Chapter 7: Primary prevention of asthma
Key changes
• Advice about primary prevention of asthma is now provided separately from advice about secondary
prevention
• Specific recommendations aimed at reducing the risk of a child developing asthma
No exposure to tobacco smoke during pregnancy or after birth
Encourage vaginal delivery where possible
Discourage use of broad-spectrum antibiotics in the first year of life
• Breast-feeding is advised, but for reasons other than prevention of allergy or asthma.
Rationale for change
For clinical utility, advice about primary prevention of asthma has been separated from information about
secondary prevention of symptoms in patients with an existing diagnosis of asthma. In this chapter, a
summary is provided of evidence about potential factors contributing to the development of asthma, such
as nutrition (breast-feeding, vitamin D, delayed introduction of solids, probiotics), exposure to allergens
and pollutants, and the potential role of microbial effects, medications and psychosocial factors.
Present evidence supports the following recommendations for reducing the risk of a child developing
asthma: 1) children should not be exposed to tobacco smoke during pregnancy or after birth; 2) vaginal
delivery should be encouraged where possible; and 3) the use of broad-spectrum antibiotics in the first
year of life should be discouraged.
Breast-feeding is still advised, but for reasons other than prevention of allergy and asthma.