Related Experiment Videos
Concerns and expectations of parents with atopic infants
T Arvola1, A Tahvanainen, E Isolauri
1Department of Paediatrics, University of Tampere, Finland. kltaar@uta.fi
Insights
Managing early childhood atopic disease is challenging for parents. A multidisciplinary team approach effectively diagnoses food allergies and improves infant eczema symptoms through dietary interventions.
Area of Science:
- Pediatrics
- Allergy and Immunology
- Dermatology
Background:
- Rising incidence of atopic diseases in developed nations.
- Early-onset atopic conditions pose significant challenges for infants and their families.
- Understanding parental experiences and expectations in managing childhood atopic disease is crucial.
Purpose of the Study:
- To identify parental challenges in managing early-onset atopic diseases in children.
- To assess parental expectations and outcomes from healthcare professional interventions.
- To evaluate the effectiveness of a multidisciplinary team approach in managing atopic infants.
Main Methods:
- Questionnaire-based study of 81 high-risk atopic infants and their parents.
- Intervention by a pediatric team including nurses, pediatricians, dietitians, and dermatologists.
- Diagnostic testing (skin prick tests, food challenges) and dietary management during weaning.
Main Results:
- Positive skin prick tests for cow's milk (30%), egg (26%), and cereals (19%).
- High positive rate (56%) in double-blind placebo-controlled cow's milk challenges.
- Significant reduction in atopic eczema severity (SCORAD scores from 19.3 to 8.2) after dietary intervention.
- 90% of parents found caring for an atopic infant more demanding than a healthy child.
Conclusions:
- A comprehensive, multidisciplinary team approach is effective for managing atopic infants.
- Accurate diagnosis of food allergies and tailored dietary advice are key parental expectations.
- Intervention improved infant symptoms and met parental expectations for diagnosis, dietary guidance, and follow-up.
Abstract:
The incidence of atopic diseases has rapidly increased in developed countries. The purpose of this study was to describe the problems that parents experience when atopic disease occurs in their children at an early age and what parents expect and get from health care professionals in the management of these problems. The parents of 81 high-risk atopic infants completed a questionnaire during the infant's first attendance at the Tampere University Hospital, Finland. The patients were treated by an intervention team comprising a pediatric nurse and two pediatricians consulting with dietician and a dermatologist to detect the infant's specific food allergies and to introduce and advise on appropriate diets at weaning. After a 9-month intervention period, the parents' perception of the intervention was evaluated by a second questionnaire. The skin prick test was positive to cow's milk in 30%, to egg in 26%, and to cereals in 19%, of infants during breast-feeding. Double-blind placebo-controlled cow's milk challenge was positive in 56% of infants. Upon introduction of a tolerated weaning diet, subjective symptoms and the extent and intensity of atopic eczema diminished as evidenced by lowered SCORAD scores, from 19.3 to 8.2 (F= 57.6, p < 0.0001; SCORAD scoring index combining extent, severity and subjective symptoms of atopic eczema). Ninety per cent of parents found the care of an atopic infant more demanding than that of a healthy child. This was because of the persistence of symptoms, such as atopic eczema and pruritus, and restlessness during sleep. For the management of these problems the parents advocated diagnostic evaluation and elimination of specific foods from the diet of the lactating mother. They expected from the intervention accurate diagnosis of food allergies, practical advice on elimination diets, alleviation of symptoms, and follow-up of growth and nutrition, and they considered the care provided by the intervention team to suffice in these aims. The present data support a comprehensive team approach to the care of atopic infants and their parents.