Prevention strategies for Asthma:

Primary prevention:

1. Since there is conflicting data on early life exposure to pets, no general recommendation can be made with regard to avoiding pets for primary prevention of allergy and asthma (level III). However, families with biparental atopy should avoid having cats or dogs in the home (level II).
2. There are conflicting and insufficient data for physicians to recommend for or against breastfeeding specifically for the prevention of asthma (level III). Due to its numerous other benefits, breastfeeding should be recommended.

Secondary prevention:

3. Health care professionals should continue to recommend the avoidance of tobacco smoke in the environment (level IV).
4. For patients sensitized to house dust mites, physicians should encourage appropriate environmental control (level V).
5. In infants and children who are atopic, but do not have asthma, data are insufficient for physicians to recommend other specific preventive strategies (level II).

Tertiary prevention:

6. Allergens to which a person is sensitized should be identified (level I), and a systematic program to eliminate, or at least to substantially reduce, allergen exposure in sensitized people should be undertaken (level II).

It has been assumed that breastfeeding is preventative against early childhood wheezing and the subsequent development of asthma and that exposure to pets is a risk factor for the development of asthma. Recent studies have brought these general assumptions into dispute, and we considered the available data addressing these 2 important issues.