RESULTS OF A MULTICENTER STUDY ON THE PREVENTION OF ATOPY IN “AT RISK” BABIES (3 YEARS FOLLOW-UP)

Abstract

We have planned a prevention programme of atopic diseases in high risk babies with the cooperation of 40 Maternity Hospitals. The aim of this study is to evaluate the effect of dietary and environmental measures in the development of atopic disease in newborns of atopic parents. The dietary measures are the following exclusive breast feeding for the first six months of life; elimination of cow's milk (CM) and egg from the diet of the nursing mother; soy milk (Isomil Abbott) supplement when breast milk is not sufficient; selected weaning after the 6th month of life. The environmental measures are the following: no smoking in the house; strict environmental controls for the elimination of house dust; no pets in the house; day-care center attendance delayed to after 3 years of age. All infants were seen at an age of 1, 3, 6, 9, 12 months and twice-a-year afterwards, and a detailed history is taken and the presence of symptoms and signs of atopic disease are examined (bronchial asthma, atopic dermatitis (AD), food allergy): Up to now, 732 children are 2 year old: 379 (52%) are males and 353 (48%) females; 98 (13%) have two or more relatives affected by atopic disease, 634 (87%) have one relative affected. 242/732 (33%) were exclusively breast feed until the 6th month of life, 139/732 (19%) received exclusively soy milk, 212/732 (29%) received breast milk and soy milk supplement, and 139/732 (19%) were CM formula fed. At the last follow-up (2 years) the cumulative prevalence of atopic disease was 17% (125/732 children). In detail, 83 (11%) showed AD, 28 (4%) asthma, and 14 (2%) rhinitis. Of the 125 babies with atopic diseaae, 81/379 (21%) were malei and 44/353 (12%) females (p<0.01); 28/98 (29%) of the babies have two or more relatives affected by atopic disease, 97/634 (15%) have one relative affected by atopic disease (p<0.01). Among the children who developed atopic diseases: 13% (31/242) were exclusively breast-fed until the six month of life, 10% (14/139) received soy milk, 15% (32/212) were breast milk and soy-milk fed, and 34 % (48/139) CM fed. The very low prevalence of atopic disease in the infants who followed the preventive measures (12%) and the higher (34%) in those who did not (p<0.01) stresses the importance of such manipulations for the prevention of atopy in “at risk babies”.