1. 1. -IBCLC ,
2. 2. = 5-15% / 25-35% 20-40% 2 40-60% 2 50-70%[i] [i] :.- ;. , 17: 125-131,2005 1 1 ( ) Hst A, Halken S. Primary prevention of food allergy in infants who are at risk. Curr Opin Allergy Clin Immunol. 2005;5(3):255-259. ( )
3. 3. : : , , , : -, : , , ,
4. 4. : -
5. 5. 50% (sIgA) , , sIgA ,
6. 6. ! : , 1 ng (nanogram= !) - , . 0.5 32 ng/L - . 40 ml - 21! Businco, Bruno, & Giampietro 1999
7. 7. IgE H IgE IgE : IgE ( ) 1 Furukawa et al., 1994
8. 8. ; ! ,
9. 9. ; 2000: : (>10, >12), >12 : >2 & >3
10. 10. 6 4-6
11. 11. , ! 10 , .
12. 12. ; ; : 4-6 , 6 4 Zutavern A. et al Pediatrics 2008 4-6 10-12 5 12 Kopplin Jj et al Allergy Clin Immunol 2010
13. 13. ; ; 9 => 8 Goksoer et al PAI 2013 6-12 => . 4 Kiiefte-de Jong JC pediatrics 2012 12 => , , 12 Magnusson et al Am J Clin Nutr 2013 DIPP () < 6 ,
14. 28. () . 1 , ( ) 1 . , ! , : , , , ( , )
15. 29. The overlap effect , : transforming growth factor- . , . TGF- . soluble CD14 6 lysosyme , HUMAN LACTATION RESEARCH 2011 --- , ,
16. 30. , - ( window of opportunity) 4-6 Prescott S.et al PAI 2008 & SichererSH ,JACI 2008, Grimshaw KEC et al ,Pediatrics 2013
17. 31. ; , . !
18. 32. : ! . Gdalevich, Mimouni 2001, Oddy 2000 & 2004 :
19. 33. : 3% 1% : ( 2-6 , 1 ), ! : (65% , 19% , 6% , 3% ) ( , )
20. 34. 3 1. - 2. 2 4 ( 72-96 ) . , , 9-12 6 , 3. . , , , , . 4. 5. 6. , , / ( ), BREASTFEEDING MEDICINE Vol.6, No 6, 2011; ABM Clinical Protocol #24: Allergic Proctocollitis in the Exclusively Breastfed Infant
21. 35. ; : IgA : IgG1, IgG4 IgA IgA IgG4 , . ! Jarvinen KM, Westfall JE, Seppo MS, et al. Role of maternal elimination diets and human milk IgA in the development of cow's milk allergy in the infants. Clin Exp Allergy. 2014;44(1):69-78.
22. 36. ! 640 4 11 : / , , 1 2 530 98 5
23. 37. , 2011, . , 2008 1998
24. 38. : 530 5 : 13.7% 1.9% 98 5 : 35.3% 10.6%
25. 39. , : , - IBCLC !!