Atopic Dermatitis In Early Childhood Research Articles

466 The relationship between atopic dermatitis and childhood symptoms of attention deficit/hyperactivity disorder: A longitudinal cohort study

The rise in atopic dermatitis (AD) has been paralleled by rising prevalence of attention deficit/hyperactivity disorder (ADHD) in the past few decades, especially in developed and Western countries. Previous research shows a possible association between AD and ADHD, but data have been mixed, likely due to poorly defined phenotypes and heterogeneity in measuring AD and ADHD. Furthermore, most studies have been limited by cross-sectional designs. To test our hypothesis that active and more severe early childhood AD is associated with clinician-diagnosed ADHD at age 7, and hyperactive symptoms as measured by the Strengths and Difficulties Questionnaire (SDQ) at ages 7, 10, 13, and 16 years, we analyzed data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a large population-based birth cohort from the UK. Using logistic regression models, we found that AD (defined as at least two reports of flexural dermatitis from a standardized and validated questionnaire) was not associated with clinician-diagnosed ADHD at age 7 based on the Development and Wellbeing Assessment (Odds Ratio 1.07, 95% CI 0.64-1.78, adjusted for potential confounders including maternal stress during pregnancy, maternal age at delivery, maternal smoking during pregnancy, socioeconomic status, and maternal smoking). We found a trend toward higher effect estimates in younger ages, though this was not statistically significant, and we found no evidence of an interaction with parental-reported sleep quantity. Additionally, we did not find any significant cross-sectional associations between active AD and symptoms of hyperactivity based on the SDQ at four subsequent assessments between ages 7 and 16. Our results do not provide evidence to support an association between AD and ADHD in a large cohort of children followed from birth. Our research challenges the current paradigm that AD is strongly associated with ADHD.

Jaundiced Neonates Receiving Phototherapy and Risk of Atopic Dermatitis in the First 2 Years of Life: A Case-Control Study

Background Only alimited number of studies have evaluated the association between phototherapy-treated neonatal jaundice and the development of atopic dermatitis (AD) in the early childhood. In this context, the present study is aimed to assess the relationship between the AD development in the childhood and the history of phototherapy in the case of neonatal jaundice. Materials and Methods 92 children younger than two years of age who were admitted in Besat hospital and Imam Khomeini clinic (Hamadan, Iran) were enrolled in this case-control study. The subjects were classified into the case (children with AD, n=43), and control (children without AD, n=49) groups. AD was diagnosed by an allergist according to the AD diagnostic criteria. The history of neonatal jaundice treatment with phototherapy as well as the medical records of all the recruited subjects was investigated. The data were collected by physician according to clinical manifestations and medical records. The association between phototherapy-treated jaundiced neonates and developing AD was examined. Results 92 children were recruited.The mean age of the participants in the case and control groups was 10.56 and 9.89 months, respectively. About 74% (n=14) of the phototherapy-treated neonatal jaundice patients developed AD in their early childhood. Logistic regression analysis was used to evaluate the effect of jaundice treatment with phototherapy on the AD development in the early childhood. The prevalence of AD was higher in the patients with positive history of jaundice treatment with phototherapy (p < 0.05, OR=4.24, 95% CI: 1.38-13.06). Conclusion Based on the results, atopic dermatitis in early childhood was significantly associated with neonatal jaundice treatment by phototherapy.

The Association Between Mercury Exposure and Atopic Dermatitis in Early Childhood: A Mothers and Children's Environmental Health Study.

Atopic dermatitis is a chronic and relapsing inflammatory skin disease. Although mercury has been suggested as a risk factor, the underlying mechanism and the relationship between mercury and atopic dermatitis remains unclear. The objective of the present study was to investigate the relationship between mercury exposure and the presence of atopic dermatitis in early childhood. This study is part of the prospective Mothers and Children's Environmental Health cohort study. A total of 1,751 pregnant women were enrolled in Mothers and Children's Environmental Health. After delivery, children were followed up. Blood samples were collected and mothers were asked about the presence of atopic dermatitis in their children via a questionnaire at 6, 12, 24, 36, and 60 months of age. After excluding participants who did not meet the inclusion criteria, a total of 1,061 mother-children pairs were included in the analysis. The geometric mean of mercury concentrations in cord blood was 5.1 µg/L. In adjusted models, cord blood mercury exposure (odds ratio [OR] = 1.1; 95% confidence interval [CI] = 1.0, 1.2 at 12-24 months) and postnatal mercury exposure (OR = 1.2; 95% CI = 1.0, 1.5 at 24-36 months, OR = 1.4; 95% CI = 1.1, 1.8 at 48-60 months) were associated with the presence of atopic dermatitis in children. Postnatal mercury exposure at 24 months of age increases the risk of atopic dermatitis in children.

Preschool atopic dermatitis and adolescent contact allergy

Atopic dermatitis is a common skin disease in children. The disease presents with red, itching and scaly skin, and results in a weakened skin barrier. When atopic dermatitis starts in early childhood, children may be treated with medical ointments and moisturizers for a long time. Such products often contain substances that can cause contact allergy. Contact allergy is caused by skin contact with chemical substances that are allergenic, e.g. contact allergens. Repeated contact with the allergen will result in dermatitis. This study investigated if atopic dermatitis in early childhood increases the risk for contact allergy in the teenage years. The study was performed among 2215 16‐year‐olds in Sweden. These 16‐year‐old participants had been followed since birth with questionnaires, clinical examinations and blood tests, to study environmental factors and allergies in children as part of a large population study called the BAMSE study. At 16 years, the participants were tested for contact allergy with a skin patch test. Nickel allergy was the most common contact allergy and fragrance (perfume) allergy was second most common. The results of this study indicate that atopic dermatitis in early childhood may increase the risk of having contact allergy to perfumes at 16 years, but not the risk of nickel allergy at 16 years. This study indicates that avoiding scented and perfume‐containing products is a good idea in children with atopic dermatitis in early childhood.

Palmar hyperlinearity in early childhood atopic dermatitis is associated with filaggrin mutation and sensitization to egg.

Palmar hyperlinearity is a typical clinical feature of Filaggrin gene (FLG) null mutations. There are reports of FLG mutations and allergic sensitization; however, reports on the relationship between palmar hyperlinearity to sensitization are limited. This study aimed to examine the association between palmar hyperlinearity and sensitization in atopic dermatitis (AD) children. This cross-sectional, case-control study included children ˂ 6years old with moderate-severe AD whose parents consented for mutation analysis and photographic documentation. Each child underwent genotyping to detect the eight most prevalent FLG mutations in the Japanese population: R501X, 3321delA, S1695X, Q1701X, S2554X, S2889X, S3296X, and K4022X. Clinical features and parameters including egg-specific IgE were examined, and palm photographs were evaluated by 12 trained dermatologists blinded to genotyping results. Of the 57 patients (age range, 2months to 5years; median, 22months), 16 were heterozygotes and three were compound heterozygotes. Palmar hyperlinearity, as recognized by more than two-thirds of dermatologists, was significantly associated with FLG mutation (P=0.002, OR=6.98, 95% CI=2.1-23.7), and this association was observed especially in children over 2years. Cross-shaped crease of the thenar eminence, as known in previous reports, also demonstrated significant correlation with FLG mutation. When the children were divided according to the presence or absence of palmar hyperlinearity, the egg white-specific IgE was significantly higher in the hyperlinearity group (55.9 vs 18.3IU/mL, P<0.05). Palmar hyperlinearity indicates possible inherited barrier abnormalities of the skin in early childhood. Its identification may help to predict a more accurate prognosis, such as sensitization.

Association of maternal allergy with human milk soluble CD14 and fatty acids, and early childhood atopic dermatitis.

This study aimed to investigate whether maternal allergy is associated with soluble CD14 (sCD14) and fatty acid composition in different stages of lactation and the onset of atopic dermatitis (AD) in early childhood. In total, 443 mother-child groups (445 children) were enrolled in the Prediction of Allergies in Taiwanese Children birth cohort study. Colostrum and mature milk at 2months postpartum (2-month HM) were collected from lactating mothers. Information regarding parental allergy histories and physician-diagnosed atopic diseases was obtained using age-specific questionnaires (0-2years). We compared sCD14 levels and the composition of 30 fatty acids in the colostrum and 2-month HM, respectively, between allergic and non-allergic mothers and between children with and without AD by the age of 2years. In total, 185 (41.8%) mothers presented with allergies, and 154 (34.6%) children had physician-diagnosed AD by the age of 2years. Both in the colostrum and 2-month HM of 289 lactating mothers, sCD14 levels were significantly lower in allergic mothers whose children presented with AD compared with children who did not (P=0.015 and 0.044, respectively). Among the children with AD who were born to non-allergic mothers, sCD14 levels were lower. However, the result was not statistically significant (P=0.376 and 0.264, respectively). Our data revealed the lack of associations between fatty acid composition and AD (P>0.05). Decreased sCD14 levels in the colostrum and 2-month HM were associated with AD at 2years of age, particularly among children born to mothers with allergies.

Atopic dermatitis at preschool age and contact allergy in adolescence: a population-based cohort study.

Atopic dermatitis (AD) is characterized by an impaired skin barrier, which can allow enhanced penetration of allergens. It is not clear whether AD influences the risk of developing contact allergy. To examine the association between AD at preschool age and contact allergy at 16 years of age. At 16 years of age, 2215 adolescents from the population-based cohort BAMSE were included. These adolescents had been followed with repeated questionnaires regarding AD throughout childhood, and contact allergy was assessed by skin patch test at 16 years. AD at preschool age was associated with contact allergy to at least one of the tested substances at 16 years of age among boys [adjusted odds ratio (OR) 1·51, 95% confidence interval (CI) 1·03-2·20] but not among girls (adjusted OR 0·77, 95% CI 0·54-1·10). AD at preschool age was not associated with contact allergy to nickel in either boys or girls. In contrast, AD at preschool age was associated with contact allergy to fragrance mix I (adjusted OR 3·10, 95% CI 1·66-5·80). This association was observed especially for AD at preschool age in combination with IgE sensitization to airborne or food allergens (adjusted OR 3·80, 95% CI 1·67-8·61). The results suggest that AD in early childhood may be associated with contact allergy to fragrances, but not to nickel, in adolescence.

Phenotypes of atopic dermatitis identified by cluster analysis in early childhood.

Atopic dermatitis is a chronic, relapsing, inflammatory skin disease that usually appears in early childhood and develops into a heterogeneous disease during childhood. The clinical course and treatment for atopic dermatitis can differ according to its phenotype and/or endotype. This study aimed to identify clinical phenotypes of atopic dermatitis in early childhood. Data were obtained from 572 children under 3 years of age with atopic dermatitis. Cluster analysis applied to 11 variables, and we identified four clusters of atopic dermatitis. Children in cluster A (n = 141) had early-onset atopic dermatitis with high blood eosinophil counts, serum total immunoglobulin E and rates of sensitization to food allergens. Children in cluster B (n = 218) had early-onset atopic dermatitis with low blood eosinophil counts, serum total immunoglobulin E and rates of sensitization to both food and inhalant allergens. Children in cluster C (n = 53) had early-onset atopic dermatitis with high C-reactive protein levels and white blood cell counts. Children in cluster D (n = 160) had middle-onset atopic dermatitis with high serum total immunoglobulin E and rates of sensitization to inhalant allergens. Cluster A had the highest Scoring for Atopic Dermatitis and transepidermal water loss values. Age at onset, age at diagnosis, white blood cell count, eosinophil count, C-reactive protein and serum total immunoglobulin E level were the strongest predictors of cluster assignment. Analysis of these six variables alone resulted in correct classification of 95.5% of the subjects. These results support the heterogeneity of atopic dermatitis, even in early childhood.

Racial/Ethnic Differences in Incidence and Persistence of Childhood Atopic Dermatitis

Although previous studies have explored racial/ethnic differences in incident atopic dermatitis (AD) in childhood, few studies have examined risk factors associated with AD persistence. As such, we sought to examine differences in incidence and persistence of childhood AD by race/ethnicity accounting for sociodemographic characteristics and perinatal vitamin D levels. Using data from Project Viva, a prospective prebirth cohort in eastern Massachusetts, we studied 1,437 mother-child pairs with known AD status to examine the associations of race/ethnicity with maternally reported child AD. We used multivariable logistic regression, adjusting for sociodemographic factors and maternal plasma vitamin D, to estimate adjusted odds ratios (aORs) of AD incidence at early childhood and persistence at mid-childhood. Compared to non-Hispanic whites, non-Hispanic blacks (aOR= 2.71, 95% confidence interval= 1.75-4.19) and other non-Hispanics (aOR= 1.80, 95% confidence interval= 1.16-2.80) were more likely to have incident AD. Non-Hispanic blacks (aOR= 6.26, 95% confidence interval= 2.32-16.88) and Hispanics (aOR= 6.42, 95% CI= 1.93-21.41) with early childhood AD were more likely to have persistent AD. In conclusion, compared with non-Hispanic whites, AD incidence and persistence are higher among certain nonwhite racial/ethnic subgroups. Further research is warranted to identify environmental, socioeconomic, and genetic factors that may be responsible for the observed differences.

Assessment of atopic dermatitis as a risk factor for chronic spontaneous urticaria in a pediatric population.

Background: Atopic dermatitis (AD) and chronic spontaneous urticaria (CSU) represent two of the most common chronic inflammatory pruritic skin diseases. Any relationship between atopic skin disorders and CSU is controversial, mostly due to the paucity of relevant epidemiologic and pathogenetic data. Objective: To evaluate whether a history of AD in early childhood represents a risk factor for the subsequent occurrence of CSU in a pediatric population. Methods: Retrospective data of new cases of patients who visited the outpatient allergy unit of a tertiary pediatric hospital in Athens, Greece, between June 2014 and August 2016, were analyzed. Diagnoses of CSU and AD were based on diagnostic criteria proposed by the European Academy of Allergy and Clinical Immunology and the Hanifin and Rajka criteria, respectively. The data analyzed included CSU and AD diagnoses and the association with gender and season of birth as well as a personal and family history of allergy-related diseases (e.g., asthma, allergic rhinitis, AD, and food and drug allergies). Results: Records from 2261 children were included in the analysis (1365 boys; mean ± standard deviation [SD] age, 8.7 ± 5.8 years). Fifty-one children (31 boys; mean ± SD age, 9.1 ± 4.6 years) were diagnosed with CSU, whereas AD was reported in 761 children (466 boys; mean ± SD age, 5.2 ± 3.8 years). Multivariate data analysis showed that the children with a history of an early diagnosis of AD were at increased risk for later CSU occurrence (odds ratio 2.923 [95% confidence interval, 1.647-5.189], p < 0.001). No significant associations were observed with respect to other demographic and atopy-associated characteristics of the patients. Conclusion: Results of our study indicated that AD may constitute an important risk factor to the subsequent occurrence of CSU. This notion warrants further study with well-designed prospective cohorts.

Fetal growth and incidence of atopic dermatitis in early childhood: Results of the Ulm SPATZ Health Study

Fetal growth may be a precursory factor in observed association between birthweight and atopic dermatitis (AD), however, recent studies utilizing fetal ultrasound-based data have reported contradictory results. This study aims to clarify previous findings through comprehensive investigation of association between several trimester-specific ultrasound-based anthropometric measures with AD diagnosis by age 3 years. Measurements of 386 newborns in the Ulm SPATZ Health Study were converted into adjusted z-scores categorized as “low” (≤1 SD below mean), “normal,” or “high” (≥1 SD above mean). AD cases were defined using parent- or pediatrician-report of physician-diagnosis or clinical diagnosis. Adjusted risk ratios (RR) with 95% confidence intervals (95% CI) were calculated using modified Poisson regression. Compared to normal, both low and high 2nd trimester abdominal circumference [RR 1.51, (95% CI 1.01; 2.24) and 1.83 (1.21; 2.76)], high 2nd trimester head- abdominal circumference ratio [1.69 (1.16; 2.48)], and faltering 2nd to 3rd trimester [1.59 (1.04; 2.43)] head circumference were associated with greater AD risk. High 3rd trimester femur length [0.54 (0.31; 0.94)] was associated with lower risk. Using more inclusive exposure cut-points (0.8 SD), lower 1st trimester crown-rump length was also associated with greater AD risk. Our data suggest several different patterns of fetal growth may be differentially associated with AD.

Current understanding of allergic march and the role of eczema in its development

An increasing morbidity of atopic diseases (atopic dermatitis, food allergy, asthma and allergic rhinitis) documented in large cohort epidemiological studies is at least partially determined by high hygienic standards of living. Over the last 40 years, the accepted concept of pathogenesis of atopic diseases, the so-called atopic march, was proposed by Fouchard in 1973. It referred to the natural history of atopy manifestation, with a typical sequence of symptoms presented as atopic dermatitis in early childhood for subsequent development of allergic respiratory symptoms in late childhood and adolescence. New data suggests that the leading role of atopic dermatitis in atopic march might be less pronounced than previously expected, indicating coexistence rather than succession of atopic symptoms. The objective of this paper is to present the currently discussed concepts of atopic dermatitis – its pathogenesis, etiology, course and role in the development of other allergic diseases. More widely, we will present: 1. The genetic factors involved in skin barrier disruption with the leading role of loss-of-function gene for filaggrin mutation, 2. Genetic defects and epigenetic regulation of the immune system 3. Epidermal changes with physical barrier dysfunction as well as 4. Skin microbiome disturbances with Staphylococcus aureus colonization leading to abnormalities of the epidermal protective barrier.

Cesarean Section Delivery and Development of Food Allergy and Atopic Dermatitis in Early Childhood

E Papathoma, M Triga, S Fouzas, G Dimitrious. Pediatr Allergy Immunol. 2016:27(4):419–424 To investigate the association between cesarean delivery and physician-diagnosed food allergy and atopic dermatitis during the first 3 years of life. A prospective birth cohort study of children born at ≥34 weeks’ gestation at the University Hospital of Patras, Greece, between August 2009 and March 2011. Four hundred fifty-nine children born in the same tertiary maternity unit were examined at birth and followed up at 1, 6, 12, 18, 24, 30, and 36 months …

Does Breast-feeding Relate to Development of Atopic Dermatitis in Young Korean Children?: Based on the Fourth and Fifth Korea National Health and Nutrition Examination Survey 2007-2012.

PurposeThere have been conflicting reports concerning the relationship between breast-feeding and the development of atopic dermatitis (AD) in early childhood. The objective of this study was to investigate the associations between breast-feeding and the risk of AD in early childhood in Korea.MethodsWe combined the fourth and fifth Korea National Health and Nutrition Examination Survey data collected from 2007 to 2012 and analyzed 2,015 children at 1 to 3 years old. Regression analysis was used to determine the association of the following variables: AD, feeding types, duration of breast-feeding, and others.ResultsThe annual prevalence of exclusive breast-feeding and AD decreased. Parents with allergic diseases preferred breast-feeding and extended duration of feeding compared with those without. In multiple logistic regression analyses, exclusive breast-feeding in feeding type I (P=0.070; adjusted odds ratio [OR]=1.990), exclusive breast-feeding in feeding type II (P=0.095; adjusted OR=1.495) and breast-feeding duration (P=0.430; adjusted OR=1.013) were not significantly related to AD.ConclusionsBreast-feeding was not found to be associated with an occurrence of AD in young children. Rather, parents with histories of allergic diseases tended to prefer breast-feeding and extend its duration. To clarify the role of breast-feeding in the development of AD, a nation-wide prospective study is needed.

Prenatal phthalate exposure associates with low regulatory T-cell numbers and atopic dermatitis in early childhood: Results from the LINA mother-child study

Prenatal phthalate exposure associates with low regulatory T-cell numbers and atopic dermatitis in early childhood: Results from the LINA mother-child study

Cesarean section delivery and development of food allergy and atopic dermatitis in early childhood.

Delivery by Cesarean section (CS) may predispose to allergic disorders, presumably due to alterations in the establishment of normal gut microbiota in early infancy. In this study, we sought to investigate the association between CS and physician-diagnosed food allergy and atopic dermatitis during the first 3years of life, using data from a homogeneous, population-based, birth cohort. A total of 459 children born and cared for in the same tertiary maternity unit were examined at birth and followed up at 1, 6, 12, 18, 24, 30 and 36months of age. Participants with symptoms suggestive of food allergy or atopic dermatitis were evaluated by a pediatric allergy specialist to confirm the diagnosis based on well-defined criteria. The rate of CS was 50.8% (n=233). Food allergy was diagnosed in 24 participants (5.2%) while atopic dermatitis was diagnosed in 62 children (13.5%). Cesarean section (OR 3.15; 95% CI 1.14-8.70), atopic dermatitis of the child (OR 3.01; 95% CI 1.18-7.80), parental atopy (OR 4.33; 95% CI 1.73-12.1), and gestational age (OR 1.57; 95% CI 1.07-2.37) were significant and independent predictors of food allergy. Children with at least one allergic parent delivered by CS had higher probability of developing food allergy compared with vaginally delivered children of non-allergic parents (OR 10.0; 95% CI 3.06-32.7). Conversely, the effect of CS on atopic dermatitis was not significant (OR 1.35; 95% CI 0.74-2.47). Delivery by CS predisposes to the development of food allergy but not atopic dermatitis in early childhood. Cesarean section delivery seems to upregulate the immune response to food allergens, especially in children with allergic predisposition.

Neonatal risk factors of atopic dermatitis in Denmark - Results from a nationwide register-based study.

Atopic dermatitis (AD) is a chronic inflammatory skin condition with a multifactorial etiopathogenesis. Studies have suggested that several perinatal factors may influence the risk of AD in early childhood. We investigated possible neonatal risk factors such as jaundice, blue light phototherapy, birthweight, gestational age at birth, and season of birth on the risk of developing AD in the first 5years of life. Data were collected through Danish nationwide administrative registers. All newborn children between 1997 and 2007 (n=673,614) were included in the cohort. Incidence rate ratios (IRRs) were estimated with 95% confidence intervals (95% CIs) by multivariate Poisson regression analyses. We identified a total of 85,743 children with AD in the first 5years of life. The risk of AD was slightly increased in children with neonatal jaundice (IRR 1.13 [95% CI 1.06-1.21]). Preterm birth was inversely associated with the risk of AD (IRR 0.74, [95% CI 0.68-0.81]) as well as low birthweight (IRR 0.68, [95% CI 0.61-0.75]). Children born in fall and winter seasons had an increased risk of AD compared to spring and summer. No association between neonatal blue light therapy and the risk of AD was found. Low birthweight and preterm birth were inversely associated with AD, while neonatal jaundice and cold seasons of birth were associated with an increased risk of AD.

Clostridia in the gut and onset of atopic dermatitis via eosinophilic inflammation

The balance of commensal and pathogenic microbiota in the intestine plays an important role in immune system development through the establishment of gastrointestinal epithelial barriers and immune system homeostasis. [1] Peterson L.W. Artis D. Intestinal epithelial cells: regulators of barrier function and immune homeostasis. Nat Rev Immunol. 2014; 14: 141-153 Crossref PubMed Scopus (1660) Google Scholar Alterations to this balance may cause systemic chronic inflammation and may lead to the development of allergic diseases. [1] Peterson L.W. Artis D. Intestinal epithelial cells: regulators of barrier function and immune homeostasis. Nat Rev Immunol. 2014; 14: 141-153 Crossref PubMed Scopus (1660) Google Scholar Studies on the association between gut microbiota in early life and atopic dermatitis (AD) led to inconclusive results with a poor mechanistic understanding. 2 Penders J. Stobberingh E.E. Thijs C. et al. Molecular fingerprinting of the intestinal microbiota of infants in whom atopic eczema was or was not developing. Clin Exp Allergy. 2006; 36: 1602-1608 Crossref PubMed Scopus (99) Google Scholar , 3 Watanabe S. Narisawa Y. Arase S. et al. Differences in fecal microflora between patients with atopic dermatitis and healthy control subjects. J Allergy Clin Immunol. 2003; 111: 587-591 Abstract Full Text Full Text PDF PubMed Scopus (284) Google Scholar , 4 Penders J. Gerhold K. Stobberingh E.E. et al. Establishment of the intestinal microbiota and its role for atopic dermatitis in early childhood. J Allergy Clin Immunol. 2013; 132: 601-607.e608 Abstract Full Text Full Text PDF PubMed Scopus (208) Google Scholar , 5 Abrahamsson T.R. Jakobsson H.E. Andersson A.F. Bjorksten B. Engstrand L. Jenmalm M.C. Low diversity of the gut microbiota in infants with atopic eczema. J Allergy Clin Immunol. 2012; 129 (440.e431–432): 434-440 Abstract Full Text Full Text PDF PubMed Scopus (578) Google Scholar , 6 Nylund L. Nermes M. Isolauri E. Salminen S. de Vos W.M. Satokari R. Severity of atopic disease inversely correlates with intestinal microbiota diversity and butyrate-producing bacteria. Allergy. 2015; 70: 241-244 Crossref PubMed Scopus (146) Google Scholar

Early weaning is beneficial to prevent atopic dermatitis occurrence in young children.

Epidemiological data on infant feeding practices and allergic diseases are controversial. The purpose of this study was to explore the association of early weaning with the occurrence of atopic dermatitis (AD). We conducted a matched case-control study on incident physician-diagnosed AD in early childhood including 451 cases and 451 controls. Data on several factors, including feeding practices, were collected through an interviewer-administered questionnaire. Odds ratios (OR) and the corresponding 95% confidence intervals (CIs) were estimated through logistic regression models, conditioned on study center, age, sex, and period of interview, and adjusted for potential confounders. Early weaning, defined as the introduction of solid foods at 4 or 5 months of age, was inversely related to the risk of AD, with children weaned at 4 months having lower AD risk (OR = 0.41, 95% CI, 0.20-0.87) compared to those exclusively breastfed. Similar results were observed for weaning started at 5 months of age (OR = 0.39, 95% CI, 0.18-0.83). This association persisted when children with and without family history of allergy were considered separately. Prolonged partial breastfeeding (breastmilk plus milk formulas) was not associated with AD. Consistently, the introduction of a high number of different solid foods reduced the risk of AD (P trend = 0.02 at 4 months of age and P trend = 0.04 at 5 months). Our data provide evidence against the preventing role of prolonged exclusive (but not partial) breastfeeding in AD occurrence and confirm recent results indicating a beneficial role of early weaning in AD.

Relationship Between Breast-Feeding and Atopic Dermatitis in Early Childhood in Korean Children: Based on the Fourth and Fifth Korea National Health and Nutrition Examination Survey 2007–2012

Relationship Between Breast-Feeding and Atopic Dermatitis in Early Childhood in Korean Children: Based on the Fourth and Fifth Korea National Health and Nutrition Examination Survey 2007–2012