To prevent atopic eczema (neurodermatitis), attention must be paid to reducing individual risk factors. Behavioral risk factors
- Diet
- Abstaining from breastfeeding infants (protective effect of breast milk feeding; breastfeeding for at least >4 months).
- Giving complementary food before completion of the fifth month of life in infants.
- Micronutrient deficiency (vital substances) – see prevention with micronutrients.
- Consumption of stimulants
- Tobacco (smoking) – smoking during pregnancy and lactation – increases the rate of atopic diseases (type I sensitization in the prick test, atopic dermatitis, bronchial asthma, allergic rhinitis (hay fever)).
- Psycho-social situation
- Stress
- Daily bathing of the children
- Omitting the daily airing of the apartment
- Use of materials made from animal products such as mattresses with feathers.
Trigger factors
The importance of trigger factors varies greatly from individual to individual. The trigger factors listed below should serve to know them and, if necessary, to avoid or reduce:
Diseases
- Infections
- Airborne allergens or bacteria
- Food allergy [only immediate-type food allergy or significant late reactions warrant abstinence measures (elimination diets)].
Medication
Vaccinations [regardless of the fact that vaccinations can lead to exacerbation of atopic dermatitis, children and adults with atopic dermatitis should be vaccinated according to the STIKO recommendations; in phases of exacerbation (significant worsening of symptoms), a vaccination date can be postponed]
Environmental exposure – intoxications (poisonings).
- Damp walls (molds; during the first year of life).
- Children who grew up on a farm with animal husbandry showed significantly less sensitization, bronchial asthma and rhinoconjunctivitis allergica compared with neighboring children without professional animal husbandry.
Prevention factors (protective factors)
- Genetic factors:
- Genetic risk reduction depending on gene polymorphisms:
- Genes/SNPs (single nucleotide polymorphism; English : single nucleotide polymorphism):
- SNP: rs7927894 in an intergenic region.
- Allele constellation: CC (0.83-fold).
- SNP: rs7927894 in an intergenic region.
- Genes/SNPs (single nucleotide polymorphism; English : single nucleotide polymorphism):
- Genetic risk reduction depending on gene polymorphisms:
- Applying an ingredient-free base cream to the entire body (several times a day and after each bath) from the third week of life until six months of age reduced the cumulative risk in newborns from at-risk families for atopic disease by 50%!The result of the study suggests the possibility that sensitization to food occurs through the skin!
- Maternal diet during pregnancy and lactation should be balanced and nutritious. On the consumption patterns of the mother and the effects on the child:
- however, there is no evidence that dietary restriction (avoidance of potent food allergens) is useful; the opposite seems to be true:
- Increased maternal consumption of peanuts in the first trimester (first three months of pregnancy) was associated with a 47% lower likelihood of allergic reactions to peanuts.
- Increased consumption of milk by the mother in the first trimester was associated with less bronchial asthma and less allergic rhinitis (hay fever; allergic rhinitis).
- Increased consumption of wheat by the mother in the second trimester was associated with less atopic dermatitis (neurodermatitis).
- There is evidence that fish (omega-3 fatty acids; EPA and DHA) in the mother’s diet during pregnancy or lactation is a protective factor for the development of atopic disease in the child.
- Probiotics during pregnancy and breastfeeding (until six months of life) reduce the risk of atopic dermatitis.
- however, there is no evidence that dietary restriction (avoidance of potent food allergens) is useful; the opposite seems to be true:
- Breastfeeding (full breastfeeding) for at least 4 months.
- Breast-milk substitutes in high-risk infants: if the mother cannot breastfeed or cannot breastfeed adequately, the administration of hydrolyzed infant formula is recommended for high-risk infants up to 4 months of age; there is no evidence of a preventive effect for soy-based infant formula; there are no recommendations for goat, sheep, or mare’s milk
- Supplemental feeding from the beginning of 5 months of age is reported to be associated with promoted tolerance development; early fish consumption is reported to have protective value.
- Diet after the 1st year of life: there are no recommendations for allergy prevention in terms of a special diet.
- Food consumption in childhood
- Increased consumption of foods containing cow’s milk, breast milk, and oats was inversely (unreversely) related to the risk of allergic asthma.
- Early fish consumption was associated with a lower risk of allergic and nonallergic asthma.
- Exposure to tobacco smoke: tobacco smoke should be avoided – this is especially true during pregnancy.
- Note on vaccinations: there is no evidence that vaccinations increase the risk of allergy; children should be vaccinated according to STIKO recommendations.
- To reduce inhalation of allergens and contact with allergens from pets; furthermore, avoid indoor and outdoor air pollutants, including exposure to tobacco smoke; it is recommended not to acquire a cat in children at risk.
- Body weight: an increased BMI (body mass index) is positively correlated with bronchial asthma – especially in bronchial asthma.
Recommendation. Taking a dietary supplement during pregnancy with omega-3 fatty acids and magnesium, calcium, folic acid and iodine, as well as a dietary supplement with probiotic cultures.
