmless. This includes things like pollen, dust mites and many different food products such as nuts. A severe reaction to these allergens which may be life-threatening is referred to as anaphylaxis.

Allergy in children is on the rise in Australia, with 10-15% suffering from asthmahttp://www.healthinsite.gov.au/topics/Asthma_Statistics ) and 40% having at least one allergic episode in childhood (http://www.allergy.org.au/content/view/182/1/) . Asthma is often of atopic origin, meaning that it is triggered by particular allergens such as dust mites, animal fur or pollen. In an atopic child, eczema is also a common condition. Other conditions caused by allergy include hives and hayfever.

There are many theories surrounding how allergies occur; one of which is the “Hygiene hypothesis” (Wills-Karp et al, 2001). This theory suggests that babies and young children whom are always in a sterile environment and thus have no exposure to pathogens (micro-organisms that can cause disease) are more likely to develop a certain subset of immune cells (Th2 T helper cells) that are associated with allergic responses. The other subset of immune cells (Th1) are more important in helping us fight off an infection, thus when under-stimulated, a drive to increase more Th2 cells may occur, predisposing the child to having allergies.

Food allergy is also relatively common, especially to allergenic products such as nuts, milk and egg. Some research at the MCRI have shown that exposure of young children to egg before 12 months reduces the chances of them becoming allergic to egg later on in life (http://www.mcri.edu.au/pages/research/news/2010/10/early-exposure-could-prevent-egg-allergy-in-babies.asp?TID=2).

Diagnosis of allergy includes the use of skin pricks where the response is recorded. An allergic reaction may appear as a red mark on the skin. Blood testing is another useful diagnostic tool.

What can be done to prevent allergy in children?

The basis of allergy and how it occurs is still yet to be fully understood. Much research has been undertaken into allergy prevention in children and there are some specific recommendations given by the Australian Society of Clinical Immunology and Allergy as shown below (Table 1,http://www.allergy.org.au/content/view/28/255/).
Although there are effective treatments in controlling allergies, a cure has not yet been discovered. One promising area of research is in the use of probiotics to treat or even prevent allergies; however more work is needed before it can be recommended as a means to prevent allergies in children (Isolauri, 2001)

TABLE : SUMMARY OF SPECIFIC RECOMMENDATIONS

Identifying infants at risk of allergic disease A family history of allergy and asthma can be used to identify children at increased risk of allergic disease
Allergen avoidance in pregnancy Dietary restrictions in pregnancy are not recommended.
Aeroallergen avoidance in pregnancy has not been shown to reduce allergic disease, and is not recommended.
Breastfeeding Breastfeeding should be recommended because of other beneficial effects.
Maternal dietary restrictions during breastfeeding are not recommended
Infant formulae In high risk infants only, If breast feeding is not possible a hydrolysed formulae is recommended (rather than conventional cows milk based formulae). Partially hydrolysed formula is available in Australia without prescription. Extensively hydrolyzed formula is more expensive, only available on prescription, and only subsidised for treatment of combined cow’s milk and soy allergic infants.Soy formulae and other formulae (eg. Goat’s milk) are not recommended for the reduction of food allergy risk.
Infant diet Complementary foods (including normal cows milk formulae) should be delayed for at least 4-6 monthsThis preventive effect has only been demonstrated in high-risk infants
There is no evidence that an elimination diet after the age of 4-6 months provides a protective effect, though this needs additional investigationAvoidance of peanut, tree nuts, and shellfish may be recommended in high risk children during the first years of life pending further study as this is unlikely to cause harm, however it must be emphasised that there is no evidence to support this recommendation.
House dust mite exposure Before definitive recommendations can be made, further research is needed to determine the relationship between early HDM exposure and the development of sensitisation and disease.No recommendation can be made at this time regarding the implementation of HDM avoidance measures for prevention of allergic disease.
Pet exposure No recommendations can be made at this time regarding exposure to pets in early life and the development of allergic disease. If a family already has pets it is not necessary to remove them, unless the child develops evidence of pet allergy (as assessed by an allergy specialist). However, at this stage we do not recommend getting new pets to reduce allergy.
Smoking and other irritants Pregnant women should be advised not to smoke in pregnancy.
Parents should be advised not to smoke.
The role of microbial agents No recommendations can be made at this time regarding the use of probiotic supplements for the prevention of allergic disease
Secondary prevention strategies Immunotherapy may be considered as a treatment option for children with allergic rhinitis, and may prevent the subsequent development of asthma.

References

  1. Opinion: The germless theory of allergic disease: revisiting the hygiene hypothesis
  2. Marsha Wills-Karp, Joanna Santeliz& Christopher L. Karp Nature Reviews Immunology 1, 69-75 (October 2001)
  3. Probiotics in human disease, Erika Isolauri, American Journal of Clinical Nutrition, Vol. 73, No. 6, 1142S-1146S, June 2001

Stimulating and learning opportunities for young children

Children rapidly acquire a range of skills including physical, emotional and cognitive capabilities during early childhood, which is also a critical period for brain development. These early experiences have a significant impact on their development; thus interactions and relationships with their parents are important. Learning opportunities are abundant in...
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Building Strong Bones

Abstract: Our bones play very important roles in general movement, posture and protecting vital organs. As we get older and suffer from joint and movement pain, bone fractures and osteoporosis we often wonder “why, oh why did I not look after my bones?” A crucial period to influence bone strength and avoid all these problems is in the early stages of growing up when bones are still developing. Let’s take a look at the stages of bone development; you may discover it’s not as simple as drinking lots of milk or simply worrying about calcium intake.

Growing Bones

Growth and development in the early years of childhood is an important stage which can have a significant impact on our health and well-being as adults. From birth to 5 years of age, we more than double in height. Although not as dramatic, growth continues until we reach the end of puberty (15-19 years for females; 16-21 for males). Coinciding with our height increase is the growth of our bones, which stop growing at the end of puberty. Whilst bones are growing, it is the only stage we are able to strengthen our bones. From birth to the start of puberty, bone mass can increase up to 7 times. Once bones stop growing, they reach their peak bone mass, which means they are as strong as they will ever be. This remains steady for the next 20 years, before the natural aging process causes a decline in bone strength. In many individuals, the bone strength becomes so low, they develop osteoporosis. Thus the early years of childhood are our only chance to influence how strong our bones will be. The peak bone mass (strength of bones) will differ for each individual depending on how well they optimized their bone growth during childhood. Strong bones are vital for general growth and basic movements, enhancing coordination, agility and good posture. Building strong bones can also reduce the risk of fractures, teeth cavities and osteoporosis. So how can one optimize their bone strength by reaching a high peak bone mass?

Our biggest growth spurt occurs in the first 5 years of life. Our growth rate then remains fairly steady until we stop growing.

Peak bone mass varies between individuals because it is dependent on nutrient intake and the building of bone mass during the first 20 years of life

How to assist strong growing bones

The formation and structure of bone requires many essential nutrients. While calcium is the most well known, there are many other vitamins and minerals that are required for healthy bone growth. Calcium along with phosphorus are minerals which is essentially what forms and makes bone tissue. Around 99% of calcium and 85% of phosphorus found in your body is located in your bones. However, to absorb these minerals from your diet and then transfer them to the bones, the body needs vitamin D. Vitamin K and magnesium also assist in this process. To form and strengthen bones, the body also needs zinc, vitamin C, manganese, folic acid and vitamin B6. If a child receives sufficient levels of these nutrients, their bones will be strong. However, if they are even marginally deficient in just one of these nutrients (not just calcium), it can result in a low peak bone mass, leaving bones weak, brittle and more prone to breakage. In addition, basic movements and posture can be affected as well as an increase risk of tooth cavities and osteoporosis. Really poor bone growth can also lead to bone deformities. The financial burden (hospital, dentist and chiropractor visits) from having weak bones can also be a strain.

How to obtain these nutrients

The nutrients required for bone growth can be obtained largely in green vegetables and dairy. However, it is very difficult to get children (particularly under the age of 5) to eat large enough portions of these food groups to obtain enough nutrients to optimize bone growth. There is a global increase in childhood obesity, suggesting today’s children are consuming diets rich in calories and fats and poor in nutrient quality. In addition, nutrient levels are significantly reduced (up to 80%) during food processing, preparation and cooking or when flavours are added so children will actually enjoy the food! To make matters worse, consuming protein-rich sources of calcium such as milk and whey-protein based formulas significantly reduce the amount of calcium that is actually absorbed due to its interaction with protein. In some countries there are also fears of contamination with dairy and meat products, placing more pressure on parents providing their child with a balanced diet. So what is a solution? There is no cause to panic. Simply provide a balance of nutrient sources through; green vegetables, fruit, nuts and meat and a variety of dairy products, not just relying on a few glasses of milk every day. When possible, introduce lightly steamed vegetables and avoid frying every meal they have. If you are still concerned about their nutrient intake, supplements containing calcium combined with the other important nutrients for bone health can assist you.

References

  1. Kerstetter, J.E., K.O. O’Brien, and K.L. Insogna, ‘Low protein intake: the impact on calcium and bone homeostasis in humans’. J Nutr, 2003. 133(3): p. 855S-861S.
  2. National Health & Medical Research Council (NHMRC), ‘Nutrient reference values for Australia and New Zealand: Including recommended dietary intakes’ (Report) 2006.
  3. Peacock, M., Calcium absorption efficiency and calcium requirements in children and adolescents. Am J Clin Nutr, 1991. 54(1 Suppl): p. 261S-265S
  4. World Health Organization (WHO), “Population-based prevention strategies for childhood obesity: report of a WHO forum and technical meeting, Geneva, 15–17 December 2009.” 2010
  5. World Health Organisation (WHO). The WHO Multicentre Growth Reference Study (MGRS) 1997-2003.

What is Lactoferrin?

The structure of lactoferrin

Abstract: Lactoferrin is a protein that is produced most abundantly in breast milk (in particular colostrum, the first milk produced after birth). However, it is also present in our saliva, tears, mucus and white blood cells. So what exactly is it doing in all these obscure places? Lactoferrin is part of your immune system to fight off many different types of infections. Let’s take a look to see exactly what it can do and why it is so unique!

Fighting off infections

Lactoferrin has very broad anti-microbial properties. This means it can reduce the infections of a large range of nasty bugs and germs. These include bacteria (eg. E.coli, salmonella and staphylococcus), viruses, fungi and parasites. Lactoferrin has the ability to not only inhibit and stop these bugs and germs from growing inside the body, it can also effectively kill them, preventing and reducing symptoms, disease and inflammation.

Boosting the Immune System

Aside from its own immune properties, lactoferrin has shown to increase the number of immune cells, proteins and pathways that help fight off infections. Lactoferrin also enhances the growth of good bacteria in the digestive system. This is important as they can fight off bad bacteria and promote a healthy digestive system, reducing symptoms like diarrhea and tummy aches and pains.

How to increase the lactoferrin supply

In the early stages of development, your child is most vulnerable to infections and illness because the immune system is still developing. Thus it is no surprise that we are sick more times in our first year, than any other year of life. Making sure your child has enough lactoferrin will assist in not only reducing the number of times they become ill, but it also reduces the severity and duration of symptoms they will have. This is one the important reasons why mother’s should breastfeed, it provides an excellent dose of lactoferrin to help your baby through a tough battle against germs and bugs. In addition, breast milk also contains antibodies and other proteins that boost the child’s immune system. Once they stop breastfeeding, the only food source that contains lactoferrin is cow’s milk; however the actual amount of lactoferrin is negligible (only 1-5% of the amount found in human breast milk). If you wish to boost your lactoferrin levels in your child or as an adult, lactoferrin supplements are available. The use of lactoferrin supplements have just recently emerged but have already shown to be effective in reducing the risk and severity of bacterial blood infections (sepsis) and lower respiratory infections in newborns, virus-induced diarrhea and vomiting in children and viral infections in adults.

Infants and children given lactoferrin supplements (red) have a significantly reduced risk of infections and reduced severity and duration of illness symptoms than those who do not take lactoferrin supplements (Control – blue).

Breastfeeding and lactoferrin supplements have proven to significantly boost the immune system and reduce the incidence and severity of illness. These two measures may go along way to relieve the stress and anxiety of parents, constantly looking after their children getting sick, time and time again.

Improve Iron status during pregnancy

Not only is lactoferrin a safe, natural way to boost your immune health during pregnancy, it can also improve iron status during this important period. The demand for iron during pregnancy increases by 50% as it is needed for the expansion of the circulatory system (fetal and placenta) and fetal brain development. Iron deficiency is the most common nutrient deficiency and iron deficiency anaemia is the most frequent anaemia in the world. Iron supplements (eg. Ferrous sulfate) are often recommended to cure iron deficiency during pregnancy; however they often fail to increase levels significantly and are well known for their gastrointestinal side effects. Lactoferrin supplements have been shown to improve iron status in pregnant women significantly greater than iron supplements of large doses. In addition, no side effects were reported with the use of lactoferrin supplements. Lactoferrin has the ability to bind to iron, improving its absorption in the intestines and its transportation to cells.

References

  1. Lonnerdal, B., Bioactive proteins in human milk: mechanisms of action. J Pediatr, 2010. 156(2 Suppl): p. S26-30.
  2. Lonnerdal, B., Nutritional roles of lactoferrin. Curr Opin Clin Nutr Metab Care, 2009. 12(3): p. 293-7.
  3. Tian, H., et al., Influence of bovine lactoferrin on selected probiotic bacteria and intestinal pathogens. Biometals, 2010. 23(3): p. 593-6.
  4. Egashira, M., et al., Does daily intake of bovine lactoferrin-containing products ameliorate rotaviral gastroenteritis? Acta Paediatr, 2007. 96(8): p. 1242-4.
  5. Manzoni, P., et al., Bovine lactoferrin supplementation for prevention of late-onset sepsis in very low-birth-weight neonates: a randomized trial. JAMA, 2009. 302(13): p. 1421-8.
  6. Mulder, A.M., et al., Bovine lactoferrin supplementation supports immune and antioxidant status in healthy human males. Nutr Res, 2008. 28(9): p. 583-9.
  7. King, J.C., Jr., et al., A double-blind, placebo-controlled, pilot study of bovine lactoferrin supplementation in bottle-fed infants. J Pediatr Gastroenterol Nutr, 2007. 44(2): p. 245-51.
  8. Okada, S., et al., Dose-response trial of lactoferrin in patients with chronic hepatitis C. Jpn J Cancer Res, 2002. 93(9): p. 1063-9.
  9. Paesano, R., et al., Lactoferrin efficacy versus ferrous sulfate in curing iron disorders in pregnant and non-pregnant women. Int J Immunopathol Pharmacol, 2010. 23(2): p. 577-87.
  10. Paesano, R., et al., Oral administration of lactoferrin increases hemoglobin and total serum iron in pregnant women. Biochem Cell Biol, 2006. 84(3): p. 377-80.