Article

Breastfeeding as prophylaxis against atopic disease: Prospective follow-up study until 17 years

University of Helsinki, Helsinki, Uusimaa, Finland
The Lancet (Impact Factor: 45.22). 10/1995; 346(8982):1065-9. DOI: 10.1016/S0140-6736(95)91742-X
Source: PubMed

ABSTRACT

Atopic diseases constitute a common health problem. For infants at hereditary risk, prophylaxis of atopy has been sought in elimination diets and other preventive measures. We followed up healthy infants during their first year, and then at ages 1, 3, 5, 10, and 17 years to determine the effect on atopic disease of breastfeeding. Of the initial 236 infants, 150 completed the follow-up, which included history taking, physical examination, and laboratory tests for allergy. The subjects were divided into three groups: prolonged (> 6 months), intermediate (1-6 months), and short or no (< 1 month) breastfeeding. The prevalence of manifest atopy throughout follow-up was highest in the group who had little or no breastfeeding (p < 0.05, analysis of variance and covariance with repeated measures [ANOVA]). Prevalence of eczema at ages 1 and 3 years was lowest (p = 0.03, ANOVA) in the prolonged breastfeeding group, prevalence of food allergy was highest in the little or no groups (p = 0.02, ANOVA) at 1-3 years, and respiratory allergy was also most prevalent in the latter group (p = 0.01, ANOVA) having risen to 65% at 17 years of age. Prevalences in the prolonged, intermediate, and little or no groups at age 17 were 42 (95% CI 31-52)%, 36 (28-44)%, and 65 (56-74)% (p = 0.02, trend test) for atopy, respectively, and 8 (6-10)%, 23 (21-25)%, and 54 (52-56)% (p = 0.0001, trend test) for substantial atopy. We conclude that breastfeeding is prophylactic against atopic disease--including atopic eczema, food allergy, and respiratory allergy--throughout childhood and adolescence.

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    • "Indoor exposure to dust, animal dander, molds, tobacco smoke, heating systems and aeroallergens may also play a role [14,15]. Evidence is contradictory about the role of breastfeeding [16,17]. Western and urban populations tend to have more eczema than those that are oriental and rural [5]. "
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    ABSTRACT: The Mushua Innu of Natuashish, Labrador, Canada seem to have a high rate of childhood eczema. Anecdotally this problem seems to be more common now than 20 years ago. There has been speculation that this could be related to food sensitization that may have arisen coincident with a move away from a traditional Innu diet. We undertook to assess the prevalence and severity of pediatric eczema in Natuashish (population 792), and investigate the level of sensitization to common food antigens. Over a three-month period we performed a population survey of all children in the community from the ages of 2-12 inclusive. The one-year prevalence of eczema was assessed using the United Kingdom Working Party's diagnostic criteria, and graded on the Nottingham Severity Scale. All children with eczema and twice as many age/sex matched controls were offered complete blood counts, total IgE, and food specific IgE levels for egg white, cow's milk protein and wheat. One hundred and eighty two (95% of the eligible children) were assessed. Of the 182 children examined eczema was diagnosed in 30 (16.5%) - 22 females and 8 males. The majority of children with eczema (20/30) were classified as being in the moderate and severe category. Of the 22 with eczema and 40 controls who consented to venipuncture all but 3 had IgE levels above the lab's reference range. Food specific antibody assays showed that 32, 23, and 5 percent of children with eczema were sensitized to egg, milk, and wheat respectively. None of the controls were sensitized. The children of Natuashish, Labrador have a high rate of eczema, much of it graded as moderate or severe. IgE levels were markedly elevated in children with and without eczema, with average values at least ten-fold higher than other populations. There is no evidence of an unusual amount of sensitization to egg, milk or wheat.
    Full-text · Article · Mar 2014 · BMC Pediatrics
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    • "The risk for allergic disease is increased to about one in three if one first-degree relative (parent or sibling) is atopic and to 70% if both parents are atopic [4]. The pattern of allergy expression differs with age; with the greatest incidence of food allergy and atopic eczema peaking by 1 y of age, whereas asthma and allergic rhinitis continue to increase until around 15 y of age [5]. Many childhood allergies persist, with about 50% of childhood asthma sufferers and 80% of hay fever sufferers continuing to have symptoms into adulthood [6] [7]. "
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    ABSTRACT: Objectives: The aim of this study was to investigate the relationship between maternal diet during pregnancy and lactation and development of atopic disorders in childhood. Methods: We included studies published up to August 2011 that assessed food-based maternal dietary interventions or that examined associations between maternal dietary intake during pregnancy and/or lactation and allergic outcomes (eczema, asthma, hay fever, and sensitization) in their children. Results: We included 42 studies (>40 000 children): 11 intervention studies (including 7 randomized control trials), 26 prospective cohort studies, 4 retrospective cohort studies, and 1 case-control study. In the randomized control trials, no significant difference was noted overall in the prevalence of eczema and asthma in the offspring of women on diets free from common food allergens during pregnancy. The prospective cohorts investigated a large number of potential associations, but reported few significant associations between maternal dietary intake and development of allergy. Maternal diets rich in fruits and vegetables, fish, and foods containing vitamin D and Mediterranean dietary patterns were among the few consistent associations with lower risk for allergic disease in their children. Foods associated with higher risk included vegetable oils and margarine, nuts, and fast food. Conclusion: This review did not find widespread or consistent links between mothers' dietary intake and atopic outcomes in their children. However, maternal consumption of Mediterranean dietary patterns, diets rich in fruits and vegetables, fish, and vitamin D-containing foods were suggestive of benefit, requiring further evaluation.
    Full-text · Article · Mar 2014 · Nutrition
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    • "The risk for allergic disease is increased to about one in three if one first-degree relative (parent or sibling) is atopic and to 70% if both parents are atopic [4]. The pattern of allergy expression differs with age; with the greatest incidence of food allergy and atopic eczema peaking by 1 y of age, whereas asthma and allergic rhinitis continue to increase until around 15 y of age [5]. Many childhood allergies persist, with about 50% of childhood asthma sufferers and 80% of hay fever sufferers continuing to have symptoms into adulthood [6] [7]. "
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    ABSTRACT: Objectives To investigate the relationship between maternal diet during pregnancy and lactation and development of atopic disorders in childhood. Methods We included studies published up to August 2011 which either assessed food-based maternal dietary interventions or examined associations between maternal dietary intake during pregnancy and/or lactation and allergic outcomes (eczema, asthma, hay fever and sensitization) in their children. Results We included 43 studies (over 40 000 children): 11 intervention studies (including seven RCTs), 27 prospective cohort studies, four retrospective cohort studies and one case-control study. In the RCTs, no significant difference was noted overall in the prevalence of eczema and asthma in the offspring of women on diets free from common food allergens during pregnancy. The prospective cohorts investigated a large number of potential associations, but reported few significant associations between maternal dietary intake and development of allergy. Maternal diets rich in fruits and vegetables, fish and foods containing vitamin D and ‘Mediterranean’ dietary patterns were among the few consistent associations with lower risk of allergic disease in their children. Foods associated with higher risk included vegetable oils and margarine, nuts and fast food. Conclusion This review did not find widespread or consistent links between mother’s dietary intake and atopic outcomes in their children. However, maternal consumption of ‘Mediterranean’ dietary patterns, diets rich in fruits and vegetables, fish and vitamin D containing foods were suggestive of benefit, requiring further evaluation.
    Full-text · Conference Paper · Jul 2013
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