过敏与母乳喂养家庭Allergies and the Breastfeeding Family

Karen Zeretzke

Baton Rouge, Louisiana

From: NEWBEGINNINGS, Vol. 15 No. 4, July – August 1998, p. 100

Allergies today are more common than ever before–one in five children now shows some degree of allergy by age 20. The incidence of allergies has increased tenfold over the past 20 years. This is partly due to increased exposure to known allergens (allergy-causing substances). It is also because physicians and allergy sufferers are more likely to recognize that certain symptoms or illnesses are caused by allergies (Lawrence 1994). Changes in the human diet from the days of hunter-gatherers eating seasonal foods to the year-round availability of most foods has, surprisingly, reduced the number of foods in a typical diet from around 200 to just about 20. Narrowing food choices in this manner increases exposure to these foods and predisposes people to food allergies.

今日，过敏较以往常见。现在，五个小孩中就有一个在20岁以前会出现某种程度的过敏。过敏的发生率与日俱增为过去20年的十倍。这有部分是源于与已知过敏原(造成过敏的物质)的接触日增，这也因为医师与过敏症患者较倾向认知某些症状或疾病是由过敏所引起(Lawrence 1994)。人类的饮食从狩猎及采集季节性食物改变至几乎终年都可获得大部分的食物，但令人惊讶地，典型的食物从200种降低到只有大约20种。减少食物可选择的种类，会增加摄取到这些食物的机会同时也使人们易造成食物过敏。

The earlier and more often a food is ingested, the greater likelihood it has of becoming an allergen. Babies tend to be most allergic to the foods they have been offered first. While a baby is exclusively breastfed, he is only exposed to the foods his mother eats and secretes in her milk, so his exposure to potential allergens is minimized.

某一种食物摄入得越早数量越多，此食物成为过敏原的可能性就愈大，而婴儿也会倾向于较容易对他们最早摄取到的食物过敏。婴儿若完全哺喂母乳，他只会暴露于母亲所吃下以及分泌在她乳汁中的食物，因此他暴露在潜在过敏原的可能性便大大降低了。

One long-term study of children who were breastfed showed that breastfeeding reduces food allergies at least through adolescence (Grasky 1982). Protection from allergies is one of the most important benefits of breastfeeding. The incidence of cow‘‘s milk allergies is up to seven times greater in babies who are fed artificial baby milk instead of human milk (Lawrence 1994).

一个长期对吃母乳长大的孩子所进行的研究显示哺乳可降低对食物过敏，且至少会延续到青少年时期(Grasky 1982)。避免过敏是哺乳最重要的优点之一，喂食配方奶的宝宝产生牛乳过敏的机率是喂食母乳宝宝的七倍(Lawrence 1994)。

Breastfeeding protects against allergies in two ways. The first and most obvious reason breastfed babies have fewer allergies is that they are exposed to fewer allergens in the first months of life. They aren‘‘t given formula based cow‘‘s milk or soy products. Less exposure to these foods means less chance of allergy later on. The other reason breastfed babies have fewer allergies has to do with the development of the immune system. At birth, a baby‘‘s immune system is immature. Babies depend heavily on antibodies obtained from their mothers while in the womb. Their digestive systems are not really ready for substances other than their mothers‘‘ milk. At about six weeks of age, Peyer‘‘s Patches in the intestines begin to produce immunoglobulins or antibodies. At six months of age, a baby has a functional, if immature, immune system that is capable of producing secretory immunoglobulin A (sIgA), the antibody found in all body secretions that is the first line of defense against foreign substances.

哺乳经由两种方式来避免过敏–母乳宝宝较少过敏的第一个也是最显而易见的原因就是，他们在生命的第一个月中暴露于较少的过敏原。因为他们不会被给予以牛乳或大豆制品为主要成分的配方奶，较少接触到这些食物意味着往后发生过敏的机会也较小。母乳宝宝较少过敏的另一个原因与他们免疫系统的建立有关。刚出生的婴儿，其免疫系统尚未成熟，当他们在子宫时极为仰赖来自于他们母亲的抗体。初生婴儿的消化系统也尚未真正发育完全，无法消化除了母乳之外的任何物质。大约六周后，肠道内的培氏斑(Pyer’s Patches)才会开始制造免疫球蛋白或抗体。要到六个月大以后，婴儿才会有稍具功能但尚未成熟的免疫系统，制造分泌免疫球蛋白A(sIgA)，这个抗体在身体所有分泌系统中都有，是对抗外来物质的第一道防线。

In the meantime, a baby depends on mother‘‘s milk for protection. Fed from his mother‘‘s breast, a baby first receives colostrum, the first milk, which is especially rich in antibodies, including sIgA. The sIgA “paints” a protective coating on the inside of a baby‘‘s intestines to prevent penetration by potential allergens. Mature milk continues to provide this protection-from-the-inside to help the baby remain healthy and allergy-free. Human milk and colostrum also provide antibodies specifically designed to fight germs to which either the mother or baby has been exposed.

在这期间，婴儿得依赖母乳的保护。从妈妈的乳房，宝宝最初喝到的是初乳，其中特别含有丰富的抗体，包括sIgA。sIgA会在婴儿的肠道内侧涂上一层保护层，以预防可能的过敏原侵入。成熟乳可持续提供这种内部的保护，帮助宝宝维持健康且免于过敏。母乳及初乳也提供经过特别设计过的抗体，以对抗母亲或婴儿接触到的细菌。

The tendency to be allergic is often inherited from a child‘‘s mother or father. Babies with a family history of allergy seem to have different immune responses than those without allergies.

会有过敏的倾向通常是经由孩子的母亲或是父亲遗传而来，家族里有过敏史的婴儿与其他没有家族过敏史的婴儿相比较，似乎有不同的免疫反应。

How Allergies Occur过敏是如何发生的

Allergies happen when a person‘‘s body perceives a normally harmless substance, such as pollen, mold, dust, or a particular food, as an invader. In its own defense, the body produces large amounts of the antibody immunoglobulin E (IgE). When the antibodies come in contact with the substance the body perceives as dangerous, they attach themselves to tissue and blood cells. These cells then release powerful inflammatory chemicals, called mediators: histamines, prostaglandins, and leukotrienes. These in turn affect mucous glands, capillaries, and smooth muscles, causing the sufferer to experience allergic symptoms.

过敏的产生是因一个人的身体将一般情况下无害的物质，如花粉、霉菌、灰尘或是特殊的食物视为入侵者，而启动防御系统，制造大量的抗体免疫球蛋白(IgE)。当抗体与身体认为危险的物质接触时，就会黏在组织及血球上，使细胞释放很强力的致炎化学物质，称为介质：组织胺、前列腺素以及白三烯素。这些化学物质影响黏液腺、微血管以及平滑肌，造成患者产生过敏症状。

Symptoms are usually found in more than one body system and can be downright contradictory. Reactions to food most commonly cause symptoms in the gastrointestinal system, including spitting up, diarrhea (in a breastfed infant, this means stools are looser, more watery, and greater in number and volume than usual), cramping, constipation, gas, malabsorption of nutrients (which could result in poor weight gain), and colitis. The respiratory system, skin, eyes, and central nervous system may also be involved in allergic reactions to food. The table at the bottom gives an idea of what form allergic symptoms can take.

这些症状通常会在多于一处的身体系统中发现，而且会完全的矛盾。大部份对食物的反应是产生肠胃系统的症状，包括吐奶、腹泻(对母乳宝宝来说，这表示粪便较稀、水份较多、且便便的次数与量都比平常来得多)、肠绞痛、便秘、胀气、对营养吸收不良(这会造成体重成长缓慢)以及结肠炎。而呼吸系统、皮肤、眼睛以及中枢神经系统也有可能产生与食物有关的过敏反应。本文最后的表格显示过敏会出现的症状。

Parents often use behavior to help identify allergies in their child. How a child feels will be revealed in behavior. A child who doesn‘‘t feel well can‘‘t behave well. A baby whose body chemistry is muddled by allergies will be confused and miserable.

父母亲通常以行为来确认他们的孩子是否有过敏，孩子的感觉都会表现在行为上，一个不舒服的孩子无法有好的行为，一个体内化学反应被过敏弄乱的宝宝，是慌乱而痛苦不堪的。

Cow‘‘s Milk Tops the List牛乳为过敏源之首

Lists of the foods most likely to trigger allergic responses differ from source to source and culture to culture, but cow‘‘s milk and dairy products top them all. There are more than 20 substances in cow‘‘s milk that have been shown to be human allergens (Stigler 1985). Colic and vomiting are often caused by cow‘‘s milk allergy. Eczema–dry, rough, red skin patches which can progress to open, weeping sores–is another common symptom among children allergic to cow‘‘s milk. Cow‘‘s milk has been found to cause sleeplessness in infants and toddlers. Dairy allergy has also been suggested as a cause of bed wetting in an older child.

最有可能引起过敏反应的食物种类，会因为食物来源与文化之间的不同而不同，但牛乳和乳制品却是这所有过敏原之首。在牛乳中有超过20种物质已被证明为人类的过敏原(Stigler 1985)。肠绞痛及呕吐常为牛乳过敏所致；湿疹——干燥、粗糙、皮肤有红斑点(会发展成开放且渗出性的伤口)是对牛乳过敏孩童中的另一个常见症状；牛乳已被发现会造成婴儿及幼儿难以入眠；对乳制品过敏也被认为是造成较大孩子尿床的原因之一。

When fed cow‘‘s milk-based formulas, some babies react simply because of the large amounts of cow‘‘s milk they receive. Feeding a baby artificial baby milk is equivalent to an adult drinking seven quarts (almost eight liters) of milk a day! Allergies such as these are not accompanied by changes in the immune system-there is no rise in IgE levels-and they often subside spontaneously. Parents who are bottle-feeding keep switching brands of formula until they find one that works or until the baby outgrows the symptoms.

当喂食以牛乳为主要成分的配方奶时，一些宝宝就是因为摄取了大量的牛乳而有反应，喂食宝宝婴儿配方奶一天的量，（译者按：按体重比例计算）相当于成人一天喝下七夸脱(几乎八公升)的牛乳！像这样的过敏如果不引发免疫系统的改变──IgE浓度不上升——过敏便通常会慢慢消失。奶瓶喂食的父母持续地改变配方奶的厂牌直到发现其中一种有效或宝宝长大不再出现这些症状为止。

Early and occasional exposure to cow‘‘s milk proteins can sensitize a baby so that even tiny amounts of cow‘‘s milk may trigger a response: IgE levels rise and a severe reaction may occur. Thus, sensitive babies may react to cow‘‘s milk in their mothers‘‘ diet. Small amounts of cow‘‘s milk protein may appear in a mother‘‘s milk and provoke a response in her baby, even if the mother herself is not allergic to cow‘‘s milk. If there is a family history of milk allergies, a mother may prefer to avoid dairy products in her diet as well as not offering them directly to her baby. Severe reactions could otherwise occur.

早期偶尔接触到牛奶蛋白会造成宝宝敏感，以致就算极小量的牛乳也会引起反应：IgE值上升，而可能出现严重的反应。因此，敏感的宝宝也许会因为母亲饮食中的牛乳而有所反应。即使母亲本身并不会对牛乳过敏，但小量的牛奶蛋白可能会出现在母亲的乳汁中而造成宝宝的反应。如果家族有牛乳过敏史，母亲最好避免摄取到乳制品，也不要直接提供给她的宝宝，否则可能会发生严重的反应。

Larissa Lee, from North Brunswick, New Jersey, USA, tells of her son Aleksei, who had severe eczema beginning in his first month of life. It began on his face, spread to his scalp, and then all over his body. It would ooze, then get infected. Their family doctor said it was the worst case he had ever seen. He referred them to several dermatologists, including a pediatric dermatologist. The physicians made a lot of suggestions about soaps, detergents, and lotions, but mostly they relied on hydrocortisone products to contain the rash.

来自于美国纽泽西州北Brunswick的Larissa Lee，叙述关于她生下来一个月内就患有严重湿疹的儿子Aleksei。他的湿疹从脸开始，然后蔓延至他的头上，然后是全身。这些湿疹会渗出水分，然后引起感染。他们的家庭医生说这是他见过最糟的案例。他将她们转介给数位皮肤科医师，其中包含一位小儿皮肤科医师。这些医师给了许多有关肥皂、洗洁剂和乳液的建议，但他们大部分使用肾上腺素来控制红疹。

Larissa eliminated dairy products from her diet, and within a week there was a drastic improvement in Aleksei‘‘s eczema. The eczema did not completely disappear (there is a family history of milder cases), but it became much more controllable. Larissa tried eliminating other foods from her diet to try to totally eliminate the eczema, but nothing else made the big difference that eliminating the dairy products had. During his first year, she couldn‘‘t reintroduce dairy into her diet without noticing a flare-up in Aleksei‘‘s eczema. After he turned one, Larissa could have dairy products occasionally. Now that Aleksei is two and a half, he occasionally has milk products himself without much worsening of his symptoms.

Larissa将乳制品从她的饮食中剔除，一周内Aleksei的湿疹有着惊人的改善，湿疹并未完全消失(他们有较轻微情况的家族史)，但是它变得更容易控制。Larissa试着从她的饮食中排除其他食物想要完全消除湿疹，但并没有像排除乳制品般有那样大的改变。在头一年, 她每次摄取到乳制品, 总会发现Aleksei的湿疹突然发作。在他一岁以后，Larissa才能偶而吃点乳制品。现在，Aleksei已经两岁半了，他偶而自己吃到乳制品，症状也不会加重。

Other common foods which cause allergic reactions are eggs, wheat, corn, pork, fish and shellfish, peanuts, tomatoes, onions, cabbage, berries, nuts, spices, citrus fruits and juices, and chocolate.

其他一般会引起过敏反应的食物有蛋、小麦、玉米、猪肉、鱼、贝类、花生、蕃茄、洋葱、卷心菜、莓果、坚果、香料、柑橘类水果及果汁、还有巧克力。

Some allergy sufferers have been helped by avoiding foods which have been exposed to chemicals while being grown or raised. Other things to consider avoiding include additives, flavorings, preservatives, and colorings. In many places, cows, pigs, and chickens are fed antibiotics to produce healthy animals; these may cause or trigger allergies in very susceptible individuals. Coatings on vitamins or other medications can cause an allergic response, as can fluoride, iron, and some herbal preparations. Be sure no siblings or other family members are giving the baby a taste of anything–this is one time when sharing is not appropriate. Eating foods that are chilled or cold sets off reactions for some.

有些过敏症患者会因避免食用在种植或饲养时接触到化学物质的食物而有所改善。其他要考虑避免的包括添加剂、调味剂、防腐剂以及色素。很多养殖场都会以抗生素喂食牛猪和鸡来生产健康的禽畜，在一些极为敏感的个体中，这些都可能造成或引发过敏。维他命或其他药物的覆膜，就像氟化物、铁剂以及一些草药制剂一样，也会造成过敏反应。确认没有兄弟姊妹或其他家族成员给宝宝尝任何东西——这是一个不适合分享的时机。有些人还会因吃到冷冻或冰的食物而有反应。

Sometimes mothers feel that because a food could be a potential allergen, it is best to avoid it entirely. If there is no history of allergy to these foods in the mother‘‘s or father‘‘s family, this may be an unnecessary precaution. Eating foods a mother enjoys will help her to find breastfeeding more satisfying. Mothers do not have to give up foods they love while breastfeeding. Only if a baby shows allergic symptoms should a mother consider avoiding certain foods.

有时妈妈觉得由于某种食物可能是潜藏的过敏原，所以最好要完全避开它，但如果母亲或父亲的家人都没有过敏史的话，这样的做法也许是不必要的。母亲享受食物能够让她更满足地哺乳。哺乳期间，妈妈不需要放弃爱吃的食物，只有在宝宝显现过敏症状时妈妈才需要考虑避开某些特定食物。

A Detective Game侦探游戏

There is no cure for allergies. The easiest and least expensive treatment for many who suffer from allergies to foods is simply to avoid those foods.

过敏无法治愈。对许多对食物过敏的患者来说，最简单且最便宜的治疗方式就是避免食用这些食物。

Discovering exactly which foods a baby reacts to can be a difficult process, but is well worth the effort. For a breastfed baby, this might involve keeping a record of foods eaten by the mother along with notes on the baby‘‘s symptoms and behavior. Over time, it is usually possible to see connections between certain foods and a baby‘‘s distress. If highly allergic, babies can react to foods their mothers have eaten within minutes, although symptoms generally show up between four and 24 hours after exposure. The mother then may develop an eating plan for herself which eliminates suspected foods. If this produces a happier baby, the mother can then challenge her findings by eating some of the suspected food. A repeated reaction from the baby confirms his sensitivity to this food, and his mother may well choose to limit or avoid it for some time.

正确找到宝宝有所反应的食物是个困难的过程，但却是值得努力的。对母乳宝宝来说，这可能需要随着对照宝宝的症状和行为持续记录妈妈吃下的食物。过一段时间通常有可能发现食物与宝宝病痛的关联。虽然症状通常会在接触某种食物4至24小时之后出现，但如果是高度过敏，宝宝会在妈妈吃下食物数分钟内便有所反应。接下来妈妈可以展开一个排除可疑食物的饮食计划，如果宝宝因而好转，妈妈就可以借着再食用来挑战一些她所怀疑的食物，宝宝重复的反应可确定他对这种食物敏感，妈妈就能恰当地限制或避免食用这个食物一段时间。

Most babies will show distinct improvement after an allergenic food has been removed from the mother‘‘s diet for five to seven days, but it may take two weeks or more to totally eliminate all traces of the offending substance from both the mother and her baby. Elimination diets can be time-consuming; however, many mothers find they are worth the effort.

在妈妈不食用引起过敏的食物五到七天后，大部分的宝宝会有明显的改善，但也许得花两周或更久的时间，有问题的物质才会从妈妈与宝宝身体里完全排除。饮食排除很耗时间，但是，许多妈妈发现这值得她们努力。

Dawn Story, from Denver, Colorado, USA comments, “When you have an extremely colicky baby who doesn‘‘t seem to be comforted by anything, the only sure help is time. Nevertheless, it always made me feel better if I was doing something–anything–to try to discover what was making my baby so uncomfortable.”

来自美国科罗拉多州丹佛市的Dawn Story说：「如果妳的宝宝腹绞痛极为严重，而且完全无法安抚，唯一确认有帮助的便是时间。虽然如此，但如果我作了任何一些事去尝试探索到底什么引起我的宝宝如此不安，总是能让我觉得舒服一些。」

Rotation Diets循环饮食

Many mothers have found that following a rotation diet permits them to eat even foods to which the baby has reacted (Stigler 1985). A rotation diet allows troublesome foods to be eaten in a rotating schedule so that there is a three to seven day gap in between days the food is eaten. This allows a food to be completely eliminated from the mother‘‘s body before she ingests it again, which can prevent allergic symptoms from developing in her baby. The stronger the baby‘‘s reaction to the food, the longer the mother should go before exposing the baby to it again. Trial and error will permit the mother to make the best choice for her circumstances.

许多妈妈发现遵循循环饮食的方法使她们能吃那些甚至会引发宝宝过敏反应的食物(Stigler 1985)。循环饮食方法允许摄入问题食物，但是要有一个间隔，约为3~7天。这个方式让妈妈在下次吃相同食物时，此食物已经从她体内完全排除，因此可以避免宝宝产生过敏症状。宝宝对食物的过敏反应愈强，妈妈吃这种食物的间隔就要愈长。尝试与错误可让妈妈为她所处的状况做最好的选择。

Foods that cause problems in babies often bother their mothers as well, but so much more subtly that the mothers are unaware until eliminating a food makes both mother and baby feel better, Ironically, foods that the mother craves and eats on a daily basis often fall into this category.

会引起宝宝发生问题的食物，通常也会对妈妈造成困扰，但很不可思议的是直到排除某种食物，使妈妈与宝宝都觉得好一点之后，妈妈才会察觉；讽刺的是，妈妈每天迫切想吃的食物时常都会落入这个范畴中。

When a child begins eating solids, some mothers experience dermatitis or eczema on their nipples which may be caused by a food her baby or toddler is eating or medications he may be taking. Residuals of that substance in his mouth may cause reactions on the mother‘‘s skin.

当孩子开始吃固体食物之后，有些妈妈的乳头会有皮肤炎或是湿疹，这可能是因她的宝宝或幼儿吃下的食物或药物所引起。在他口腔里的物质残留可能造成妈妈皮肤上的反应。

Robin Slaw‘‘s daughter, Alanna, has a dairy sensitivity which appeared immediately after birth. But it took Robin almost three months to realize that the nightmarish colic Alanna was experiencing was controllable, simply by removing dairy products from her diet. Alanna would scream at the top of her lungs every evening, from 10 PM until 2 AM, and nothing that Robin or her husband did would help. They spent many hours walking her, literally bouncing off the hallway walls from exhaustion.

Robin Slaw的女儿Alanna 在出生后立即出现对乳品过敏。但是Robin几乎花了三个月才了解到，只要在她饮食中剔除乳制品，Alanna恶梦似的肠绞痛是可以控制的。Alanna每天晚上10点到凌晨2点，都会使尽力气哭叫，而Robin 或她的丈夫完全没办法帮上什么忙，他们花了许多时间一直抱着摇着她往走廊走动，以防她哭到精疲力竭。

After Alanna got over her colicky stage, Robin thought she was over her sensitivity to dairy products, and when she was a year old, allowed her to start having dairy products in her diet. It wasn‘‘t until she was three years old that Robin finally associated Alanna‘‘s out-of-control temper tantrums with her consumption of dairy products. Robin removed dairy products from Alanna‘‘s diet, and now she‘‘s fine. Robin adds, “I can always tell when she tries to slip a little milk on her cereal in the morning. She turns into a rude and inconsiderate child, instead of the normally boisterous but caring six-year- old that she is.”

在Alanna熬过肠绞痛这个阶段之后，Roblin想她已经过了对乳制品的敏感时期，而当她一岁时，开始在她的饮食中加入乳制品。直到她三岁时，Robin终于将Alanna无法控制的易怒脾气与乳制品联想在一起。Robin将乳制品从Alanna的饮食中剔除，现在她非常好。Robin补充道：「当她早上在麦片中试着加一点牛奶时，我总是辨别得出来，她变成一个粗鲁且不顾别人的小孩，而不是原来那个通常喧哗却关心别人的六岁小孩。」

Robin‘‘s second daughter, Sarah, has multiple food sensitivities that all appeared by the time she was three months old. “It was a long slow struggle to find all her sensitivities. We started with our family doctor, who couldn‘‘t diagnose her rashes, but sent us to a dermatologist. The dermatologist then sent us to a pediatric dermatologist, who diagnosed atopic dermatitis, and suggested that certain foods could be the source of her reactions. I had already suspected this, and was trying to eliminate what I knew were common allergens, but in the US, it‘‘s very hard to get away from wheat and corn if you eat any processed foods. Through lots of hard work, and the help of a wonderful book called Is This Your Child? by Doris Rapp, I managed to identify almost all of her allergies by the time she turned one. The only two I hadn‘‘t discovered yet were chocolate (which I suspected but hadn‘‘t confirmed, since I didn‘‘t eat it often anyway) and oats, which I hadn‘‘t even begun to suspect.”

Robin的第二个女儿Sarah在三个月大之前就显现对许多食物敏感。「找出她所有的敏感物是一个艰辛漫长的过程，我们一开始去看我们的家庭医生，他无法诊断她的疹子，但将我们介绍给一个皮肤科医师，这位皮肤科医师介绍我们去看一位小儿皮肤科医师，他诊断为异位性皮肤炎，并且提示某些食物可能是她过敏的根源。我早已怀疑是如此，而且已试着将我所知道一般的过敏原都排除了，但是在美国，如果你吃的是加工过的食物，很难将小麦与玉米从中排除。经过许多的努力，以及一本Doris Rapp著的–Is This Your Child一书的帮助，到她一岁时我顺利完成确认了她将近所有的过敏，只剩两个我尚未发现的是巧克力(我曾怀疑过但不确定，因为我不常吃)以及我甚至不曾怀疑过的燕麦片。」

Sarah wasn‘‘t interested in solid foods until after the end of her first year. Robin has scrupulously removed all allergenic foods from both Sarah‘‘s diet and her own, and reports that Sarah can now eat nuts, peanuts, oats, and corn with no reaction. By offering these foods infrequently and staying on a rotation diet, Robin hopes to keep Sarah from developing any new allergies.

Sarah直到一岁以后才对固体食物感兴趣，Robin小心翼翼地将所有的过敏源从Sarah以及她自己的饮食中移除，并记录Sarah现在可以吃坚果、花生、燕麦片还有玉米而不会有所反应。Robin希望藉由不常提供这些食物以及继续实行循环饮食，以避免Sarah再发生任何新的过敏。

Other Options其他的选择

Other treatment options for allergies include medication, immunotherapy, and allergy tests. These can be particularly helpful when the allergen is one not easily avoided, such as pollen, dust, and environmental allergens.

其他过敏治疗的选择，包括药物、免疫疗法以及过敏原的测试。这对不容易避免的过敏原特别有帮助，例如花粉、灰尘以及环境中的过敏原。

Changing the child‘‘s environment by stripping his room to the bare walls and floor will often help an allergic child; the results have been likened to a military barracks look. No curtains, bedspreads, fluffy quilts, dust ruffles, carpeting, rugs, shutters, blinds, upholstered furniture, stuffed animals (except those which are hypoallergenic on both the outside and the inside), or furred or feathered pets. Shades may be used on the windows; pillows should be synthetic; blankets should be cotton or synthetic and should be washed weekly; mattress and box springs should be encased in plastic and furniture should be plain wood or plastic. The closet should hold only the clothes for the current season–no stored items. The space under the bed should be kept empty. Heating/air conditioning vents can be covered in muslin “shower caps” for easy removal and washing. Walls, woodwork, and furniture should be scrubbed at least every three months. If a vaporizer is used, it must be kept scrupulously clean. Some families have found air cleaning machines worth the investment.

改变孩子的环境，将孩子房间墙壁挂的与地板铺的家饰拆除精光，对于有过敏的孩子常有所帮助，这个结果看起来与简陋的兵营相似，没有窗帘、床罩、蓬松的被褥、防尘皱褶罩子、地毯、小地垫、百叶窗、帘子、安装了套子的家具、填充玩偶(除了里、外都使用低过敏物质的以外)、或是有毛皮或羽毛的宠物。窗户上可以用遮阳棚；枕头应该用合成纤维；毯子应该用棉制或合成纤维且必须每周洗涤；床垫和弹簧床应该装进塑料套里，家具应该用简单木制或塑料制。衣橱应该只放置当季的衣物——勿堆存物品。床下的空间清空。冷暖气通风口应该用细薄棉布覆盖，就像”浴帽”般可容易拿下清洗。墙壁、木制门和家具应该至少每三个月擦洗一次。如果有使用喷雾器(增加湿度的电器)，务必保持彻底整洁。有些家庭会发现购置一台空气清新机很值得。

Changing to unscented soaps and laundry powders and avoiding other products with additives, such as hair sprays, deodorants, disposable diapers and wipes, and other personal hygiene products has helped some families. Avoiding fumes and odors where possible, such as those from gas (both fuel for automobiles and cooking and heating fuel), paint, pesticides, chemicals, exhausts, insulation materials, new carpeting, and hay and other dried harvest products may also help.

改成使用无香味的肥皂和洗衣粉以及避免其他含添加物的产品，例如：头发喷雾剂、除臭剂、纸尿布及湿纸巾、以及其他的个人卫生用品，这样的改变使一些家庭都得到了帮助。避免可能的烟雾及气味，像是来自汽油与瓦斯燃烧、油漆、杀虫剂、化学制品、废气、绝缘材料、新地毯、干草以及其他晒干的农产品，也会有帮助。

Prevention for Subsequent Children为后续的孩子所做的预防措施

Once a family has experienced an allergic child, parents want to avoid allergy problems for subsequent children. Studies have shown that if a mother avoids all foods to which any members of her family show sensitivity during her entire pregnancy and period of lactation, later children are far less likely to have allergic symptoms (Chandra 1989). Avoiding eating any food in large amounts during pregnancy will lessen the likelihood of infant allergies to that food.

一旦家庭曾有一个过敏的孩子，父母亲便会希望为后续的孩子避免过敏问题。研究显示假如妈妈在整个怀孕及哺乳过程中，能够避免所有会引起任何家庭成员过敏的食物，之后的孩子似乎极少有过敏的症状(Chandra 1989)。在怀孕期间避免大量地吃任何食物将可降低新生儿对该食物过敏的可能性。

Tricia Jalbert, from Oakland, California, USA, tells of her daughter, Gwen, who awoke frequently in pain and was hard to settle back to sleep. She was also extremely colicky and would spit up often. The pain, the colic, and the spitting confused Tricia, making her too tired to think things through. When Gwen was close to a year Tricia learned that her husband had had diarrhea his whole first year of life. Now the Jalberts are eliminating milk products from their diet in preparation for a future pregnancy, as they don‘‘t want to take any chances that another baby will have any problems with cow‘‘s milk protein. Gwen likes to have a little cow‘‘s milk to drink from time to time, but she only takes a couple of sips of it. Tricia says she thinks that Gwen knows to stay away from it.

来自于美国加州奥克兰的Tricia Jalbert 描述她的女儿Gwen，常常痛醒而难以再入睡，她也有严重的腹绞痛而且时常会吐奶。她的疼痛、腹绞痛和吐奶使Tricia张皇失措，疲惫得无法去思考整件事。当女儿快一岁时，Tricia 才知道她的丈夫一岁前都一直有腹泻的情形。如今Jalbert 家会排除乳制品为未来的怀孕做准备，因为他们不希望冒任何险让下一个宝宝对牛乳蛋白产生过敏。Gwen时常会想喝点牛乳，但她都只啜饮两三口。Tricia说她女儿知道要远离乳制品。

A pregnant woman who avoids cow‘‘s milk products must be sure to get adequate calcium from other sources, either through her diet or a calcium supplement. Ruth Lawrence recommends reagent quality powdered calcium carbonate (Lawrence 1994). Dietary sources of calcium include calcium-enriched tofu, collards, spinach, broccoli, turnip greens, kale, liver, almonds and Brazil nuts, as well as canned sardines and salmon.

怀孕的妇女若避免摄取乳制品，就必须确保可从其他食物或补充钙片来摄取足够的钙质。Ruth Lawrence建议食用有质量的粉末状碳酸钙(Lawrence 1994)。可获得钙质的食物来源包括含有丰富钙质的豆腐、羽衣甘蓝叶、菠菜、绿花菜、芜菁叶、甘蓝、肝脏、杏仁还有巴西坚果，罐装的沙丁鱼和鲑鱼也是。

Mothers who avoid potential allergens during pregnancy seem to have a lower incidence of pre-eclampsia, swelling, and yeast infections. They also have less trouble with runny noses during pregnancy (Stigler 1985). These benefits to mothers may help compensate for giving up foods they may enjoy.

怀孕期间避开潜在过敏原的妇女似乎有较低的初期子痫、水肿和真菌感染的发生率，她们在怀孕期间也较少有流鼻涕的困扰(Stigler 1985)。这些好处足以弥补让母亲们放弃自己钟爱食物的痛苦吧。

Pregnant mothers may also wish to stay inside on days when the pollen count is high. Research shows there is a seasonal clustering of higher miscarriages, late-pregnancy bleeding, extreme swelling, and ectopic pregnancies during hayfever season; and 10 days after an elevated ragweed count, hospitals admit more women with toxemia of pregnancy (Stigler 1985).

怀孕的妈妈也希望能在花粉量较高的时候待在室内。研究显示在花粉热流行期有大量的流产、怀孕后期出血、严重的水肿和子宫外孕；豕草花粉量达最高期10天后，医院有更多妊娠毒血症的妇女去求诊。(Stigler 1985)。

Although taking steps to reduce exposure to allergens may be tedious and difficult, the results are rewarding. It‘‘s extraordinary to see a child change from a whiny, irritable, aggressive, rash-prone, doesn‘‘t-know-what-he-wants, non-sleeper to a pleasant, clear-skinned, easy-going child who sleeps well. Once parents are confronted with this dramatic change, they are willing to do what it takes to help their child.

虽然逐步降低接触过敏原非常令人厌烦且困难，但结果是很值得的，特别是看到孩子从哭吼、易怒、好挑衅、易于急躁、不知自己要什么、不肯入睡的人，改变成睡得好、快乐、皮肤光洁、又随和的孩子。一旦父母亲面临到这些戏剧性的改变，他们都会乐意去做对孩子有帮助的事。

Possible Symptoms of Allergy过敏可能的症状

Generally more than one body system is involved in an allergic reaction. Gastrointestinal symptoms are most common.

通常一种过敏反应会牵连着多个身体系统，而肠胃的症状是最常见的。

（Daisy 审稿）

Resources

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[1] Crook, W. Tracking Down Hidden Food Allergies. Jackson, Tennessee: Professional

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[2] Crook, W. You and Allergy. Jackson, Tennessee: Professional Books, 1984.

[3] La Leche League International. THE WOMANLYART OF BREASTFEEDING.

Schaumburg, Illinois: LLLI, 1997.

[4] Lawrence. R. Breastfeeding: AGuide for the Medical Profession, 4th edition. St. Louis:

Mosby, 1994.

[5] Mohrbacher, N. and Stock, J. THE BREASTFEEDING ANSWER BOOK. Schaumburg,

Illinois: LLLI, 1997.

[6] Rapp, D. Is This Your Child? New York: William Morrow and Company, Inc., 1991.

[7] Rapp, D. Sneezing, Wheezing and Scratching. LosAltos, California: The ECR

Collection, 1974.

[8] Riordan, J. and Auerbach, K. Breastfeeding and Human Lactation. Boston,

Massachusetts: Jones and Bartlett, 1993.

Periodical Articles:

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[10] Chandra, R., Puri, S., and Hamed, A. Influence of maternal diet during lactation and use

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[11] Gerrard, J. Food allergy: two common types as seen in breast and formula fed babies.

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[12] Gruskay, F. Comparison of breast, cow and soy feedings in the prevention of onset of

allergic disease: a 15-year prospective study Clin Pediatr, 1982;21 (8):486-91.

[13] Host, A, Husby, S., and Osterballe, O. Aprospective study of cow‘‘s milk allergy in

exclusively breastfed infants. Acta Paediatr Scand, 1988; 77:663-70.

[14] Jandl, A. Allergies. NEWBEGINNINGS, Mar-Apr 1996; 40-41.

[15] Kahn, A, Mozin, M., Casimir. C., et al. Insomnia and cow‘‘s milk allergy in infants.

Pediatrics, 1985; 76:880-85.

[16] Lesniewski, L. Coping with allergies. NEWBEGINNINGS, Sept-Oct 1988 140-142.

[17] Merrett, T., et al. Infant feeding and allergy: 12-month prospective study of 500 babies

born into allergic families. Ann Allergy, 1988; 61:13.

[18] Mohrbacher, N. Reducing the risk of allergies. NEWBEGINNINGS, Sept-Oct

1988;143-44.

[19] Saarinen, L. and Kajosaari, M. Breastfeeding as prophylaxis against atopic disease:

prospective follow-up study until 17 years old. Lancet, 1995 346:1065-69.

[20] Sehee, C. Late solids and allergies. NEWBEGINNINGS, Sept-Oct 1988:142-43.

[21] Shircliff, S. Bottoms up. NEWBEGINNINGS. Mar-Apr 1995; 43-44.

[22] Stigler, U. Preventive dietary management: prenatal, neonatal and in infancy. Clin Ecol,

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[23] Sutin, K. Eliminating foods worked wonders. NEWBEGINNINGS, Sept-Oct 1988;

145.

Karen Zeretzke is an LLL Leader and serves as Area Professional Liaison for LLL of

Alabama/Mississippi/ Louisiana, USA. She and her husband, Fred, an engineer, live in Baton

Rouge, Louisiana, with their eight children, ages 10 to 28. Karen has been an IBCLC since

1988 and has a private practice as a lactation consultant.