Atopic Dermatitis In Infants Research Articles

Using family atopy scores to identify the risk of atopic dermatitis in infants

Background Atopic dermatitis is the first manifestation ofallergic disease in early life. Early interventions may prevent thedevelopment of allergy disease. Allergy trace cards have beenused to identify the level of allergic risk, based on family atopyscores. Because environmental factors may also influence thedevelopment of atopic dermatitis, the usefulness of the allergytrace card needs to be reevaluated.Objective To compare the incidence of atopic dermatitis ininfants aged 0-4 months with total family atopy scores of > 0 tothose with scores of 0.Methods We conducted this cohort study from June 1, 2012 toDecember 31, 2012 at Sanglah Hospital, Denpasar. Family atopyscore was tabulated from all pregnant woman in the ObstetricOutpatient Clinic and the Maternity Room. Subjects were dividedinto two groups based on their total family atopy score: those withscores > 0 and those with scores of 0. The appearance of atopicdermatitis symptoms in the infants were evaluated until theyreached 4 months of age. The incidence of atopic dermatitis intwo groups was compared using Chi-square test.Results The incidence of atopic dermatitis in this study was 10.9%.The group with total family atopy scores of 0 had a significantlyhigher incidence of atopic dermatitis than the group with scores> 0 (adjusted RR 22.5; 95%CI 8.8 to 57.0; P = 0.001).Conclusion The incidence of atopic dermatitis is higher ininfants with total family atopy score > 0 and this group has a 22.5times higher risk of atopic dermatitis compared to infants withtotal family atopy score of 0. Allergy trace cards are relevant indifferentiating the risk of atopy with regards to development ofatopic dermatitis. We suggest that family atopy scores be evaluatedduring antenatal care in order to limit the development of atopicdermatitis in infants.

Patterns of clinical management of atopic dermatitis in infants and toddlers: a survey of three physician specialties in the United States.

JM Saavedra, M Boguniewicz, S Chamlin. J Pediatr. 2013;163(6):1747–1753 The goal of this study was to describe atopic dermatitis (AD) management patterns in children aged ≤36 months as reported by pediatricians, dermatologists, and allergists in the United States. A nationally representative survey was administered to pediatricians ( n = 101), dermatologists ( n = 26), and allergists ( n = 26). Main outcomes included referrals to health care professionals, suggested/ordered laboratory tests, and management approaches (dietary, pharmacologic, or combination of both) according to age, AD location, and severity. Significant differences were observed in referrals to health care professionals ( P < .001). Pediatricians more frequently referred …

Using family atopy scores to identify the risk of atopic dermatitis in infants

Using family atopy scores to identify the risk of atopic dermatitis in infants

PS-271 Cytokine Content Of Human Milk And Atopic Dermatitis In Breastfed Infants

Background The protective effect of breastfeeding has been linked to immunomodulating agents in human milk, including cytokines. Objective To evaluate the possible relationship between human milk cytokine content and atopic dermatitis in breastfed term infants. Material and methods In 114 samples of milk fed to term infants, IL-1β, IL-2, IL-4, IL-5, IL-10, IFNγ, TGF-β1 and TNF content were determined by flow cytometry. Breastfeeding duration and diagnosis of atopic dermatitis were telephonically recorded at 18 months. Results Atopic dermatitis appeared in 24 infants (21%). No allergies were recorded in 89 (78%). We found no significant differences in maternal age (34.8 ± 2.7 vs 34.7 ± 3.6 years), maternal allergies (54% vs 46%), birth-weight (3288 ± 512 vs 3270 ± 586 g) or breastfeeding duration (5.7 ± 1.2 vs 5.6 ± 1.4 months). Cytokines studied were detected in the following samples of mature milk: IL-1β 25%, IL-2 42%, IL-4 23%, IL-5 17%, IL-10 28%, IFNγ 25%, TGF-β1 16% and TNF 18%. In milk fed to infants with atopic dermatitis, mean concentration of TGF-β1 was higher (428 ± 221 vs 282 ± 222 pg/ml), while that of IL-1β (2.2 ± 1.1 vs 3.6 ± 7.5 pg/ml), IL-2 (6.7 ± 3.3 vs 9.6 ± 6.8 pg/ml), IL-4 (2.0 ± 0.7 vs 4.0 ± 5.2 pg/ml), IL-5 (0.6 ± 0.3 vs 1.2 ± 0.9 pg/ml), IL-10 (1.8 ± 0.7 vs 3.8 ± 3.1 pg/ml), IFNγ (2.9 ± 4.2 vs 5.9 ± 9.1 pg/ml) and TNF (2.2 ± 0 5 vs 5.4 ± 7.1 pg/ml) was lower, although differences were only significant for IL-10 (p = 0.02). Conclusions The results suggest a possible relationship between human milk IL-10 content and atopic dermatitis in infants. However, wide variability in cytokine concentration means the sample size must be increased to draw definitive conclusions.

The Link between Serum Vitamin D Level, Sensitization to Food Allergens, and the Severity of Atopic Dermatitis in Infancy

To investigate the association between serum vitamin D levels, sensitization to food allergens, and the severity of atopic dermatitis in infants. We investigated serum 25-hydroxyvitamin D (25[OH]D) and specific immunoglobulin E levels to common or suspected food allergens in 226 infants with atopic dermatitis or food allergy. The severity of atopic dermatitis by the Scoring Atopic Dermatitis index and amount of vitamin D intake was measured in subcohort children. Sensitization to food allergen was categorized by the number (non-, mono-, and poly-) of sensitized allergens and the degree (undetected-, low-, and high-level) of sensitization. Significant differences in 25(OH)D levels were found between groups on number (P=.006) and degree (P=.005) of food sensitization. The polysensitization group had significantly lower levels of 25(OH)D than the nonsensitization (P=.001) and monosensitization (P=.023) group. High-level sensitization group had significantly lower 25(OH)D levels compared with undetected (P=.005) and low-level (P=.009) sensitization group. Vitamin D deficiency increased the risk of sensitization to food allergens (OR 5.0; 95% CI 1.8-14.1), especially to milk (OR 10.4; 95% CI 3.3-32.7) and wheat (OR 4.2; 95% CI 1.1-15.8). In addition, the Scoring Atopic Dermatitis index was independently related to 25(OH)D levels after adjusting for the level of sensitization (adjusted R(2)=0.112, P=.031). Our results suggest that vitamin D deficiency increases the risk of sensitization to food allergens and that atopic dermatitis may be more severe in infants with vitamin D deficiency.

Oral application of bacterial lysate in infancy diminishes the prevalence of atopic dermatitis in children at risk for atopy

Numerous interventions such as avoidance of food allergens, prolonged breast feeding and supplementation of pro-and/or prebiotics have been tried as primary prevention of atopic dermatitis. Recent data suggest that prevention of infantile eczema is possible in a subgroup of children by feeding bacterial lysates early in life. Bacterial lysates of Escherichia coli and Enterococcus faecalis were found to impair allergic immune responses in rats. An interventional trial in 606 infants at risk for atopy showed a reduction of atopic dermatitis at the end of the treatment phase (month 2 until month 7) of 50% in a subgroup of children with single heredity for atopy. This was even more pronounced in the group of children with paternal heredity for atopy. This effect was still seen at age 1 year. There was no effect on food sensitisation. In conclusion, an immune modulation in terms of prevention of atopic dermatitis in infancy if single atopic family history is present seems to be possible by feeding bacterial lysates early in life.

Prebiotics and probiotics: the prevention and reduction in severity of atopic dermatitis in children

The purpose of this review was to identify whether supplementation with prebiotics and/or probiotics help prevent the development or reduce the severity of atopic dermatitis in children less than three years of age. Since 1997, immunostimulatory supplements, such as prebiotics and probiotics, have been investigated. Various supplementations include probiotics (single strain or mix), probiotics with formula, probiotics mix with prebiotics, and prebiotics. In this narrative review, we examined 13 key articles on prebiotics and/or probiotics, and their effects on infant atopic dermatitis. Among the selected studies, a total of 3,023 participants received supplements or placebo. Eight out of the 13 (61.5%) studies reported a significant effect on the prevention of atopic dermatitis after supplementation with probiotics and/or prebiotics. Five out of the 13 (38.5%) studies indicated significant reduction in the severity of atopic dermatitis after supplementation. Based on the available studies, supplementation with certain probiotics (Lactobacillus rhamnosus GG) appears to be an effective approach for the prevention and reduction in severity of atopic dermatitis. A mix of specific probiotic strains prevented atopic dermatitis among infants. Based on studies with prebiotics, there was a long-term reduction in the incidence of atopic dermatitis. Supplementation with prebiotics and probiotics appears useful for the reduction in the severity of atopic dermatitis. Additional interventional studies exploring prebiotics and probiotics are imperative before recommendations can be made.

Additive effect between IL-13 polymorphism and cesarean section delivery/prenatal antibiotics use on atopic dermatitis: a birth cohort study (COCOA).

BackgroundAlthough cesarean delivery and prenatal exposure to antibiotics are likely to affect the gut microbiome in infancy, their effect on the development of atopic dermatitis (AD) in infancy is unclear. The influence of individual genotypes on these relationships is also unclear. To evaluate with a prospective birth cohort study whether cesarean section, prenatal exposure to antibiotics, and susceptible genotypes act additively to promote the development of AD in infancy.MethodsThe Cohort for Childhood of Asthma and Allergic Diseases (COCOA) was selected from the general Korean population. A pediatric allergist assessed 412 infants for the presence of AD at 1 year of age. Their cord blood DNA was subjected to interleukin (IL)-13 (rs20541) and cluster-of-differentiation (CD)14 (rs2569190) genotype analysis.ResultsThe combination of cesarean delivery and prenatal exposure to antibiotics associated significantly and positively with AD (adjusted odds ratio, 5.70; 95% CI, 1.19–27.3). The association between cesarean delivery and AD was significantly modified by parental history of allergic diseases or risk-associated IL-13 (rs20541) and CD14 (rs2569190) genotypes. There was a trend of interaction between IL-13 (rs20541) and delivery mode with respect to the subsequent risk of AD. (P for interaction = 0.039) Infants who were exposed prenatally to antibiotics and were born by cesarean delivery had a lower total microbiota diversity in stool samples at 6 months of age than the control group. As the number of these risk factors increased, the AD risk rose (trend p<0.05).ConclusionCesarean delivery and prenatal antibiotic exposure may affect the gut microbiota, which may in turn influence the risk of AD in infants. These relationships may be shaped by the genetic predisposition.

PD06 ‐ Early elevated blood eosinophils are predictive for the development of atopic dermatitis in an atopic birth cohort

At 4 weeks of life and 7 months of life, respectively, 233/ 559 and 107/467 infants showed elevated blood eosinophils counts in the total study group. Elevated blood eosinophils observed at 4 weeks were significantly associated with the occurrence of AD in the whole study group at the time points 7 months (p =0.0073), one year (p=0.0035), two years (p=0.0069) and three years (p=0.006) of life. This observation was seen in the active group as well as the placebo treated group. Blood eosinophil counts at 7 months of life showed only borderline significance for developing AD (p=0.06) at the same age, and blood eosinophil counts at one year of life showed no association with AD. Conclusion Elevated blood eosinophils at age 4 weeks of life seem to be of predictive value for the onset of atopic dermatitis in infancy and early childhood in a high risk birth cohort. Eosinophil counts later in infancy were less correlated with AD prevalence. Early eosinophil counts can therefore be helpful for counseling the parents but furthermore can identify target groups for interventional trials aiming at allergy prevention.

Association Between Sun Exposure During The First 6 Months Of Life and The Cumulative Incidence Of Atopic Dermatitis In Infants

Ultraviolet (UV) B radiation-induced vitamin D decreases the risk of infections, and subsequently reduces the development of autoimmune diseases by alteration of the TH1/TH2 balance (Grant WB, 2008, Photochem Photobiol). Furthermore, with multiple immunomodulatory pathways, sunlight, both UVB and UVA, independently suppresses immunity in the skin and internal organs, and reduces microorganisms in environment. On the other hand, neonatal TH2-dominant immunity develops towards tolerance and/or TH1-dominant immunity by complex gene-environment interactions, such as microorganisms, diets and tobacco smoke.

Infant atopic eczema and subsequent attention‐deficit/hyperactivity disorder – A prospective birth cohort study

Comorbidity between childhood atopic eczema (AE) and attention-deficit/hyperactivity disorder (ADHD) has been observed, but temporal relationships remain unclear. We analyzed data of a population-based, prospective birth cohort study among 770 children included at baseline in 2000/2001 with follow-up up to age 11. Information on age at diagnosis of AE, rhinoconjunctivitis, and ADHD was obtained by questionnaires administered to parents and for AE also to caring physicians. Adjusted relative risks (aRR) with 95% confidence intervals (95% CI) were modeled with a modified Poisson regression. Early AE up to age 4 yr was reported for 14.8% of the children by the parents and for 26.0% by the physicians with only fair agreement between these reports (kappa = 0.36). Based on parental reports, the association of early AE with early ADHD was strong (aRR: 5.17, 95% CI: 2.18; 12.28), but absent for late ADHD [aRR: 0.50 (0.13; 2.02)]. The association of late AE with late ADHD [aRR: 3.03 (0.75; 12.29)] was not statistically significant. This pattern was independent of the presence of rhinoconjunctivitis. The observed comorbidity between AE and ADHD may indicate vulnerability to develop ADHD symptoms in response to AE symptoms or through a common underlying mechanism. This vulnerability seems to decrease with time since AE onset and may be greater in early life. These temporal relationships should be considered in future research investigating mechanisms linking both diseases and in clinical efforts to screen for and prevent ADHD symptoms in children with AE.

Atopic dermatitis as a systemic disease

Atopic dermatitis (AD) is a chronic inflammatory disease that seriously affects the quality of life of these patients. Both immune deviations and epidermal barrier deficiency have been defined as pathophysiologic mechanisms in the disease development. The atopic march, or the natural progression form atopic dermatitis in infancy to asthma and allergic rhinitis, is a classic example for the multiorgan involvement in atopy. It has been hypothesized that epidermal barrier impairment is the primary pathologic condition responsible for the atopic march. In recent decades, a growing body of evidence has accumulated that AD can be accompanied by a variety of systemic diseases, such as autoimmune disorders, ophthalmologic involvement, eosinophilic gastroenteritis, inflammatory bowel disease, nephritic syndrome, and metabolic diseases. This contribution reviews these associations and focuses on the possible common underlying mechanisms of AD and the associated syndromes. We present a concept on AD as a multiorgan systemic disease.

A pilot study for foetal exposure to multiple persistent organic pollutants and the development of infant atopic dermatitis in modern Japanese society

Increasing evidence supports that harmful chemicals accumulating in the human body may pose a significant threat to infant health through foetal exposure. Persistent organic pollutants (POPs) are thought to enhance the risk for later development of allergic disease like atopic dermatitis (AD). However, few studies have evaluated the effect of foetal exposure to various POPs on the development of AD in early infancy. Here, we describe the impact of foetal exposure to a number of POPs on the occurrence of AD in 7-month-old infants. The participants were 81 infants with or without AD who participated in a birth cohort study, where the concentrations of 15 polychlorinated biphenyl (PCBs) congeners, dichlorodiphenyltrichloroethane (p,p′-DDT), dichlorodiphenyldichloroethylene (p,p′-DDE), β-hexachlorocyclohexane (β-HCH), hexachlorobenzene (HCB), cis-nonachlor, trans-nonachlor, mirex, oxychlordane, and 27 polybrominated diphenyl ether (PBDEs) congeners were measured in the umbilical cord tissues collected immediately after birth. At 7months, 27 of the 81 infants (33.8%) were diagnosed with AD. Of all POPs examined, total concentrations of 27 PBDE congeners were associated with a significantly decreased incidence of AD. Notably, the concentration of 27 PBDEs was significantly lower in AD infants than in non-AD infants (P<0.01), and the risk of AD development decreased with increasing PBDE levels. These results suggest that foetal exposure to PBDEs is a possible contributing factor to reducing AD in early infancy.

Black currant seed oil supplementation of mothers enhances IFN‐γ and suppresses IL‐4 production in breast milk

The first year of infancy is crucial for the development of atopic immune response. Inadequate early Th1 and Treg responses and increased production of Th2 cytokines are associated with atopy. Breast milk contains several immunomodulatory cytokines and other factors that might influence the maturation of the infant's immune system. We assessed the cytokines in breast milk of mother of newborn infants and their associations with black currant seed oil (BCSO) supplementation during pregnancy, mother's atopic status and the development of infant's atopic dermatitis. Mothers and infants from an intervention study by black currant seed oil (n = 31) or olive oil as placebo (n = 30) were included in the study. Breast milk samples were collected during the first 3 months of breastfeeding. Breast milk levels of IL-4, IL-5, IL-10, IL-12, IFN-γ and TNF were measured by Luminex technology. BCSO intervention group had decreased level of IL-4 (p = 0.044) and elevated level of IFN-γ (p = 0.014) in breast milk as compared to olive oil group. No significant differences were observed in IL-5, IL-10, IL-12 and TNF levels between the BCSO and olive oil groups. Mothers who had atopic dermatitis had significantly decreased levels of IL-10 (p = 0.044) in breast milk. Breast milk of the mothers of the children who developed atopic dermatitis had lower levels of IFN-γ (p = 0.039) as compared to the breast milk of the mothers of the children without dermatitis. Dietary intervention with BCSO had immunomodulatory effects on breast milk cytokine production towards Th2 to Th1 immunodeviation.

Patterns of Clinical Management of Atopic Dermatitis in Infants and Toddlers: A Survey of Three Physician Specialties in the United States

To describe atopic dermatitis (AD) management patterns in children ≤36 months old as reported by pediatricians, dermatologists, and allergists in the US. A nationally-representative survey was administered to pediatricians (n = 101), dermatologists (n = 26), and allergists (n = 26). Main outcomes included referrals to health care professionals, suggested/ordered laboratory tests, management approach (dietary, pharmacologic, or combination of both) by age, AD location, and severity. Significant differences were observed in referrals to healthcare professionals (P < .001). Pediatricians more frequently referred to dermatologists than allergists in mild (52.4% vs 32.0%) and moderate/severe (60.6% vs 38.1%) cases. Dermatologists referred to allergists less frequently for mild (9.1%) than moderate/severe (40.7%) AD cases. Pediatricians (59%), allergists (61.5%), and dermatologists (26.9%) reported treating at least some of their patients with AD with dietary management (infant formula change) alone (with or without emollients). Soy-based formulas were often used. For mild AD, the most commonly reported first-line pharmacologic treatments included topical emollients, topical corticosteroids, and barrier repair topical therapy/medical devices. Over 80% of physicians used a dietary and pharmacologic combination approach. Dermatologists were most likely to manage AD symptoms with a pharmacologic-only approach. AD lesion location influenced pharmacologic treatment in >80% of physicians. Significant and distinct differences in AD treatment approach exist among physicians surveyed. Most pediatricians and allergists use formula change as a management strategy in some patients, whereas dermatologists favor a pharmacologic approach. This diversity may result from inadequate evidence for a standard approach. Consistent methods for managing AD are needed.

Nutrient Supplementation and Atopic Dermatitis

Source: Foolad N, Brezinski EA, Chase EP, et al. Effect of nutrient supplementation on atopic dermatitis in children. JAMA Dermatol. 2013; 149(3): 350-355; doi: 10.1001/jamadermatol.2013.1495Investigators from the University of California at Davis performed a systematic literature review to determine the impact of nutrient supplementation on the prevention or reduction in severity of atopic dermatitis (AD) in children. The investigators searched the Cochrane Central Register of Controlled Trials, MEDLINE, and the Latin American and Caribbean Health Science Literature databases for clinical trials and cohort studies published between 1946 and 2012. For inclusion, studies needed to involve children <3 years old with or at risk for AD, and report the prevalence, incidence, or AD severity. Studies that met selection criteria were independently reviewed by 2 investigators. Data abstracted from each study included type of nutrient and primary outcome measures. The risk of bias for all included studies was also assessed.There were 21 studies that met selection criteria, 20 of which were randomized controlled trials. The studies included 6,859 participants, infants or mothers who were pregnant or breastfeeding, who received nutrient supplementation; there were 4,134 controls. Selected studies examined the effect of 4 different nutrient supplementations: probiotics, prebiotics, formula, and fatty acids. There was a low risk of bias among the selected studies.Of the 21 selected studies, nutrient supplementation was found to prevent the development of AD in 11 of 17 studies and decrease the severity of AD in 5 of 6 studies. Specifically, 6 of 10 studies on the effect of probiotics found that they reduced the incidence of AD. The results of other included studies suggested that partially hydrolyzed whey and extensively hydrolyzed casein formulas were effective in preventing the development of AD, especially among infants without a family history. Certain fatty acids, such as γ-linolenic acid, reduced AD severity but not its development, while prebiotics reduced AD incidence but not severity.The investigators conclude that certain nutrient supplements appear to decrease AD incidence and severity, but further research is needed to validate these findings and determine their mechanism of action.Dr Wright has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.The incidence of AD in infants has increased and reached an estimated 20% over the past 30 years.1 Multiple studies have attempted to examine the effects of dietary nutrient supplementation on the development and severity of AD. To date, this topic has been somewhat controversial and study designs and conclusions have varied. This review summarizes the results of 20 randomized controlled trials addressing this question. Although not all included studies found nutrient supplementation to be helpful in decreasing the incidence and/or severity of AD, many did. Interventions with the most compelling supporting evidence used supplementation with certain probiotics.Although these conclusions are certainly intriguing, no studies to date have adequately addressed the question of mechanism of action for nutritional supplementation. Also, no studies have established a causal link between ingestion of certain nutrients, concomitant changes in the intestinal flora, and positive effects on the frequency and severity of AD. Further studies are needed to investigate these questions, as well as to establish whether nutrient supplementation has any lasting preventive effects. In addition, if the benefits of nutrient supplementation are further confirmed, recommended guidelines for nutrient supplementation will need to be established.

Pet exposure and risk of atopic dermatitis at the pediatric age: A meta-analysis of birth cohort studies

Findings on pet exposure and the risk of atopic dermatitis (AD) in children are inconsistent. With the aim to summarize the results of exposure to different pets on AD, we undertook a meta-analysis of epidemiologic studies on this issue. In August 2012, we conducted a systematic literature search in Medline and Embase. We included analytic studies considering exposure to dogs, cats, other pets, or pets overall during pregnancy, infancy, and/or childhood, with AD assessment performed during infancy or childhood. We calculated summary relative risks and 95% CIs using both fixed- and random-effects models. We computed summary estimates across selected subgroups. Twenty-six publications from 21 birth cohort studies were used in the meta-analyses. The pooled relative risks of AD for exposure versus no exposure were 0.72 (95% CI, 0.61-0.85; I(2) = 46%; results based on 15 studies) for exposure to dogs, 0.94 (95% CI, 0.76-1.16; I(2) = 54%; results based on 13 studies) for exposure to cats, and 0.75 (95% CI, 0.67-0.85; I(2) = 54%; results based on 11 studies) for exposure to pets overall. No heterogeneity emerged across the subgroups examined, except for geographic area. This meta-analysis reported a favorable effect of exposure to dogs and pets on the risk of AD in infants or children, whereas no association emerged with exposure to cats.

Sensitization to Malassezia in children with atopic dermatitis combined with food allergy

The yeast Malassezia belongs to our normal cutaneous flora, but is capable of sensitizing individuals with atopic dermatitis (AD). Our objective was to investigate the prevalence of sensitization to Malassezia with a 10-yr follow-up among children suffering from AD combined with food allergy (FA) in relation to the extent of AD in infancy. One hundred and eighty seven infants diagnosed with AD and milk/wheat allergy before 1yr of age were included in the study. The area of AD was estimated from patient records of the first visit and measured with SCORAD at the 10-yr follow-up. Specific IgE against Malassezia was determined with ImmunoCAP™ at 11yr of age. In infancy, 24 children (13%) were allergic to milk, 71 (38%) to wheat, and 92 (49%) to both milk and wheat, and 94 (50%) children had mild, 57 (30%) moderate and 36 (19%) severe AD. At the 10-yr follow-up visit, 19 (10%) of the children had ongoing milk and/or wheat allergy; 147 children (79%) had mild AD and 30 (16%) had SCORAD index of 0. Specific IgE against Malassezia mix was positive (≥0.35kU/l) in 27% and specific IgE against M.sympodialis in 20% of the 187 children. The area of AD in infancy was associated with a greater risk of having allergen-specific IgE to Malassezia at the 10-yr follow-up. The risk ratio for FA was 3.11 (95% CI: 2.05-4.72; p<0.001) if specific IgE to Malassezia was positive. Infants with severe AD and FA seem to have a greater risk of becoming sensitized to Malassezia during a 10-yr follow-up.

The management of atopic eczema in infants and children

Atopic eczema is a chronic inflammatory, dry skin condition characterised by an itchy red rash ( National Institute for Health and Clinical Excellence, 2007 ). The role of the health visitor is important in supporting parents who have children with atopic eczema, as they are often the first health professional to see the infant's skin and hear about the concerns of the parent. Emollients are effective when treating and managing atopic eczema, and topical corticosteroids are effective for the management of acute flare-up as they can relieve symptoms of itching and treat inflammation. However, it is also important to consider trigger factors such as food allergens. Giving parents information on trigger factors and how to manage these will empower them to gain control of their infant or child's atopic eczema.

Mislabelled cow's milk allergy in infants: a prospective cohort study

BackgroundAlthough cow's milk allergy (CMA) is one of the most common food allergies, mislabelling non-allergic infants as being allergic to cow's milk is more common. Despite this, characteristics of families...