Säuglingsernährung und atopische Dermatitis – eine prospektive Beobachtungsstudie

Abstract

Recommendations for primary prevention of allergic diseases in high-risk children include hypoallergenic infant formulas (HA) if breastfeeding is insufficient. The primary objective of our study was to investigate the atopic dermatitis (AD) preventive effect of breastfeeding and HA-nutrition in the first 2 years of life and to follow the increase in weight. Altogether 174 newborns with a hereditary risk for atopy were enrolled in the study, 121 children were investigated at the age of 2 months, 111 at the age of 4 and 106 at the age of 6 months. A total of 45 infants were in the first half-year of life exclusively breastfed and 61 infants were mainly fed with HA. The body weight of initially HA-fed children was 7870G (SD 949) significantly higher as the one of breastfed children (7508 G, SD 912, p=0.0571), in addition the weight increase was also significantly higher in HA-fed infants at the age of 6 months (p=0.0042). The frequency of AD as well as SCORAD score at the age of 6 to 24 months was comparable in both groups. Neither the milk-specific IgE antibodies nor the proliferation of peripheral blood mononuclear cells (PBMC) to bovine beta-Lactoglobulin (BLG) at the age of 6 months had a prognostic value for development of atopic dermatitis. The likelihood to develop AD in the first 2 years of life was comparable in exclusively breastfed as in HA-fed infants with hereditary risk for atopy. The initially HA-fed children demonstrated at the age of 6 months higher body weight and weight increase as the exclusively breastfed infants. The efficacy of nutritional intervention on the incidence of AD in high-risk children for atopy could not be predicted by milk-specific IgE antibodies or BLG-specific proliferation of PBMC.