Differences in Dietary Management of Infant Atopic Dermatitis Among Pediatricians, Allergists, and Dermatologists in the United States

Abstract

S U N D A Y 362 Differences in Dietary Management of Infant Atopic Dermatitis Among Pediatricians, Allergists, and Dermatologists in the United States Laura Czerkies, MS, RD, Erica Horodniceanu, Vardhaman Patel, Marc Botteman, MSc, Jose Saavedra, MD; Nestle Nutrition, Florham Park, NJ, Pharmerit International, Bethesda, MD, College of Pharmacy, University of Illinois, Chicago, IL. RATIONALE: Cow milk-based formula use is one etiologic factor of atopic dermatitis (AD), the most common chronic skin disease of infancy. However, data regarding clinical management practices of AD are limited. One study objective was to estimate differences among specialties in the use of formula change for dietary management of AD in non-exclusively breastfed infants 5 years, and 80.4% treated >50 AD patients during the past year. Overall, 59.4% PED, 61.5% ALLER, and 26.9% DERM use formula change alone in >5% of infants for AD management. When infants are receiving intact protein formula, 44.0% PED, 45.8% ALLER, and 73.7% DERM recommend change to soy-based formula, and 46.2 % PED, 41.7%ALLER, and 15.8% of DERM recommend extensively hydrolyzed formula (EHF) (p50.06). For infants receiving partially hydrolyzed formula, 61.5% PED, 50.0% ALLER and 36.8%DERM recommend EHF (p50.01). For infants already consuming EHF, amino acid-based formulas are recommended by 62.6% PED, 66.7% ALLER, and 26.3% of DERM (p<0.001). CONCLUSIONS: In non-exclusively breastfed infants with AD, infant formula change is a common management approach, with significant variations among specialties. Despite recommendations to the contrary, soy-based formulas continue to be widely used as an alternative in managing atopic conditions.